Coronary angiography

Coronary angiography is an X-ray imaging procedure used to examine the coronary arteries that supply blood to the heart. The procedure is performed with the use of a contrast agent injected into the vessels, allowing visualization of their anatomy and detection of narrowing (stenosis), occlusions, or other abnormalities. It is considered one of the most accurate diagnostic methods for coronary artery disease (CAD).

When is coronary angiography performed?

Main indications

1. Coronary artery disease (CAD). For confirmation of the diagnosis in patients with symptoms such as chest pain (angina), shortness of breath, or general weakness.
2. Suspected myocardial infarction. In emergency situations to identify vessel occlusion and rapidly restore blood flow.
3. Before cardiac surgery. Assessment of coronary artery status prior to procedures such as coronary artery bypass grafting (CABG) or coronary stenting.
4. Follow-up after treatment. Evaluation of vessel patency after stent implantation or bypass surgery.
5. Chronic heart diseases. To clarify the cause of arrhythmias or heart failure.

Advantages of coronary angiography

1. High diagnostic accuracy. Provides detailed visualization of the coronary arteries.
2. Minimally invasive. The procedure is performed through a small vascular puncture, reducing trauma.
3. Possibility of immediate treatment. If required, angioplasty or stent placement can be performed during the same procedure.
4. Rapid recovery. Patients are usually discharged on the same day or the following day.

How is the procedure performed?

Preparation for coronary angiography

The patient undergoes preliminary evaluation, including:

• Electrocardiography (ECG) and blood tests (coagulation profile, inflammatory markers, and renal function).
• Echocardiography to assess overall cardiac function.
• Informing the physician about any known allergies to contrast agents or medications.

Procedure steps

• Anesthesia. Local anesthesia is applied at the puncture site (most commonly the radial or femoral artery).
• Catheter insertion. A catheter is introduced through the artery and guided to the coronary vessels under X-ray control.
• Contrast injection. Contrast material is injected through the catheter to visualize the coronary arteries.
• Image acquisition. A series of X-ray images is obtained for detailed analysis.
• Catheter removal. After completion, the catheter is removed and the puncture site is closed.

The procedure usually takes 20–40 minutes.

After the procedure

1. Hospital observation. The patient is monitored for 4–6 hours to ensure stability.
2. Restriction of physical activity. Intensive physical exertion should be avoided for at least 24 hours.
3. Hydration. Increased fluid intake is recommended to facilitate elimination of the contrast agent.
4. Vital sign monitoring. Regular measurement of blood pressure, heart rate, and body temperature.

Procedure outcomes

1. Accurate diagnosis. Allows precise assessment of the severity and location of coronary artery narrowing.
2. Reduction of complication risk. Early detection of pathology helps prevent myocardial infarction.
3. Treatment effectiveness assessment. Enables evaluation of coronary status after bypass surgery or stenting.

Coronary angiography is considered the gold standard for diagnosing diseases of the coronary arteries. It enables early detection of pathology, prevention of myocardial infarction, and selection of the most appropriate treatment strategy. The procedure is safe, highly accurate, and requires minimal recovery time. Adherence to medical recommendations and regular follow-up examinations help ensure long-term cardiovascular health.