You may want to have a say in this decision, or you may simply want to follow your doctor's recommendation. Either way, this information will help you understand what your choices are so that you can talk to your doctor about them.
Have an angiogram to find out if you need
treatment for coronary artery disease.
Don't have an angiogram.
Key points to remember
An angiogram can show how serious your coronary artery disease
is and how best to treat it. It shows if your coronary arteries are clogged,
where they are clogged, and by how much. The test can help your doctor see if
you need treatment such as medicines,
angioplasty, or
coronary artery bypass surgery.
Your
doctor may recommend that you have an angiogram if:
The results of a cardiac stress test
suggest that you have severe heart disease.
You are having chest
pain (angina) while you are at rest or during only moderate
physical activity. Or you are taking medicines for chest pain, but they do not
control it.
You have another heart problem, such as
heart failure, that may be caused by heart
disease.
If during the test the doctor sees that your
arteries are badly blocked, you may need to have an
angioplasty or
bypass surgery right away. So before you have the
test, it's a good idea to talk with your doctor about these treatments. Ask
what the test might show and what your choices are in each case.
You may not need an angiogram if you can control your chest
pain and other symptoms with medicines and are otherwise healthy.
You may not want an angiogram if you already know that you don't want to have
angioplasty or bypass surgery.
During
an angiogram, a thin tube called a catheter is placed in an artery of your arm
or leg and gently threaded up into your heart. A special dye goes through the
catheter. The dye helps the arteries show up on the X-ray. The doctor checks
the X-rays to see if your coronary arteries are clogged or blocked.
Coronary artery disease occurs when fatty deposits
called plaque (say "plak") build up inside the
coronary arteries. The coronary arteries wrap around
the heart and supply it with blood and oxygen. When plaque builds up, it
narrows the arteries and limits how much blood can get to your heart.
Coronary artery disease can occur slowly over time without your knowing
it. You may not have any symptoms until the arteries are very narrow. Symptoms
include chest pain (angina) and shortness of breath.
Without treatment, coronary artery disease can lead to serious
problems, such as a
heart attack or a
stroke.
Your doctor is likely to suggest that you adopt healthy
habits such as quitting smoking, eating
a heart-healthy diet, and getting regular exercise. By doing these things,
you can slow the spread of the disease and improve your quality of life.
You may need to take medicines to lower your
cholesterol or
high blood pressure. Your doctor may prescribe aspirin
to reduce your risk of heart attack. And he or she may prescribe other
medicines to control chest pain (angina), if you
have it.
If lifestyle changes and medicines don't work well enough
to relieve your symptoms and lower your risk for a heart attack, you may need
to have
angioplasty or
bypass surgery.
If during the angiogram
the doctor sees that your arteries are badly blocked, you may need angioplasty
or bypass surgery right away. You may want to talk with your doctor about these
treatments before you have an angiogram. During the test, you will not be able
to decide about more treatment, because you will be sleepy from medicines.
Your doctor may suggest that you have this test if:
A
cardiac stress test suggests that you have severe
heart disease. This test checks for changes in your heart while you exercise.
You have chest pain (angina) while
you are at rest or during only moderate physical activity. Or you are taking
medicines for chest pain but they do not control it.
You have
another heart problem, such as
heart failure, that may be caused by heart
disease.
You probably do not need an
angiogram if you can control your angina and other symptoms with medicines and
lifestyle changes and if you are otherwise healthy.
Compare your options
Compare
What is usually involved?
What are the benefits?
What are the risks and side effects?
Have an angiogram
Have an angiogram
An
angiogram takes about 1 to 3 hours. You will get a
shot to numb the site where a catheter is placed in your blood
vessel.
After the test, you must stay in bed for several hours with
your arm or leg straight. You may go home the same day or the next day.
The test helps you and your doctor decide which treatment will
improve your symptoms and lower your risk for a heart attack.
An angiogram has some rare but serious risks. They include:
Heart
attack.
Stroke.
Allergic reaction to the dye used to
see the coronary arteries.
Kidney damage related to the
dye.
Bleeding at the site where the tube is placed.
Don't have an angiogram
Don't have an angiogram
Try lifestyle changes such as quitting smoking, eating a
heart-healthy diet, and getting regular exercise if
you are worried about heart disease.
