An angiogram is a specialised test carried out to assess your heart condition. The test gathers information on the state of the coronary arteries, the heart valves and the chambers of the heart. It is essential when planning possible heart surgery or angioplasty.

The test involves passing one or two fine tubes (catheters) through blood vessels, from either your arm or the top of your leg, to your heart. The tubes can be used to measure pressures inside the heart and to inject a dye so that X-ray pictures can be taken of the heart and coronary arteries.

As this test is carried out using X-ray screening, if you think you may be pregnant you must let us know before you are due to come into hospital.

You should have a bath or shower on the morning of the test. We will usually ask you to have nothing to eat for four hours before the test, and nothing to drink for two hours before the test.

During the procedure

When you arrive on the ward you will be asked to put on a hospital gown. A needle will then be put into the back of your hand.

The procedure is carried out in an investigation room which contains special X-ray and monitoring equipment. You will be taken to the room on your hospital bed. The staff in the investigation room will be wearing gowns, masks and hats.

You will be transferred from your bed to an X-ray table. Heart monitor wires will be attached to your arms and legs. Your groin or arm (wherever the catheter will be inserted) will be cleaned with an antiseptic lotion and sterile towels will cover the surrounding area. A local anaesthetic will be injected to numb your skin so you will not feel any pain when the tube is passed into your blood vessel.

Once the catheter is in the blood vessel, you will not feel it as it is passed up to your heart. Occasionally you may feel a few extra heartbeats (palpitations), but this is perfectly normal.

The X-ray equipment will be placed close to your chest. This procedure usually involves a dye being injected through the tube into the heart. During this injection it is common to feel flushed for up to 30 seconds. You may also feel you have wet yourself, but you won't have done!

The procedure usually takes about half an hour, sometimes less. When the catheters are taken out, pressure will be applied to the area for about 15 minutes to allow the blood vessel to seal. You will not need any stitches.

After the procedure you will be transferred back to the ward.  You will need to rest lying flat, for half an hour.  You can then sit up for between three and four hours.  If the catheter was inserted through your groin, please keep your leg as still as possible to reduce bruising. When you are sitting up you will be able to eat and drink as normal. The nurse caring for you will check your blood pressure and feel the pulses in your feet and wrist (depending on where the catheter is inserted).
 
You will normally be able to go home on the same day. However, some patients need to stay in overnight. You will be told the results of the angiogram before you go home, but you may need to come back to the outpatient department to discuss your progress.

There are risks with any procedure inside the body, but your consultant must be certain that the potential benefit outweighs the risk.

In a very small number of cases this procedure could trigger a heart attack, stroke or serious disturbance to the heart rhythm. These complications can be life-threatening. In this case, emergency heart surgery may be needed during or soon after the procedure.

If the catheter is inserted at the groin, minor complications of bleeding and bruising are common. Sometimes more serious damage can be caused to the blood vessels.
 

At home

If the catheter was inserted at the groin, avoid heavy lifting or vigorous walking for two to three days after leaving hospital. You will have a plaster over the wound. You can remove this after two days. You must not to drive in the two days after the procedure.

It is common to have a small amount of blood leaking from your wound. However, there is a very small risk that the wound will bleed a lot. If this happens, don't panic. Lie down on the floor (not the bed), and you, or better still, a relative or friend, should press over the wound with the flat of the fingers of both hands, or a clenched fist, for five minutes and then slowly release. If the bleeding continues, you should call for an ambulance and continue to press on your wound.

It is slightly more common to develop a painful bruise over the wound in your groin. This is due to bleeding under the skin. If a painful lump develops, especially if the groin becomes painful when walking, go to see your GP. Bruising and discolouration above and below the groin, even down to the knee, may develop over the week after the procedure. This will change from a blue-purple colour to a yellow one, but is often not painful and is not serious. You can take painkillers for minor discomfort.

If, within the first week back home, you think there could be a problem with your wound, go to see your GP.