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Cardiology

Coronary Angiography

An X-ray dye test that shows exactly where your heart's arteries are narrowed and how badly, so your cardiologist can plan the right treatment.

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Coronary Angiography at Prakash Hospital, Cardiology
Test duration
30 to 60 minutes
Anaesthesia
Local, with mild sedation
Hospital stay
Same day or one night
Results
Usually explained the same day
On this page

Overview

Chest tightness when you climb stairs, an abnormal treadmill test, breathlessness that doesn't add up. They can all lead to the same question: are the arteries that feed your heart narrowed, and if so, where?

Coronary angiography answers that directly. A cardiologist passes a thin, flexible tube called a catheter through an artery in your wrist or groin up to your heart, then injects a dye into the coronary arteries. X-ray pictures taken as the dye flows show each narrowing, how tight it is and how many vessels are involved. The pictures themselves are called a coronary angiogram.

It is a test, not a treatment. But if it finds a severe blockage, angioplasty with a stent can often be done in the same sitting through the same tube, provided you have agreed to that beforehand.

Our cardiology team performs angiography alongside ECG, echocardiography, treadmill testing and Holter monitoring, so the tests before and after your angiogram happen under one roof.

Why the test is done

Your cardiologist may suggest an angiogram when other tests point to coronary artery disease, or when there's no time for other tests at all, as during a heart attack.

  • Chest pain or tightness on exertion (angina) that continues despite medicines
  • An abnormal treadmill test, echocardiogram or CT scan of the heart
  • A heart attack, when the test is done urgently and often followed straight away by angioplasty
  • Unexplained breathlessness or heart failure, to see whether blocked arteries are the cause
  • Symptoms returning after a previous stent or bypass surgery
  • Before valve surgery or some other major operations, in people at risk of heart disease

Types of test

Through the wrist (radial)

The catheter goes in through the artery at your wrist. You can usually sit up soon afterwards, and bleeding problems are less common, so this is the first choice for most patients.

Through the groin (femoral)

The large artery at the top of the thigh is used when the wrist artery is too small or twisted, or when bigger equipment is needed. You'll need to lie flat for a few hours afterwards.

Preparing for the test

  • Blood tests a few days before, including kidney function (creatinine) and blood counts, plus an ECG
  • Don't eat for about 4 to 6 hours before the test. We'll confirm the timing and whether you can sip water
  • Tell us about blood thinners. Aspirin is usually continued, but warfarin and some newer anticoagulants may need stopping first, only on your cardiologist's advice
  • If you take metformin for diabetes, you may be asked to pause it on the day of the test and for 48 hours after
  • Mention any past reaction to X-ray dye. Tablets taken beforehand can usually prevent a repeat
  • If you have kidney disease, you'll get extra fluids through a drip before and after to protect your kidneys
  • Bring your earlier reports and a list of your medicines, and leave jewellery at home
  • Arrange for someone to take you home. Don't drive for at least 24 hours afterwards

What happens during the test

  1. 01

    Getting ready in the cath lab

    You lie on a narrow table under the X-ray camera. ECG stickers go on your chest and a drip goes into your arm, and you may be given a mild sedative. You stay awake so you can follow instructions.

  2. 02

    Numbing the skin

    The skin over your wrist or groin is numbed with local anaesthetic, and a short plastic sheath is placed in the artery. You'll feel pressure but not sharp pain.

  3. 03

    Guiding the catheter

    A thin catheter is passed through the sheath and steered to the openings of your coronary arteries using live X-ray images. You won't feel it moving, because the inside of the blood vessels has no pain nerves.

  4. 04

    Dye and pictures

    Dye is injected into each artery while the camera moves around you to film it from several angles. You may feel a warm flush for a few seconds, or be asked to hold your breath.

  5. 05

    Removing the catheter

    The catheter and sheath come out. At the wrist, a tight band goes over the puncture and is loosened gradually over a few hours. At the groin, firm pressure or a small closure device seals the artery.

Understanding your results

Your cardiologist usually talks you through the findings the same day, often with the pictures on screen. The report covers each of the main arteries (the left main, the left anterior descending, the circumflex and the right coronary artery) and gives the narrowing in each as a percentage.

Narrowing below about 50% is usually treated with medicines and lifestyle changes. A narrowing of 70% or more in a major artery, especially if you have symptoms, is considered significant. Borderline narrowings in between sometimes need a pressure-wire measurement to decide whether they really limit blood flow.

From that pattern, the choice is usually between medicines alone, angioplasty, or bypass surgery (CABG) when the disease involves several arteries or the left main artery. A normal angiogram is good news too: it rules out significant blockages and can save you from more tests.

Benefits and risks

Benefits

  • Shows the exact location and severity of each blockage, which other tests can only suggest
  • Guides the choice between medicines, angioplasty and bypass surgery
  • A critical blockage can often be treated in the same sitting
  • Through the wrist, most people sit up and walk within an hour or two

Possible risks

  • Bruising or a small lump at the puncture site, which is common and settles in a week or two
  • Bleeding from the artery, more likely with the groin approach
  • A reaction to the dye, usually mild itching or a rash
  • Strain on the kidneys from the dye, mainly in people with kidney disease or diabetes
  • Serious problems such as a heart attack, stroke or damage to the artery are rare, well under 1 in 100

After the test

  1. 01

    First few hours

    You rest while nurses check the puncture site, pulse and blood pressure. After a wrist approach you can usually sit up straight away. After a groin approach you lie flat for 2 to 4 hours. Drink plenty of water to flush out the dye.