Personal stories about deciding whether to have an angiogram
These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.
My heart
medication just isn't working as well as it used to. Although my angina is
stable, I am not feeling as well as I'd like to. I want to have the energy to
play with my grandkids and the confidence to take the vacations my wife and I
always planned, without the fear of having a heart attack. I've decided to have
an angiogram so that my wife, my doctor, and I can make a decision about
whether there may be something else that can help me.
Julian, age 68
I asked my
doctor what she thought we would find out from an angiogram. She said that
based on my other tests, she was pretty sure that I had a blockage in one of my
main heart arteries, but that the only way to be sure was to do the
angiography. When I asked her what she'd recommend if she found the blockage,
she felt either angioplasty or open-heart bypass surgery would be needed. Well,
I had watched my sister go through open-heart surgery, and I can tell you that
it's not for me. So my doctor and I decided that we would try some different
kinds of medication to keep my angina under control, and see how things went. I
can still have the test—and the surgery—if I change my mind, but for now I'm
doing just fine as I am.
Reynaldo, age 75
After my father died of a heart attack at
58 and my brother had one at 55, I was worried that I was next. When my chest
pain got bad and my doctor recommended an angiogram, I was all for it. I
decided I would rather have the test, and then surgery if I need it, to avoid a
heart attack if possible.
Mabel, age 60
I was
getting chest pain after I walked a few blocks, or even less if it was cold
out. I thought it was just my lungs, but when I saw my doctor, he said he
thought it was my heart. So I took a treadmill test and based on my results, my
doctor thought I probably had some blockage in my heart arteries, but it didn't
seem too bad. We decided to try some medication and see if that helps instead
of having that test where they look at the dye in your heart. I have been doing
well and almost never get chest pain anymore.
Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.
Reasons to have an angiogram
Reasons not to have an angiogram
My chest pain is affecting my quality of life.
I'm able to control my chest pain with medicines.
More important
Equally important
More important
I'm worried that I could have a heart attack if I don't get treatment.
I'm not that worried about having a heart attack.
More important
Equally important
More important
If an artery is badly blocked, I know I may need emergency angioplasty or surgery.
I already know that I don't want angioplasty or bypass surgery.
More important
Equally important
More important
I'll be more motivated to adopt healthy habits and quit smoking if I know how bad my heart disease is.
Finding out that my heart disease is bad won't help me make changes.
More important
Equally important
More important
My other important reasons:
My other important reasons:
More important
Equally important
More important
Where are you leaning now?
Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.
Having an angiogram
NOT having an angiogram
Leaning toward
Undecided
Leaning toward
What else do you need to make your decision?
Check the facts
1.
An angiogram can help me and my doctor decide which treatment is best for my heart disease.
TrueYou're right. An angiogram helps you and your doctor decide whether you need medicines, angioplasty, or coronary artery bypass surgery.
FalseSorry, that's not right. An angiogram helps you and your doctor decide whether you need medicines, angioplasty, or coronary artery bypass surgery.
I'm not sureIt may help to go back and read "What is a coronary angiogram?" An angiogram helps you and your doctor decide whether you need medicines, angioplasty, or coronary artery bypass surgery.
2.
I may not need an angiogram if I can control my chest pain and other symptoms with medicines and I'm otherwise healthy.
TrueYou're right. Some people will do well just by taking medicines to control their symptoms.
FalseSorry, that's not right. Some people will do well just by taking medicines to control their symptoms.
I'm not sureIt may help to go back and read "Why might your doctor recommend having an angiogram?" Some people will do well just by taking medicines to control their symptoms.
3.
If I have an angiogram, I don't need to do anything else to treat my heart disease.
TrueSorry, that's wrong. If the test shows that you have heart disease, you'll need to adopt healthy habits such as quitting smoking, eating a heart-healthy diet, and getting regular exercise. You may also need to take medicines.
FalseYou're right. If the test shows that you have heart disease, you will need to adopt healthy habits such as quitting smoking, eating a heart-healthy diet, and getting regular exercise. You may also need to take medicines.
I'm not sureIt may help to go back and read "How might the test affect your treatment for heart disease?" If the test shows that you have heart disease, you will need to adopt healthy habits and may need to take medicines.
Decide what's next
1.
Do you understand the options available to you?
