Before the test, you will be given medicine to help you relax. You will be awake and able to follow instructions during the test.

An intravenous line is placed in your arm. The health care provider cleans and numbs an area on your arm or groin. A cardiologist makes a small cut in the area, and inserts a thin flexible tube (catheter) into an artery. Using x-rays as a guide, the doctor carefully moves the thin tube (catheter) into your heart.

When the tube is in place, dye is injected through it. The dye flows through the blood vessels, making them easier to see. X-rays are taken as the dye moves through the blood vessels. These x-ray pictures create a "movie" of the left ventricle as it contracts rhythmically.

The procedure will usually last less than one hour but may be considerably longer.

You will be told not to eat or drink for 6 to 8 hours before the test. The procedure takes place in the hospital. Some people may need to stay in the hospital the night before the test.

A provider will explain the procedure and its risks. You must sign a consent form for the procedure.

You will feel a sting and burn when the local anesthetic is injected. You may feel pressure when the catheter is inserted. Occasionally, a flushing sensation or a feeling that you need to urinate occurs when the dye is injected.

Left heart angiography is performed to assess the blood flow through the left side of the heart.

A normal result shows normal blood flow through the left side of the heart. Blood volumes and pressures are also normal.

Abnormal results may be due to:

• A hole in the heart (ventricular septal defect)
• Abnormalities of the left heart valves
• An aneurysm of the heart wall
• Areas of the heart that are not contracting normally
• Blood flow problems on the left side of the heart
• Heart-related blockages
• Weakened pumping function of the left ventricle

Coronary angiography may be needed when blockage of the coronary arteries is suspected.

Risks associated with this procedure include:

• Abnormal heartbeats (arrhythmias)
• Allergic reaction to dye or sedating medicines
• Artery or vein damage
• Cardiac tamponade
• Embolism from blood clots at the tip of the catheter
• Heart failure due to the volume of the dye
• Infection
• Kidney failure from the dye
• Low blood pressure
• Heart attack
• Hemorrhage
• Stroke

Right heart catheterization may be combined with this procedure.

Left heart ventricular angiography has some risk because it is an invasive procedure. Other imaging techniques may carry less risk, such as:

• CT scans
• Echocardiography
• Magnetic resonance imaging (MRI) of the heart
• Radionuclide ventriculography

Your provider may decide to perform one of these procedures instead of left heart ventricular angiography.

Angiography - left heart; Left ventriculography

Kern MJ, Seto AH, Herrmann J. Invasive hemodynamic diagnosis of cardiac disease. In: Libby P, Bonow RO, Mann DL, Tomaselli GF, Bhatt DL, Solomon SD, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 12th ed. Philadelphia, PA: Elsevier; 2022:chap 22.

Patel MR, Bailey SR, Bonow RO, et al. ACCF/SCAI/AATS/AHA/ASE/ASNC/HFSA/HRS/SCCM/SCCT/SCMR/STS 2012 appropriate use criteria for diagnostic catheterization: a report of the American College of Cardiology Foundation Appropriate Use Criteria Task Force, Society for Cardiovascular Angiography and Interventions, American Association for Thoracic Surgery, American Heart Association, American Society of Echocardiography, American Society of Nuclear Cardiology, Heart Failure Society of America, Heart Rhythm Society, Society of Critical Care Medicine, Society of Cardiovascular Computed Tomography, Society for Cardiovascular Magnetic Resonance, and Society of Thoracic Surgeons. J Am Coll Cardiol. 2012;59(22):1995-2027. PMID: 22578925 www.ncbi.nlm.nih.gov/pubmed/22578925/.

Valente AM, Dorfman AL, Babu-Narayan SV, Krieger EV. Congenital heart disease in the adolescent and adult. In: Libby P, Bonow RO, Mann DL, Tomaselli GF, Bhatt DL, Solomon SD, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 12th ed. Philadelphia, PA: Elsevier; 2022:chap 82.

Updated by: Michael A. Chen, MD, PhD, Associate Professor of Medicine, Division of Cardiology, Harborview Medical Center, University of Washington Medical School, Seattle, WA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.