What is it?
It is an invasive imaging procedure that allows the doctor to look at the heart structures that include, coronary arteries, cardiac valves, aorta, and heart muscles to determine a treatment plan.

How does the procedure work?
A catheter is a long narrow tube that is inserted through a plastic introducer sheath and introduced inside the blood vessel at the arm or leg. The doctor observes the course of the catheter’s movement through a special X-ray machine towards the coronary arteries (blood vessels surrounding the heart).
How is the procedure visualized?

Contrast material appears dark inside the coronary vessels.
Once the catheter reaches the heart the procedure goes through what is called coronary angiography. This works by injecting contrast material through the heart’s chambers, valves, and major vessels.

Narrowing of a coronary vessel
Angiography allows to detect any narrowing or blockage in the coronary artery.
In more specialized hospitals and research centers, there is a more sophisticated methods of catheterization to visualize the walls of the vessels which is called intra-vascular ultrasound (IVUS). At the tip of the catheter a sound-probe is installed and inside the blood vessels sound waves map out the detailed images of the interior walls of the arteries. This can provide a first person point of view in the arteries and the extent of the vascular disease.

IVUS allows the doctor to visualize the narrowing or blockage of arteries.
Reference
Cardiac Catheteriation and coronary interventional procedures. (Cleveland Clinic) http://my.clevelandclinic.org/services/angioplasty/hic_cardiac_catheterization_and_coronary_interventional_procedures.aspx
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