What is an angiogram?
An angiogram, or angiography, is a cardiac procedure that uses contrast dye to see if your arteries are blocked or narrowed. X-ray technology is also used to view the dye in the arteries and look for blockages.
Your doctor can use coronary angiography to see how blood moves through the arteries supplying blood to your heart. They can also see if you are at risk of reduced blood flow, which can cause angina (chest pain) or a heart attack.
An angiogram is a type of cardiac catheterization, one of the most commonly performed heart procedures. Catheterization refers to procedures in which catheters, thin, hollow tubes are inserted into your arteries under X-ray guidance. If your doctor finds a blockage, they might perform a procedure to remove it and re-open your artery.
Why might I need an angiogram?
Coronary angiography helps doctors identify if and where your arteries have blockages and to what extent. Your doctor might recommend one if you have symptoms of heart disease.
Atherosclerosis can affect arteries throughout your body. When it develops in the arteries supplying your heart, it’s called coronary artery disease, the most common form of heart disease and the leading cause of death in the United States.
If your doctor is concerned about your risk of coronary artery disease, your doctor will usually recommend other less invasive tests first. You may undergo a blood test, stress test or electrocardiogram (EKG or ECG), which measures your heart’s electrical activity.
Your doctor might also recommend an angiogram if you have:
- Abnormal results on a heart stress test
- Chest pain that seems unrelated to other conditions
- Had a recent heart attack
You might have an angiogram before heart surgery to evaluate abnormalities, diseases or obstructions. It is important to note that when it comes to the need for an angiogram, this is general information, and you should follow the specific guidance and instructions given to you by your doctor.
How to prepare for an angiogram
Before your angiography procedure, your doctor will discuss the benefits and risks with you.
They’ll want to have a complete picture of your health, so they might ask about:
- Any medicines you take, including over-the-counter drugs and herbal supplements
- Other health conditions you have
- If you might be pregnant
- Allergies or previous reactions (if any) to contrast dye
Once you schedule your procedure, you may need to:
- Have other imaging scans or tests to measure your blood count, kidney function and clotting ability
- Stop taking certain medications, such as blood thinners
- Stop or adjust your dose of insulin if you have diabetes
Drink plenty of water the day before. Being well-hydrated helps reduce risks associated with the dye. Also, follow your doctor's instructions about eating and drinking. If you live alone, you should ask someone to stay with you for the first night in case you have any problems after your procedure.
The angiography procedure
Your angiogram will take place in a heart catheterization lab (sometimes called a cath lab). Make sure you know when and where to check in for your procedure and arrive on time.
You can usually go home the same day, but this will depend on the results and whether a procedure to remove a found blockage is required.
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Before the procedure
You are usually asked to fast (not eat or drink) for eight hours before your procedure. When you get to the hospital, you will meet your doctor, who will explain the procedure.
You will receive local anesthesia, which means the area where your doctor inserts the catheter will be numb, but you will remain awake during the procedure.
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During the procedure
You will lie on a table while an intravenous (IV) line is inserted into a vein in your arm. Your IV may deliver a sedative to help you relax, as well as other medicines and fluids.
A nurse will clean part of your body, usually your arm or groin, and numb it with a local anesthetic. Your cardiologist will then insert a needle with a thin, hollow tube called a catheter through an artery. Under the guidance of X-rays, they will thread this through your arteries to your heart.
Next, your doctor injects the iodine dye. You might feel some pressure at the site of the catheter and a warm, flushing feeling when the dye is injected. Some people feel an urge to urinate, nausea or slight discomfort.
Your doctor will use X-rays to examine the flow of the dye and identify any blockages. If your doctor finds a blockage, they’ll consider its size, your overall health and other factors to decide whether to perform another procedure.
During the angiogram, your doctor can perform two common procedures if needed:
- Angioplasty: Your doctor inserts a small, deflated balloon in your artery through the catheter. Once the balloon is in place, your doctor inflates it to widen the artery and push plaque against the artery wall.
- Stent placement: This procedure is performed after angioplasty. A small mesh tube called a stent is placed inside the artery to keep it open.
How long does an angiogram take?
An angiogram usually takes about 30 to 60 minutes, but it can be longer if your doctor needs to do other procedures, such as placing a stent or performing an angioplasty.
How long it takes depends on your overall health, the complexity of the test, and the type of angiogram. For example, a CT coronary angiogram is often quicker than a traditional X-ray angiogram.