2.
Are you clear about which benefits and side effects matter most to you?
3.
Do you have enough support and advice from others to make a choice?
Certainty
1.
How sure do you feel right now about your decision?
Not sure at all
Somewhat sure
Very sure
2.
Check what you need to do before you make this decision.
You can use it to talk with your doctor or loved ones about your decision.
Get the facts
Compare your options
What matters most to you?
Where are you leaning now?
What else do you need to make your decision?
1. Get the facts
Your options
Have an angiogram to find out if you need
treatment for coronary artery disease.
Don't have an angiogram.
Key points to remember
An angiogram can show how serious your coronary artery disease
is and how best to treat it. It shows if your coronary arteries are clogged,
where they are clogged, and by how much. The test can help your doctor see if
you need treatment such as medicines,
angioplasty, or
coronary artery bypass surgery.
Your
doctor may recommend that you have an angiogram if:
The results of a cardiac stress test
suggest that you have severe heart disease.
You are having chest
pain (angina) while you are at rest or during only moderate
physical activity. Or you are taking medicines for chest pain, but they do not
control it.
You have another heart problem, such as
heart failure, that may be caused by heart
disease.
If during the test the doctor sees that your
arteries are badly blocked, you may need to have an
angioplasty or
bypass surgery right away. So before you have the
test, it's a good idea to talk with your doctor about these treatments. Ask
what the test might show and what your choices are in each case.
You may not need an angiogram if you can control your chest
pain and other symptoms with medicines and are otherwise healthy.
You may not want an angiogram if you already know that you don't want to have
angioplasty or bypass surgery.
During
an angiogram, a thin tube called a catheter is placed in an artery of your arm
or leg and gently threaded up into your heart. A special dye goes through the
catheter. The dye helps the arteries show up on the X-ray. The doctor checks
the X-rays to see if your coronary arteries are clogged or blocked.
What is coronary artery disease?
Coronary artery disease occurs when fatty deposits
called plaque (say "plak") build up inside the
coronary arteries. The coronary arteries wrap around
the heart and supply it with blood and oxygen. When plaque builds up, it
narrows the arteries and limits how much blood can get to your heart.
Coronary artery disease can occur slowly over time without your knowing
it. You may not have any symptoms until the arteries are very narrow. Symptoms
include chest pain (angina) and shortness of breath.
Without treatment, coronary artery disease can lead to serious
problems, such as a
heart attack or a
stroke.
How might the test affect your treatment for heart disease?
Your doctor is likely to suggest that you adopt healthy
habits such as quitting smoking, eating
a heart-healthy diet, and getting regular exercise. By doing these things,
you can slow the spread of the disease and improve your quality of life.
You may need to take medicines to lower your
cholesterol or
high blood pressure. Your doctor may prescribe aspirin
to reduce your risk of heart attack. And he or she may prescribe other
medicines to control chest pain (angina), if you
have it.
If lifestyle changes and medicines don't work well enough
to relieve your symptoms and lower your risk for a heart attack, you may need
to have
angioplasty or
bypass surgery.
If during the angiogram
the doctor sees that your arteries are badly blocked, you may need angioplasty
or bypass surgery right away. You may want to talk with your doctor about these
treatments before you have an angiogram. During the test, you will not be able
to decide about more treatment, because you will be sleepy from medicines.
Why might your doctor recommend having an angiogram?
Your doctor may suggest that you have this test if:
A
cardiac stress test suggests that you have severe
heart disease. This test checks for changes in your heart while you exercise.
You have chest pain (angina) while
you are at rest or during only moderate physical activity. Or you are taking
medicines for chest pain but they do not control it.
You have
another heart problem, such as
heart failure, that may be caused by heart
disease.
You probably do not need an
angiogram if you can control your angina and other symptoms with medicines and
lifestyle changes and if you are otherwise healthy.
2. Compare your options
Have an angiogram
Don't have an angiogram
What is usually involved?
An
angiogram takes about 1 to 3 hours. You will get a
shot to numb the site where a catheter is placed in your blood
vessel.
After the test, you must stay in bed for several hours with
your arm or leg straight. You may go home the same day or the next day.
Try lifestyle changes such as quitting smoking, eating a
heart-healthy diet, and getting regular exercise if
you are worried about heart disease.
