Having an angiogram isn't an everyday walk in the medical park. This procedure is reserved for people with chest pain or other signs of an imminent heart attack. To perform the test, your cardiologist or radiologist (by this time, you’re way past the primary-care-physician stage) inserts a very small tube called a catheter into an artery, sends dye through the tube into your bloodstream, and watches an X-ray monitor to see how freely the dye flows. If the dye suddenly slows or stops, blocked by a clot or narrowed area, your doctor may perform immediate angioplasty, the surgical procedure that removes the blockage and clears the blood vessel. In most cases, after clearing the vessel, the surgeon inserts a stent — a tiny spring — into the artery to hold it open, hopefully forever. The stent is designed to prevent restenosis, the technical term for blocking an artery after it has been cleared out. If the artery is blocked again, the treatment is a new angioplasty and a new stent.
In order to be able to do an angioplasty, the blockage must not be too far down the coronary artery or else the balloon won’t be able to fit in there. If you have multiple blocked arteries or an angioplasty can’t be performed, a cardiac surgeon can perform coronary bypass surgery whereby he takes arteries from one place in your body, such as the internal mammary arteries, and attaches them to your coronary circulation. If one does never need an angiogram, the good news is that it can save your life and keep you alive for years and years to come, which gives you plenty of time to work on controlling your cholesterol.