Coronography without artery occlusion

Coronography is an invasive X-ray examination of the heart's blood vessels (coronary arteries) that allows physicians to accurately determine whether the arteries are narrowed, stiffened, or blocked. This examination is most commonly performed when coronary artery disease is suspected, a condition in which the heart muscle does not receive sufficient blood supply due to changes in the coronary arteries. Even when no blockage is detected, coronography provides a detailed visualization of the blood vessels and enables the physician to plan further monitoring, treatment, or lifestyle modifications. At Meliva multidisciplinary clinics, coronography is performed using modern diagnostic equipment and an individualized patient care approach, from preparation through post-procedural treatment decisions. The examination supports informed clinical decision-making even in cases where arterial blockage has not yet developed but early vascular changes are already present.

When is coronography performed?

Coronography is recommended for patients who:

• experience chest pain or pressure, particularly during physical activity;
• are suspected of having coronary artery disease or have identified risk factors (high cholesterol, diabetes, family history);
• have had a previous myocardial infarction or are suspected of having an acute coronary syndrome;
• have inconclusive results from other diagnostic tests (e.g., echocardiography or Holter monitoring);
• require assessment before cardiac surgery or after angioplasty.

The examination may also be performed as a preventive measure for high-risk patients, especially those participating in a cardiovascular disease prevention program.

How should you prepare for coronography?

Before the examination, it is important to:

• inform your physician about all medications you are taking, especially blood-thinning medications;
• notify your physician about any allergies, particularly to contrast media or iodine;
• avoid eating and drinking for 4 to 6 hours before the procedure (according to your physician's instructions);
• consult a specialist regarding preparation requirements during a cardiologist consultation.

How is coronography performed?

The procedure usually takes 30 to 40 minutes. It is performed under local anesthesia at the puncture site, and general anesthesia is not required, as the patient needs to cooperate with the physician throughout the procedure. Coronography is generally painless; however, a sensation of warmth or temporary chest discomfort may occur during the injection of the contrast agent. In rare cases, allergic reactions or complications at the puncture site may occur. When clinically indicated, coronography may be immediately followed by an interventional procedure, such as percutaneous coronary intervention (PCI).

What should you know after the procedure?

After the examination:

• to prevent bleeding, a compression bandage is applied to the puncture site on the arm. If the procedure was performed via the femoral artery, a weight may be placed on the leg for 4 to 6 hours, or the puncture site may be sealed using a dedicated vascular closure device;
• the patient should remain lying down and rest for several hours, especially if the puncture was performed through the femoral artery;
• after approximately 6 hours, patients are usually allowed to get up, but physical exertion should be avoided and the puncture site should be monitored;
• drinking plenty of fluids is recommended, as this helps eliminate the contrast agent from the body;
• if pain, bleeding, or swelling occurs at the puncture site, medical attention should be sought immediately.

The examination results are often discussed with the patient the following day, and treatment or further diagnostic investigations are planned accordingly.

What does the examination reveal?

Coronography is valuable even when no complete arterial blockage is found:

• early signs of atherosclerosis may be detected, such as arterial wall stiffening or calcification;
• mild or moderate narrowing of blood vessels that may progress over time can be identified;
• functional abnormalities, such as vascular spasms, may be observed.

These findings enable physicians to optimize treatment, prescribe medications to lower cholesterol or blood pressure, and recommend dietary changes or increased physical activity.

Coronography without arterial occlusion: cost and reimbursement

Price with NHIF reimbursement: €0

The service may be reimbursed by the National Health Insurance Fund (NHIF) under the standard reimbursement scheme. In such cases, the service may be provided free of charge. Alternatively, following a physician consultation, the patient may choose additional paid and/or higher-cost medical or non-medical services, materials, or other options. Cardiac health can also be assessed through participation in a cardiovascular disease prevention program.

Why is it important to get checked even if you have no symptoms?

Coronary artery disease often progresses silently without obvious symptoms. Chest pain or shortness of breath may appear only when the disease has already advanced. Regular cardiac examinations help identify risks early and prevent serious complications such as myocardial infarction or sudden cardiac arrest. The results of the examination help determine the most appropriate treatment strategy, whether medication, angioplasty, or cardiac surgery. It is also important to adopt healthy lifestyle habits, including smoking cessation, maintaining a balanced diet, controlling blood pressure, and engaging in regular physical activity. These measures are an essential part of maintaining long-term cardiovascular health.

Contacts:

Kaunas: ligonine.savanoriu423@meliva.lt

Vilnius: ligonine.laisves64@meliva.lt