The procedure will begin with the physician inserting an intravenous (IV) line into the patient’s arm. The IV allows the physician to give the patient a sedative and other necessary medications during the procedure. Small devices (electrodes) will be taped to the patient’s body, which allow the physician to monitor the heart rate.

The physician typically uses the groin or upper thigh area as the place to insert the catheter on its way to the heart, but some physicians may choose to begin at the arm or wrist. Whichever area is chosen will then be cleaned, shaved and numbed with a local anesthetic. The catheter is then fed through the artery in that area (e.g., the femoral artery in the groin or upper thigh) and up into the heart. There may be some minor discomfort during this period.

When the catheter reaches the target area, the dye is injected through the catheter and into a coronary artery. This dye will allow the physician to clearly see the coronary arteries on the angiogram. The patient may feel hot and flushed for about 10 seconds as the dye is administered. Patients may also be asked by the physician to take certain actions, such as coughing or deep breaths, to help the dye travel through the coronary arteries. During this time, still or moving angiograms are taken to record the test results.

The dye is easily visible to the physician monitoring the angiogram images. A “shadow” cast by the dye will show blockages of the arteries and abnormal motions of the heart walls. In the case of diseased arteries, for example, arterial walls may appear to be abnormally narrow or irregularly shaped.

Once the angiogram is completed, the catheter is removed from the body and the hole is sealed with a plug inserted under the skin or with pressure placed on the point of catheter entry. Stitches may also be necessary if the point of catheter insertion was in the elbow area. The entire process of taking angiograms lasts approximately 20 to 30 minutes, or a total of 1.5 hours from pre-procedural preparation to the removal of the catheter.

Other procedures such as angioplasty and stent placement can be performed during the same setting based on the finding of the diagnostic study and the feasibility of such intervention in a given patient.