Coronary Angiography in Navi Mumbai

Coronary angiography is performed under local anaesthesia at the wrist with mild intravenous sedation. Most patients experience only mild pressure at the catheter insertion site and no pain during the procedure. There are no pain-sensing nerves inside blood vessels or the coronary arteries, so the passage of the catheter is painless. When contrast dye is injected, a brief warm, flushing sensation is common — this is temporary, lasting only a few seconds, and is harmless.

The coronary angiography procedure itself typically takes 30 to 60 minutes. Complex cases or those requiring additional functional testing (FFR, IVUS) may take longer. Including pre-procedure preparation and post-procedure observation, patients should plan for approximately 4 to 6 hours at the hospital. In most cases of elective diagnostic angiography performed via the radial approach, same-day discharge is routine.

The radial approach is a technique where the catheter is inserted through the radial artery at the wrist rather than the femoral artery at the groin. The landmark RIVAL trial (NEJM, n = 7,021) established that radial access reduces major bleeding complications by 73% compared to femoral access. Patients can sit up and walk immediately after the procedure, and same-day discharge is routinely possible. Radial access is the preferred approach at Heartwise Cardiology wherever anatomically feasible.

Coronary angiography is a safe, routinely performed procedure with a major complication rate of less than 0.1% in experienced interventional centres (ESC Guidelines 2023). The risk of stroke or heart attack related to the procedure is less than 0.05%. Minor complications — such as bruising at the access site — occur in under 2% of cases with radial access. The procedure is performed in a dedicated Cath Lab with full resuscitation equipment and a trained cardiac team present throughout.

Angiography results are reported as percentage stenosis — the degree of narrowing in each coronary artery. Blockages below 50% are generally non-significant and managed with medications. Stenosis between 50–70% is intermediate and may require additional functional testing (FFR) to decide on treatment. Stenosis above 70% is clinically significant and typically warrants angioplasty with stenting. Total occlusions (100% blockage) are treated urgently. Your cardiologist will explain your specific results in detail after the procedure.

Fast for 4 to 6 hours before the procedure. Inform your cardiologist of all medications — particularly blood thinners (aspirin, clopidogrel, warfarin) and diabetic medication (metformin should be stopped 24–48 hours prior). Blood tests, an ECG, and kidney function tests (creatinine) will be done beforehand. Arrange a companion who can drive you home, as you will not be permitted to drive for 24 hours. Leave jewellery at home and wear comfortable, loose-fitting clothing.

If the angiography reveals significant coronary artery disease, your interventional cardiologist will discuss three possible treatment paths: optimised medical therapy alone (for mild disease), coronary angioplasty and stenting (PCI — often performed in the same sitting as the angiogram, known as an ad-hoc procedure), or coronary artery bypass surgery (CABG — recommended for complex multi-vessel disease or left main artery involvement). The best option depends on the number, location, and severity of blockages as well as your overall health.

Coronary angiography is classified as a listed medical procedure and is covered under most Indian health insurance policies, including CGHS (Central Government Health Scheme), ECHS (Ex-Servicemen Contributory Health Scheme), and Ayushman Bharat Pradhan Mantri Jan Oyoana (PM-JAY). Most private health insurers (Star Health, New India, ICICI Lombard, HDFC Ergo) also cover the procedure. Pre-authorisation from your insurer and an original cardiologist referral letter are typically required. Contact Heartwise Cardiology on 97695 17636 for insurance guidance.