Dr. Donald A. St. Claire Jr., MD

During an angiogram, the doctor inserts a very thin, flexible tube called a catheter into a blood vessel through an opening in the groin or arm. The catheter is threaded through the body to the site of the suspected problem, where a small amount of dye is injected into the bloodstream and x-rays are taken. The dye makes the surrounding blood vessels visible via x-ray.

If necessary, certain procedures can be performed after an angiogram while the catheter is in place. Angioplasty is the use of a catheter to widen narrowed or blocked arteries. Stents are like tiny coiled springs that hold blood vessels open, and they can be placed during a catheterization. Damaged heart valves can also be repaired or replaced.

A typical angiogram takes about an hour to perform, but it may be longer if the catheterization is used to perform procedures on the blood vessels. It may be uncomfortable at times but is usually not painful. Afterwards, patients may be monitored for up to six hours to make sure any bleeding from the insertion site has stopped. They are given fluids to help flush the dye from their body. For a day or two after an angiogram it is important for patients to drink plenty of fluids and keep strenuous activity to a minimum.

During angioplasty, a patient is given a sedative while lying on a table under an x-ray machine. A catheter (a thin, flexible, and hollow tube) is inserted into the patient's skin in the arm or groin and guided into the blocked artery. Dye is injected via the catheter, and x-rays are used to position the tip of the catheter exactly at the blockage. The tiny balloon is guided through the catheter and inflated with saline. It pushes the plaque out of the way, squishing it against the walls of the artery. The balloon may be inflated and deflated several times to let blood pass by. A stent, a tiny tube of metal mesh like a spring, may be inserted to help keep the artery open. Then the x-ray is used again to check that blood is flowing properly, the catheter is removed, and the tiny incision is bandaged.

There are no nerves within veins and arteries, so an angioplasty is generally not painful. However, there may be some discomfort at the site of the incision and when the balloon is inflated. Overall, angioplasty is a very effective and low-risk procedure, useful for helping patients avoid more difficult bypass surgery.

Heart attacks typically feel like pain or pressure in the chest that can radiate out to the back, arm, or jaw. Some other symptoms can include fatigue or weakness, shortness of breath, sweating, and nausea.

Treatment aims to increase blood flow to the heart muscle by opening up blocked blood vessels. Medications are sometimes used to dissolve clots in the arteries. Aspirin and other medications such as Plavix can thin the blood and make clots less likely to form. Dilators can widen blood vessels to make room for more blood to flow. Doctors can also use a procedure called catheterization to look at the blood vessels around the heart directly, place stents, or widen vessels using angioplasty. In extreme cases bypass surgery can be used to help blood flow better. After recovery, it is important to lead a healthy lifestyle and take any prescribed medications in order to protect the heart.