Personal stories about deciding whether to have an angiogram
These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.
"My heart medication just isn't working as well as it used to. Although my angina is stable, I am not feeling as well as I'd like to. I want to have the energy to play with my grandkids and the confidence to take the vacations my wife and I always planned, without the fear of having a heart attack. I've decided to have an angiogram so that my wife, my doctor, and I can make a decision about whether there may be something else that can help me."
— Julian, age 68
"I asked my doctor what she thought we would find out from an angiogram. She said that based on my other tests, she was pretty sure that I had a blockage in one of my main heart arteries, but that the only way to be sure was to do the angiography. When I asked her what she'd recommend if she found the blockage, she felt either angioplasty or open-heart bypass surgery would be needed. Well, I had watched my sister go through open-heart surgery, and I can tell you that it's not for me. So my doctor and I decided that we would try some different kinds of medication to keep my angina under control, and see how things went. I can still have the test—and the surgery—if I change my mind, but for now I'm doing just fine as I am."
— Reynaldo, age 75
"After my father died of a heart attack at 58 and my brother had one at 55, I was worried that I was next. When my chest pain got bad and my doctor recommended an angiogram, I was all for it. I decided I would rather have the test, and then surgery if I need it, to avoid a heart attack if possible."
— Mabel, age 60
"I was getting chest pain after I walked a few blocks, or even less if it was cold out. I thought it was just my lungs, but when I saw my doctor, he said he thought it was my heart. So I took a treadmill test and based on my results, my doctor thought I probably had some blockage in my heart arteries, but it didn't seem too bad. We decided to try some medication and see if that helps instead of having that test where they look at the dye in your heart. I have been doing well and almost never get chest pain anymore."
— Jean, age 62
3. What matters most to you?
Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.
Reasons to have an angiogram
Reasons not to have an angiogram
My chest pain is affecting my quality of life.
I'm able to control my chest pain with medicines.
More important
Equally important
More important
I'm worried that I could have a heart attack if I don't get treatment.
I'm not that worried about having a heart attack.
More important
Equally important
More important
If an artery is badly blocked, I know I may need emergency angioplasty or surgery.
I already know that I don't want angioplasty or bypass surgery.
More important
Equally important
More important
I'll be more motivated to adopt healthy habits and quit smoking if I know how bad my heart disease is.
Finding out that my heart disease is bad won't help me make changes.
More important
Equally important
More important
My other important reasons:
My other important reasons:
More important
Equally important
More important
4. Where are you leaning now?
Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.
Having an angiogram
NOT having an angiogram
Leaning toward
Undecided
Leaning toward
5. What else do you need to make your decision?
Check the facts
1.
An angiogram can help me and my doctor decide which treatment is best for my heart disease.
True
False
I'm not sure
You're right. An angiogram helps you and your doctor decide whether you need medicines, angioplasty, or coronary artery bypass surgery.
2.
I may not need an angiogram if I can control my chest pain and other symptoms with medicines and I'm otherwise healthy.
True
False
I'm not sure
You're right. Some people will do well just by taking medicines to control their symptoms.
3.
If I have an angiogram, I don't need to do anything else to treat my heart disease.
True
False
I'm not sure
You're right. If the test shows that you have heart disease, you will need to adopt healthy habits such as quitting smoking, eating a heart-healthy diet, and getting regular exercise. You may also need to take medicines.
Decide what's next
1.
Do you understand the options available to you?
2.
Are you clear about which benefits and side effects matter most to you?
3.
Do you have enough support and advice from others to make a choice?
Certainty
1.
How sure do you feel right now about your decision?
Not sure at all
Somewhat sure
Very sure
2.
Check what you need to do before you make this decision.
I'm ready to take action.
I want to discuss the options with others.
I want to learn more about my options.
3.
Use the following space to list questions, concerns, and next steps.
Credits
Author
Robin Parks, MS
Editor
Kathleen M. Ariss, MS
Associate Editor
Pat Truman, MATC
Primary Medical Reviewer
Caroline S. Rhoads, MD - Internal Medicine
Specialist Medical Reviewer
Robert A. Kloner, MD, PhD - Cardiology
Specialist Medical Reviewer
Ruth Schneider, MPH, RD - Diet and Nutrition
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