What Is a Pulmonary Angiogram?

Jacquelyn Gilchrist

A pulmonary angiogram is a diagnostic procedure that a doctor will perform to check for problems with blood circulation in the lungs. The doctor may order this test performed on patients he suspects of having a blood clot in the lungs, called a pulmonary embolism, as well as other lung problems. Any type of angiogram is an x-ray, or imaging test, that works by tracking the movement of a contrast dye that is injected into the patient. Patients may experience some discomfort from the test, but it should not cause them pain. They should anticipate a brief period of recovery following the procedure.

Pulmonary circulation is the movement of blood from the heart, to the lungs, and back to the heart again.
Pulmonary circulation is the movement of blood from the heart, to the lungs, and back to the heart again.

Frequently, this diagnostic test is used to detect any blockages in the lungs, such as blood clots. A pulmonary angiogram may also show if the structure of the lungs is abnormal or if the patient has a congenital defect, such as narrowed blood vessels going to and from the lungs. It can also diagnose pulmonary hypertension, which occurs when the blood pressure of the lung's arteries is too high. Sometimes, it may show a lung tumor.

The doctor will instruct the patient to refrain from eating or drinking for six to eight hours prior to the procedure. Patients should go to the hospital without jewelry and they should expect to put on a hospital gown. The doctor should be informed if the patient is taking any medications, especially blood thinners, nonsteroidal anti-inflammatory drugs (NSAIDs), or diabetes medications.

To begin a pulmonary angiogram, the patient will lie on an x-ray table and a numbing medication will be injected into the skin. A sedative will likely be administered intravenously. The doctor will then insert a catheter into a vein near the groin, which will then be guided up to a pulmonary artery. Contrast dye can then be injected into the area so that any abnormalities can be viewed on the x-ray. This will be repeated with the other arteries leading to and from the lungs.

Some recovery time is required for this procedure. Patients will likely lie flat for several hours immediately following the pulmonary angiogram. Since a sedative is often used, patients must not drive or consume alcohol for the rest of that day. The patient will be instructed to keep the leg straight while he rests for the next six to 12 hours. Some patients may notice tenderness and bruising of the leg afterward.

Before undergoing a pulmonary angiogram, patients should discuss the potential risks with their doctors. Rarely, the heart may be irritated, which can interfere with the heart's rhythm. Patients should alert the doctor immediately if they experience chest pain or problems breathing during the pulmonary angiogram. Rarely, the contrast dye may cause kidney damage. Other risks can include excessive bleeding or nerve damage.

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