Here’s what to expect:
- Getting ready and anesthesia: 10–15 minutes
- Placing the catheter: 10–15 minutes
- Injecting contrast dye and taking images: 10–15 minutes
- Removing the catheter and closing the site: 5–10 minutes
- Recovery and observation: 30–60 minutes
Your care team will give you a more accurate timeframe based on your specific situation.
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After the procedure
After your procedure, you will be moved to a recovery room. You might feel tired from the sedative.
If the catheter was placed in your groin, you might need to lie on your back for up to a few hours to prevent bleeding. Your healthcare team will tell you how long you should rest for and when you can get up. Make sure you have a friend or family member who can drive you home.
You might feel some discomfort or tenderness at the access site for up to a week after your procedure. Any bruising will usually go away after two weeks.
Your doctor will provide specific recommendations for you to follow after your procedure. You can usually resume light daily activities within a day or two. However, you will need to avoid heavy lifting, bending or stooping for two days to reduce the risk of bleeding, and you might consider taking a few days off work if your job involves strenuous physical activity.
What are the risks of an angiogram?
An angiogram is generally considered very safe. But like any medical procedure, it can involve risks.
In a small number of cases, the artery used for access can become blocked, or you might experience leakage of blood that forms a blood-filled sac, which requires further treatment. In people with diabetes or kidney problems, contrast dye may damage the kidneys.
Other risks can include:
- Allergic reaction to the iodine dye or anesthesia
- Bleeding
- Blood clots forming on the catheters
- Cardiac tamponade (pressure on your heart caused by blood or fluid building up in the space between your heart muscle and its outer covering)
- Infection
- Injury to an artery
- Irregular heartbeat (arrhythmia)
- Low blood pressure
- Rash, itching or pain at the site of the catheter
- A small risk of damage to your blood vessels or surrounding tissue
- A small risk of a heart attack or a stroke
What to expect after an angiogram
After your test, your doctor will discuss the results with you. They might recommend additional procedures if you have severe narrowing or blockages.
For example, you might need angioplasty or stenting if your doctor did not perform one or both during your angiogram. Or, your doctor may recommend coronary artery bypass graft (CABG) surgery. During CABG, your surgeon takes part of a healthy blood vessel from another part of your body to divert blood flow around the blocked part of the artery.
Your angiogram may show narrowing in your arteries that isn’t restricting blood flow. In that case, you might not need another procedure. Instead, your doctor might recommend medicine and lifestyle changes to prevent plaque buildup from getting worse and address other risk factors associated with coronary artery disease, such as high blood pressure and high cholesterol.
Frequently asked questions
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How serious is an angiogram?
An angiogram is considered a safe procedure but like any medical test it does have some risks. Serious complications are rare. Possible risks include an allergic reaction to the contrast dye, bleeding or bruising where the catheter is inserted, injury to the artery or in rare cases a piece of plaque breaking loose and causing a stroke. Most people have no problems and recover quickly after the test.
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Is an angiogram painful?
An angiogram is not usually painful. You may feel brief pressure during catheter insertion and a warm sensation when contrast dye is injected. Mild soreness or bruising at the insertion site is common afterward and can be managed with ice packs or over-the-counter pain relievers.
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How long does it take to recover from an angiogram?
Most people recover from an angiogram within a week. You may go home the same day, have mild soreness or bruising, and resume light activity after 24 hours. Avoid heavy lifting or strenuous exercise for about a week, and follow your doctor’s wound care and follow-up instructions.
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Is an angiogram the same as a heart cath?
A heart catheterization is a procedure where a thin tube is guided to the heart through a blood vessel. An angiogram is part of this procedure that uses contrast dye and X-rays to visualize the heart’s arteries, helping detect blockages or narrowing that may affect blood flow.
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How soon can I exercise after angiogram?
You can usually walk lightly within a day after an angiogram but avoid strenuous activity and heavy lifting for 5–7 days. Most return to normal exercise in a week. Always follow your doctor’s specific guidance and stop if you have pain, shortness of breath, or unusual fatigue.
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Is an angiogram considered surgery?
No, an angiogram is not considered surgery. It is a minimally invasive procedure where your provider makes a very small incision to insert a thin tube (catheter) into a blood vessel. This allows them to view your arteries without the need for open surgery.