Coronary Angiography with Intravascular Imaging (e.g., IVUS or OCT)

Coronary angiography is used to examine the arteries that supply your heart muscle with oxygen-rich blood. Doctors order this test to identify blockages or narrowing caused by plaque buildup, to evaluate chest pain or shortness of breath, to plan treatments such as angioplasty, stent placement, or bypass surgery, and to check how well your arteries are working after a heart attack or a previous procedure.

Coronary angiography is primarily used to identify blockages or narrowing in coronary arteries, which can restrict blood flow to your heart muscle. It helps doctors determine the severity of any blockages and plan appropriate treatments, such as medications, angioplasty, or stent placement. This procedure may also be used to check for other heart-related issues like artery spasm or abnormal growths.

During the procedure, a thin, flexible tube called a catheter is gently inserted into a blood vessel, usually in your wrist or groin, after the area is numbed with local anesthetic. Using X-ray guidance, the catheter is carefully guided to your heart, and a contrast dye is injected. As the dye moves through your coronary arteries, live X-ray images are recorded so your care team can see exactly where blood flow may be reduced or blocked.

The test involves inserting a thin, flexible tube (catheter) into an artery in your arm, groin, or wrist. A contrast dye is injected through the catheter to make blood vessels visible under X-ray. Specialized imaging techniques (like intravascular ultrasound or optical coherence tomography) may be used to get detailed images of the artery walls. You’ll receive sedation to stay comfortable during the procedure, which typically takes 30 minutes to an hour.

Common findings include normal, open arteries with healthy blood flow, as well as narrowed or blocked segments caused by plaque buildup, a condition known as coronary artery disease. Your doctor may also detect artery spasms, structural variations you were born with, or narrowing in previously placed stents or grafts. These results help determine whether medication, angioplasty, stenting, or bypass surgery is the most appropriate next step for you.

Common findings include coronary artery blockages (narrowing or stenosis), artery spasm, or plaque buildup. These findings help doctors assess the risk of heart events like heart attacks or strokes and guide decisions for interventions like angioplasty or stent placement. Some patients may also have normal results if their arteries appear healthy.

Before your test, you will typically be asked not to eat or drink anything for about 6 to 8 hours. Tell your care team about all medications you take, especially blood thinners and diabetes medicines, and mention any allergies to iodine, contrast dye, or latex. Certain medications may need to be adjusted in advance. Arrange for someone to drive you home afterward, wear comfortable clothing, and leave jewelry and valuables at home.

Before the procedure, your doctor may ask you to stop certain medications (like blood thinners) as directed. You’ll likely be instructed to fast for a few hours before the test. Avoid eating or drinking anything solid after midnight, but you can usually have clear liquids up until a few hours before. Bring your medical records and a list of medications to your appointment.