Your heart muscle needs its own blood supply, carried by blood vessels called the coronary arteries. Fatty deposits called plaque can build up in their walls and narrow the space for blood to flow, which may cause chest discomfort called angina.
The doctor passes a thin, flexible tube called a catheter into an artery at your wrist or groin and guides its tip through the blood vessels to the coronary arteries. Contrast dye travels through the catheter into these arteries and shows up on X-rays, so moving pictures can reveal where an artery narrows or is blocked.
You may also hear this called coronary angiography or cardiac catheterisation. The angiogram shows the doctor where a problem is and helps plan treatment, but the test on its own doesn't remove plaque or open a narrowing.
Call triple zero (000) for severe, worsening or persistent chest pain, or chest discomfort with breathlessness, sweating, nausea or pain spreading to your arm, jaw or back.
Do not wait for a routine appointment or drive yourself to hospital.
You lie on an X-ray table in a cardiac catheter laboratory, or cath lab. Sticky patches on your chest connect to a monitor that records your heartbeat, and a drip in your hand or arm lets staff give medicines. You're usually awake, although sedation may make you relaxed and drowsy.
Staff clean the wrist or groin and cover the area with sterile drapes. A local anaesthetic injection numbs the entry site before the catheter is inserted. You usually won't feel the catheter moving through your blood vessels. Tell staff if you're uncomfortable.
The X-ray equipment moves around you to take pictures from different angles. You may be asked to hold your breath briefly. As the dye is injected, you may feel a warm flush that soon passes.
When the pictures are complete, the catheter is removed. Staff apply pressure or use a closure device to stop bleeding. You then rest while nurses check your pulse, blood pressure and puncture site. How long you need to rest depends partly on whether the wrist or groin was used and whether you had any treatment.
A cardiologist may recommend an angiogram to investigate angina or suspected coronary artery disease. It's also used during or after some heart attacks, when doctors need to identify a blockage and decide how to restore blood flow.
An angiogram may follow another heart test. For example, a stress test may suggest that part of your heart isn't getting enough blood, and an angiogram can then look for a narrowed artery that might explain the result.
A CT coronary angiogram takes three-dimensional pictures with a CT scanner after dye is injected into a vein, and no catheter is passed from an artery at the wrist or groin towards the heart. The CT scan takes pictures only, while a catheter angiogram can sometimes be followed by angioplasty during the same visit, if this has been discussed and agreed beforehand. Preparation and recovery also differ, so check which test is on your referral.
The pictures show which arteries are affected and where the narrowings are. Your cardiologist considers how severe they are, along with your symptoms and other test results.
Some people can be treated with medicines and changes to everyday habits. Medicines can ease angina, lower cholesterol or reduce the chance of a blood clot. A procedure may be needed to improve blood flow if this treatment isn't enough, or urgently during a heart attack.
If angioplasty is appropriate, the doctor guides a catheter carrying a small balloon to the narrowing, and inflating the balloon widens the artery. A mesh tube called a stent is usually inserted to keep it open after the balloon and catheter are removed. Angioplasty can sometimes follow the angiogram in the same session, so that possibility should be discussed before you consent.
Bypass surgery may be considered when several arteries are affected or the position of a blockage makes stenting unsuitable. It uses blood vessels from elsewhere in the body to create a route around the blockages.
A stent or bypass improves blood flow through particular arteries but doesn't cure coronary artery disease, so ongoing medicines, support to stop smoking and care for blood pressure and cholesterol remain part of treatment.
The hospital will tell you when to stop eating or drinking and what to do with your medicines. Don't stop or change medicines yourself. Ask for clear instructions if you take blood thinners or diabetes medicines.
Tell the hospital about kidney problems, previous reactions to contrast dye and any possibility of pregnancy. A blood test may be needed to check kidney function because the kidneys remove the contrast from your blood.
Bruising or soreness where the catheter entered is common. Less common problems include significant bleeding, damage to a blood vessel, a reaction to the dye or changes in kidney function. Serious complications such as a heart attack or stroke are rare. Your doctor will discuss the risks that apply to you before you decide whether to go ahead.
Someone will need to take you home. Follow the hospital's instructions for wound care, lifting, exercise, driving and returning to work. These depend on the procedure you've had and whether you received sedation.
Contact the hospital or a doctor promptly if the wound becomes increasingly painful, red or swollen, or develops discharge. If bleeding won't stop or the area swells rapidly, call triple zero (000) for an ambulance.
Your GP or specialist can refer you to a Heartscope cardiologist to discuss symptoms or test results and whether a coronary angiogram is needed. Heartscope doesn't perform coronary angiograms at its clinics, so if one is recommended, the cardiologist can refer you to hospital. The clinic can answer questions about the consultation.
Consultations are privately billed. If you're eligible, Medicare pays part of the consultation fee when you have a valid referral from your GP or specialist. The clinic will confirm the amount left to pay before the visit.
Hospital and procedure fees are separate from the Heartscope consultation. The hospital or treating provider confirms those costs.
Heartscope cardiologists see patients at clinics in Melbourne and Queensland. If you have a referral, our team can confirm the location and appointment details.
View clinic locationsNo. Coronary angiograms are done in hospital, and Heartscope refers patients there. A consultation with a Heartscope cardiologist needs a valid referral from your GP or specialist.
Many people go home the same day after resting and having their puncture site checked. You may need to stay overnight for monitoring or further treatment.
The doctor performing the angiogram can usually discuss the initial findings after the test. A further appointment may be needed to go through treatment choices. Before leaving, check who will explain the full report and whether your GP will receive a copy.
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