(Coronary Angiography; Coronary Arteriography; Coronary Angiogram)
to view an animated version of this procedure.
Cardiac catheterization is a test that uses a catheter
(tube) and X-ray machine to assess the heart and its
Reasons for Procedure
It is used to find the cause of symptoms, like chest
pain, that could mean heart problems.
Cardiac catheterization helps doctors to:
Identify narrowed or clogged arteries of the
Measure blood pressure within the heart
Evaluate how well the heart valves and chambers
Check heart defects
Evaluate an enlarged heart
Decide on an appropriate treatment
If you are planning to have a cardiac catheterization,
your doctor will review a list of possible
complications, which may include:
Bleeding at the point of the catheter insertion
Damage to arteries
Heart attack or arrhythmia (abnormal heart
Allergic reaction to X-ray dye
Blood clot formation
Some factors that may increase the risk of complications
Allergies to medicines or X-ray dye
Age: 60 or older
Recent heart attack
What to Expect
Prior to Procedure
Your doctor may order:
Blood and urine tests
Electrocardiogram (ECG, EKG)—a test that
records the heart's activity by
measuring electrical currents through
the heart muscle
Talk to your doctor about your medicines. You
may be asked to stop taking some medicines
before the procedure, like:
Anti-inflammatory drugs (eg, ibuprofen )
Blood thinners, like warfarin (Coumadin)
Metformin (Glucophage) or glyburide and
Leading up to your procedure:
Arrange for a ride to and from the
The night before, do not eat or drink
anything after midnight.
Local anesthesia will be used at the
insertion site. A mild sedative may be
given one hour before the procedure or
through an IV (needle in your arm)
during the procedure. This will help you
Description of the Procedure
During the procedure, you will receive
IV fluids and medicines. An EKG will be
monitoring your heart's activity.
You will be awake but sedated so that you will
be more relaxed. Your doctor will ask you to do
basic functions such as coughing, breathing out,
and holding your breath. If you feel any chest
pain, dizziness, nausea, tingling, or other
discomfort, tell your doctor.
The catheter will be inserted into an artery in
either the groin or arm (usually at the crease
opposite the elbow or at the wrist). The
insertion area will be shaved, cleaned, and
numbed. A needle will be inserted into a blood
vessel. A wire will be passed through the needle
and into the blood vessel. The wire will then be
guided through until it reaches your heart. A
soft, flexible catheter tube will then be
slipped over the wire and threaded up to your
The doctor will be taking X-ray pictures during
the procedure to know where the wire and
catheter are. Dye will be injected into the
arteries of the heart. This will make the
arteries and heart show up on the X-ray images.
You may feel warm during the dye injection.
Insertion of Catheter
with Guide Wire Through
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Once in place, the catheter can be used to take
measurements. Blood pressure can be taken within
the heart's different chambers. Blood samples
may also be taken. Multiple X-ray images will be
taken to look for any disease in the arteries.
An aortogram may also be done at this time. This
step will give a clear image of the aorta (large
artery leaving the heart). Once all the tests
and images are complete, the catheter will be
Sometimes, the doctor will do a balloon
angioplasty and stenting if he finds an area in
your arteries that is narrow or clogged. These
procedures help to open narrowed arteries.
Finally, a bandage will be placed over the groin
or arm area.
How Long Will It Take?
The procedure takes about 1-2 hours. Preparation
before the test will take another 1-2
How Much Will It Hurt?
Although the procedure is generally not painful,
it can cause some discomfort, including:
Burning sensation (when skin at catheter
insertion site is anesthetized)
Pressure when catheter is inserted or
replaced with other catheters
A flushing feeling or nausea when the
dye is injected
Pain medicine will be given when needed.
Average Hospital Stay - 0-1 days
At the Care Center
EKG and blood studies may be
If the catheter was inserted in
the groin area, you will likely
need to lie still in bed and
flat on your back for a period
of time. If catheter was in the
arm, you will likely be out of
A pressure dressing may be
placed over the area where the
catheter was inserted to help
prevent bleeding. It is
important to follow the nurse's
When you return home, do the following
to help ensure a smooth recovery:
Do not drive until your doctor
says it is okay.
Do not lift heavy objects or
engage in strenuous exercise or
sexual activity for at least 5-7
Change the dressing around the
incision area as instructed.
Your doctor will explain to you
which medicines you can take and
which ones to avoid. Take
medicines as instructed.
To lower your risk for further
complications of heart disease,
you can make lifestyle changes.
These include eating a healthier
diet, exercising regularly, and
Ask your doctor about when it is
safe to shower, bathe, or soak
Be sure to follow your doctor’s
Call Your Doctor
After arriving home, contact your doctor if any of the
Signs of infection, including fever and chills
Extreme sweating, nausea, or vomiting
Change in sensation to affected leg or arm,
including numbness, feeling cold, or change in
Redness, swelling, increasing pain, a lot of
bleeding, or discharge where catheter was
Cough, shortness of breath, or difficulty
Drooping facial muscles
Changes in vision or speech
Difficulty walking or using your limbs
In case of an emergency, call for medical help right
American Heart Association http://www.americanheart.org/
Canadian Cardiovascular Society http://www.ccs.ca/
Heart and Stroke Foundation of Canada http://www.heartandstroke.com/
Cardiac Catheterization: A Patient Guide. Center for Cardiovascular
Education website. Available at:
Accessed June 10, 2008.
Cardiac catheterization. Mayo Clinic.com website. Available at:
Updated May 2010. Accessed November 9, 2010.
Reviewer: Michael J. Fucci, DO
Review Date: 09/2012
Update Date: 00/92/2012