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Coronary angiography- Invasive

Invasive coronary angiography uses X-rays to examine blood flow to the heart, most commonly for patients presenting with acute coronary syndromes, or heart attacks. This procedure is also used for patients experiencing angina with a high suspicion for significant coronary artery disease, often based on prior non-invasive investigation including exercise stress testing, a CT coronary angiogram (CTCA), dobutamine stress echocardiogram (DSE) or nuclear myocardial perfusion scan (MPS).

Coronary angiography
Invasive coronary angiogram- left coronary artery

Invasive coronary angiography is performed by a cardiologist and requires the insertion of a thin tube, called a cardiac catheter, into an artery in the wrist or groin under local anaesthetic. The cardiac catheter is then advanced to the coronary arteries followed by an injection of contrast dye which allows the cardiologist to observe any significant narrowing or blockages. The test is performed with the patient lying flat and usually takes around 20 minutes.

The patient can generally mobilise soon after coronary angiography and go home the same day. It is important to be aware that all invasive tests carry a small risk, including heart attack, stroke and bleeding. The risks and benefits should be discussed with you in advance by your heart specialist. If a severe narrowing is diagnosed during the procedure it may be possible, if appropriate, to proceed directly to treatment with coronary angioplasty and stent insertion.