  2. 02

    Going home

    Most people go home the same day or the next morning, depending on the findings and whether a stent was placed.

  3. 03

    The first week

    Don't lift anything heavy with the treated arm, or strain if the groin was used, for about 5 to 7 days. Keep the site dry for a day. Most people are back at desk work in 2 to 3 days.

  4. 04

    Follow-up

    Your cardiologist will go over the treatment plan and arrange a review. If you smoke, or have diabetes or high cholesterol, this is the time to take them seriously.

When to call your doctor

  • Bleeding from the puncture site that doesn't stop after 10 minutes of firm pressure
  • A lump at the puncture site that keeps growing or becomes very painful
  • The hand or leg on the treated side turning cold, pale, numb or weak
  • Chest pain, breathlessness or fainting
  • Fever, or redness and pus at the puncture site

Call us on +91-8826000033 or come straight to our 24/7 emergency department.

Other tests

Treadmill stress test

Shows whether your heart runs short of blood during exercise. It's a good first test for many people, but it can't show where a blockage is.

Echocardiogram

An ultrasound of the heart that shows its pumping and valves. Weak areas of heart muscle can hint at a blocked artery, but the arteries themselves aren't visible.

CT coronary angiography

A scan with dye injected into an arm vein instead of a catheter. It's good at ruling out disease in lower-risk people, but a significant blockage found this way usually still needs a catheter angiogram before treatment.

Talk to our Cardiology team

Ask about your options, the cost and your insurance before you decide. See the insurance and TPA panels we work with.

Book an Appointment+91-8826000033

This page explains Coronary Angiography in general terms. Your own plan depends on your health, your test results and your doctor's advice. Please read our medical disclaimer.

Your care team

Coronary Angiography is led by our Cardiology team, with other departments stepping in at each stage of your care.

Cardiology Department
Leads your treatment

Cardiology Department

At Prakash Hospital, our Cardiology Department offers expert, round-the-clock care, providing timely diagnosis and advanced treatments for heart conditions to keep your heart healthy and strong.

What the department treats

Interventional Cardiology

Echocardiography

Cardiac Rehabilitation

Pacemaker Implantation

Angioplasty and Stenting

Heart Failure Management

Visit the Cardiology department

Other departments involved

Emergency

Receives patients with a suspected heart attack and fast-tracks them for an urgent angiogram.

Visit department

Diagnostic

Runs your blood tests, kidney function checks and ECG before the test.

Visit department

Nephrology

Advises on protecting your kidneys from the dye if you have kidney disease.

Visit department

Related procedures

Procedures often considered alongside Coronary Angiography, or that treat related conditions.

Angioplasty (PTCA)

Opens a narrowed or blocked heart artery with a balloon and a stent, passed up from the wrist or groin.

Stress Test (TMT)

An ECG recorded while you walk on a treadmill, to check for reduced blood flow to the heart during exercise.

Echocardiography

An ultrasound of the heart that shows how well it pumps and how the valves work. Painless and radiation-free.

Cardiac Catheterisation

Measures pressure and oxygen inside the heart and lungs through a thin tube, to guide valve and heart failure care.

Holter Monitoring

A portable ECG worn for 24 to 48 hours to catch irregular heartbeats that come and go.

Neurosciences / Neurology

Stroke Management

Round-the-clock emergency scans and treatment for stroke, followed by rehabilitation and prevention.

More in Cardiology

Other procedures our Cardiology team performs.

View the department

Pacemaker Implantation

A small device under the collarbone that keeps a slow or pausing heartbeat at a safe rate.

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Frequently Asked Questions

Answers to common questions about Coronary Angiography at Prakash Hospital, Noida.

Is coronary angiography painful?

Most people feel only the sting of the local anaesthetic and some pressure at the wrist or groin. You can't feel the catheter inside your arteries. The dye can cause a warm flush for a few seconds.

Is angiography the same as angioplasty?

No. Angiography is the test that finds blockages. Angioplasty is the treatment that opens them with a balloon and usually a stent. They are often done together if a blockage needs treating and you've agreed beforehand.

Will I be awake during the test?

Yes, usually with a mild sedative to help you relax. Being awake lets you tell the team if you feel chest pain and follow instructions such as holding your breath.

Is it safe if I have kidney disease or diabetes?

It can still be done, with precautions: fluids through a drip before and after, as little dye as possible, pausing certain medicines such as metformin, and a kidney function test a couple of days later.

What if I'm allergic to the dye?

Tell us beforehand. If you had a mild reaction in the past, you'll usually be given steroid and antihistamine tablets before the test to prevent a repeat. Severe reactions are rare.

Does a normal angiogram mean my heart is fine?

It means there are no significant blockages in the main arteries. Chest pain can still come from the tiny blood vessels, spasm of the arteries, the heart valves or from outside the heart, so your cardiologist may suggest other tests.

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