Coronary Angiography is a medical procedure used to visualize the coronary arteries, which supply blood to the heart muscle, and to assess the presence of blockages, narrowing, or other abnormalities within these arteries. It is a crucial diagnostic tool for evaluating and diagnosing coronary artery disease (CAD), which can lead to reduced blood flow to the heart and may result in chest pain (angina) or more severe conditions, such as heart attacks.

Here's how coronary angiography is typically performed:

Preparation: Before the procedure, the patient is prepared by having an intravenous (IV) line inserted to provide medications and fluids. Electrocardiogram (ECG) leads are attached to monitor the heart's electrical activity. Sedation or anesthesia may be administered to help the patient relax and remain comfortable during the procedure.

Access: Coronary angiography is typically performed through the femoral artery in the groin or the radial artery in the wrist. The healthcare provider cleans the area and numbs it with a local anesthetic. A thin, flexible tube called a catheter is then inserted into the artery.

Guidance: The catheter is carefully advanced through the vascular system to the heart and coronary arteries. It is guided using X-ray imaging to ensure proper placement.

Contrast Dye Injection: Once the catheter is in position, a contrast dye is injected through the catheter directly into the coronary arteries. The dye is visible on X-ray, allowing the healthcare provider to see the blood vessels and any blockages or abnormalities.

Imaging: Continuous X-ray imaging is used to capture a series of images of the coronary arteries as the contrast dye flows through them. These images provide a detailed view of the arteries, highlighting any areas of narrowing, blockages, or other issues.

Assessment: The cardiologist reviews the images and assesses the condition of the coronary arteries. They can identify the severity and location of any blockages or stenosis (narrowing).

Decision-Making: Based on the findings, the cardiologist may decide on further treatment options, such as angioplasty and stent placement (percutaneous coronary intervention, or PCI), or they may recommend other therapies or lifestyle changes.

Closure: After the procedure, the catheter is removed, and the access site (groin or wrist) is typically sealed with a special device or manual pressure to prevent bleeding. The patient is monitored for a few hours to ensure stability.

Coronary angiography is considered the gold standard for diagnosing coronary artery disease because it provides precise information about the extent and location of blockages or narrowing in the coronary arteries. Depending on the findings, the cardiologist can make informed decisions about the most appropriate treatment, which may include angioplasty and stent placement or, in some cases, coronary artery bypass surgery (CABG).

While coronary angiography is generally safe, it carries some risks, such as bleeding or damage to the blood vessels. The benefits of accurate diagnosis and treatment planning typically outweigh these risks for patients with suspected or known CAD. The healthcare team will discuss the procedure's risks and benefits with the patient before proceeding.