Is a coronary angiogram painful?

Like any procedure, an angiogram involves the use of needles and some poking and prodding, but any discomfort is usually minor.

At the beginning of the procedure, a nurse will insert an intravenous (IV) line into a vein in your arm. The IV will allow you to receive fluids and medications easily. If you become anxious during the angiogram, you will receive more medications to help you relax.

After you are relaxed, the cardiologist will numb the area near your groin or wrist with an injection of lidocaine, a local anesthetic. This needle prick and the brief sting of the lidocaine may be the only pain you feel throughout the procedure.

You will not feel pain when the catheter, a slender flexible tube, is inserted into your artery. There are no nerves in the arteries themselves, so you will not feel the catheter moving through your arteries and into your heart. When the catheter is in position, the cardiologist will inject contrast dye through the catheter into the arteries. Most people do not feel the dye injection. However, some feel minor discomfort in their chest, typically lasting only a few seconds. A few people feel lightheaded or nauseous.

Some people say the most uncomfortable part comes after the angiogram, once the catheter is removed. To prevent bleeding, a nurse will apply pressure on your leg where the catheter was inserted and hold it for about 20 minutes. Then, after a dressing is applied, a weight (often a sandbag weighing about 10 pounds) or a clamp may be placed on the wound to help a blood clot form. Instead of putting a weight on the puncture wound, some doctors insert a small device that encourages a blood clot to form.

If the catheter was inserted in your leg, you will have to lie still and avoid bending your leg or lifting your head for two to six hours. This can be uncomfortable if you have arthritis or back pain. If needed you will be given a bedpan or urinal, but you will not be able to get out of bed.

If the catheter was inserted in your wrist, a pressure band will be applied over the wound to help a blood clot form. You will need to keep your wrist straight and elevated on a pillow for several hours, but you can sit up in a chair and use the restroom as needed.