9 May 2019 What is a coronary angiography Coronary angiography, or coronariography , is an interventional cardiology procedure that aims to identify stenoses (obstructions) in the coronary arteries. The coronary arteries are responsible for the irrigation of the cardiac muscle (myocardium). When there are obstructions of these arteries, myocardial irrigation is compromised, leading myocardium ischemia, which is usually the cause of the symptoms of angina pectoris (pain, weight, pressure in the chest). When there is an occlusion of a coronary artery, an acute myocardial infarction may occur. Coronary angiography may be indicated in situations of: Symptoms suggestive of coronary heart disease (pain, weight, pressure in the chest); Clarification or confirmation of results of other cardiovascular exams; Preoperative evaluation before cardiac or other surgical procedures. How is it performed? Coronary angiography, or coronariography, is performed in an interventional cardiology or hemodynamics laboratory. Its purpose is to identify the location and severity of coronary artery obstructions, to decide the appropriate treatment, which can be: Medication, Coronary angioplasty and medication, Cardiac surgery and medication. During coronary angiography, the patient is awake, and a mild sedation can be administered to control anxiety. The most used puncture site is the radial artery (arm). However, the puncture can also be done in the femoral artery (leg) or another access route. At the beginning of the procedure, local anesthesia is performed. Through the puncture site, are introduced catheters that will inject iodinated contrast into the coronary arteries, allowing their visualization in different projections through fluoroscopy (X-rays). In most cases, coronary angiography is painless. However, in some patients, pain, palpitations, nausea, or vomiting may occur. In this case, the medical team must be notified immediately. In this procedure patient collaboration is very important! Coronary angiography takes approximately 20 minutes. When only a diagnostic coronary angiography is performed, the patient will stay in the hospital for about 4 to 6 hours, under surveillance, and then is discharged. What is a coronary angioplasty? When the best treatment for the identified coronary obstructions is coronary angioplasty, it is possible to perform this procedure, with rare exceptions, immediately after coronary angiography. Coronary angioplasty can be done through an inflated balloon at the obstruction site and / or by placing a metallic mesh (coronary stent), which will keep the artery open and ensure the normal flow of blood to the heart muscle. A coronary angioplasty has a variable duration, which depends on the extent and complexity of the obstructions to be treated. When a coronary angioplasty is performed, the hospital stay after the procedure is completed is longer. Usually, hospitalization does not exceed 24 hours. Limitations after angiography and / or coronary angioplasty During the 48 to 72 hours following these procedures, patients should not: Drive; Make efforts that directly involve the puncture site (arm or leg); Going up stairs, if the puncture site was the leg; Load weights; Do physical exercise. There are usually other specific precautions to be taken that are indicated to each patient at the time of discharge. The content published in the Health Guide is intended for the general public and is provided for informational and educational purposes only. It does not replace individual medical assessment, diagnosis, or personalized clinical advice from a qualified healthcare professional. The content is produced or reviewed by physicians and other healthcare professionals at Hospital da Luz and is based on the knowledge available at the time of publication or the most recent update, as indicated at the beginning of each item.
