Angiogram vs Angioplasty: What’s the Difference?
An angiogram and an angioplasty are both used in the diagnosis and treatment of heart artery blockages. Despite the similar names, they are two separate procedures with different purposes.
An angiogram is a diagnostic test. It uses dye and X-ray imaging to show your cardiologist where a blockage is and how severe it is. Angioplasty is a treatment. It uses a balloon, often followed by a stent, to open that blockage and restore blood flow.
This article explains what each procedure involves, how they differ, and what to expect before, during and after each one.
What is an Angiogram?
A coronary angiogram, also known as coronary angiography, is a diagnostic procedure that allows your cardiologist to see how blood is flowing through the arteries that supply your heart. It is used to detect blockages or narrowing that could lead to problems such as chest pain or a heart attack.
How to Prepare for an Angiogram
- You will usually be asked not to eat or drink for at least six hours before the procedure.
- You will complete admission forms, either sent to you beforehand or provided at the hospital.
- The hospital may contact you closer to your admission date to confirm medications and other details.
What Happens During an Angiogram
The procedure takes place in a hospital catheterisation laboratory, usually taking 30 minutes or less, though your specialist can advise on timing specific to your case.
You will be given mild sedation through an intravenous drip to help you relax. A thin tube called a catheter is inserted into an artery, usually through the wrist, and guided up to the heart. A special dye is injected through the catheter, making the arteries visible on X-ray. You may feel a brief warm sensation when the dye is injected, though this usually passes within seconds.
Coronary angiography is usually done under local anaesthesia, meaning the insertion site is numbed rather than a general anaesthetic being used.
What Happens After an Angiogram
Once the procedure is complete, the catheter is removed, and pressure is applied to the insertion site. You will rest in a recovery area for at least four hours. Most people are able to go home within four to six hours, though some may need to stay longer for monitoring. You will not be able to drive for 24 hours afterwards. Your cardiologist will review the images and discuss the results with you, including whether further treatment such as angioplasty is recommended.
What is Angioplasty?
Coronary angioplasty, also known as percutaneous coronary intervention (PCI), is a treatment used to open a narrowed or blocked coronary artery. It improves blood flow to the heart and helps relieve symptoms such as angina (chest pain).
How to Prepare for Angioplasty
- Your cardiologist and the hospital will give you specific instructions before your procedure, including any changes to your medications.
- You will usually be asked to fast for a set period beforehand.
- Arrange for someone to drive you home afterwards, as you will not be able to drive yourself.
What Happens During Angioplasty
The procedure takes place in a hospital catheterisation laboratory and usually takes between 30 minutes and 2 hours, though your specialist can advise on timing specific to your case.
You will receive mild sedation through an intravenous drip to help you relax. A catheter is inserted into an artery, usually through the wrist or groin, and guided to the blocked section of the artery in your heart. A small balloon at the tip of the catheter is inflated, pressing the plaque against the artery wall to widen the space for blood to flow through. In most cases, a stent, a small mesh tube, is then placed to help hold the artery open. The balloon is deflated and removed, leaving the stent in place.
Angioplasty is usually done under local anaesthesia, meaning the insertion site is numbed rather than a general anaesthetic being used.
What Happens After Angioplasty
You will be moved to a recovery area for monitoring. This generally includes lying still for a period to allow the puncture site to heal, along with monitoring of your heart rate, blood pressure and the puncture site. Many people stay in hospital overnight, though this depends on your individual case. You will need someone to drive you home, as you will not be able to drive yourself. If a stent was placed, you will usually be prescribed antiplatelet medication to help prevent clotting. Always take this as prescribed, and speak to your cardiologist before stopping it, including before any dental work or surgery.
Angiogram vs Angioplasty: What’s the Difference?
| Angiogram | Angioplasty | |
|---|---|---|
| What it is | Diagnostic test | Treatment |
| Anaesthesia | Local | Local |
| Time | 30 minutes or less | 30 minutes to 2 hours |
| Recovery | A few hours, same-day discharge in most cases | Often an overnight hospital stay |
| Medication | None required afterwards | Antiplatelet medication if a stent is placed |
Is an Angiogram Needed Before Angioplasty?
In most cases, yes. An angiogram usually comes first, since it gives your cardiologist a clear picture of where a blockage is and how severe it is. That information is what guides the decision on whether angioplasty is the right next step.
From there, two things can happen. Sometimes angioplasty follows straight after, in the same hospital visit, if a blockage is found that needs treating. Other times, the angiogram is done on its own, and angioplasty is scheduled as a separate procedure once your cardiologist has discussed the results with you.
Angioplasty is not usually carried out without an angiogram beforehand, since confirming the exact location and severity of the blockage comes first.
Why Some Angioplasties Need a Stent, and Some Don’t
Most people who have angioplasty receive both a balloon and a stent, but the balloon does the initial work of widening the artery, and the stent is not always needed afterwards.
Whether a stent is placed depends on what your cardiologist sees once the artery is open. Factors that influence this include the length and location of the narrowed section, the size of the artery, and how the artery responds after the balloon is used.
In some cases, balloon angioplasty alone is sufficient. A stent is generally added when there is a higher chance the artery could narrow again or recoil after the balloon is removed.
Your cardiologist will explain what is appropriate based on what they find during your procedure.
Talk to a HeartWest Cardiologist
If you have been referred for cardiac assessment, or you are experiencing symptoms such as chest pain or breathlessness, speak with your GP about a referral to HeartWest.
HeartWest provides cardiology consultations and diagnostic services across Coolaroo, Essendon North, Hoppers Crossing, St Albans and Williamstown.
Book an appointment or call (03) 8721 0888 to speak with our medical administration team.
