Coronary Angiography (CAG)

The procedure is performed in a specialized cardiac catheterization laboratory (Cath Lab) under local anesthesia. The patient remains completely awake and can communicate with the doctor throughout the test, which typically takes only 20 to 40 minutes.
1. Preparation: The patient is placed on an X-ray table. A small area on the wrist (radial artery) or the groin (femoral artery) is cleaned, shaved, and numbed with a local anesthetic injection.

2. Catheter Insertion: A short plastic guide tube (sheath) is placed into the artery. Through this sheath, a long, thin, flexible tube called a catheter is carefully threaded up through the arterial system until it reaches the openings of the coronary arteries at the heart.

3. Dye Injection: Once the catheter is perfectly positioned, a small amount of iodine-based contrast dye is gently injected into the arteries. The patient might feel a brief, mild warm flush or tingling sensation during this injection, which is completely normal.

4. X-Ray Imaging: As the dye flows rapidly through the blood vessels, a specialized moving X-ray machine (fluoroscope) takes multiple dynamic pictures from various angles. These clear images immediately highlight any narrowed sections or complete blockages.

5. Completion: The catheter is gently withdrawn. If the entry point was in the wrist, a tight compression band is applied; if in the groin, firm manual pressure is held for about 15 minutes followed by a tight dressing.