Coronary angiography, also known as a cardiac catheterization, is a minimally invasive procedure used to visualize the coronary arteries to detect blockages or narrowing. It involves threading a thin, flexible tube called a catheter from a blood vessel in the arm (and less frequently leg) up to the heart. A special contrast dye is then injected through the catheter, and a series of X-ray images are taken to create a detailed map of the coronary arteries. The primary role of coronary angiography is to precisely locate and assess the severity of atherosclerotic plaque buildup, which can cause chest pain (angina) or lead to a heart attack. Coronary angiography provides a definitive diagnosis of coronary artery disease and serves as a crucial guide for subsequent therapeutic interventions, such as angioplasty and stenting, which can be performed immediately during the same procedure to relieve the narrowing and restore blood flow.

Percutaneous Coronary Intervention (PCI), also known as coronary angioplasty, is a non-surgical procedure used to treat coronary artery disease by restoring blood flow to the heart. It is typically performed in a cardiac catheterization lab and often follows a diagnostic coronary angiogram. During the procedure, a thin catheter with a deflated balloon at its tip is threaded through an artery in the wrist or groin to the blocked coronary artery. Once positioned, the balloon is inflated to compress the plaque against the artery wall, widening the vessel and improving blood flow. In many cases, a coronary stent—a small, mesh tube—is then placed to keep the artery open long-term. However, for some lesions, particularly those that are smaller, a drug-coated balloon can be used as an alternative to a stent. These balloons deliver an anti-proliferative drug to the artery wall before being removed, helping to prevent the artery from narrowing again without leaving behind a permanent implant. The primary role of PCI, whether with a stent or a drug-coated balloon, is to relieve symptoms, reduce the risk of heart attacks, and improve the quality of life for patients with significant coronary artery blockages.

Coronary physiology testing with a pressure wire is a way for doctors to find out if a narrowing in your heart’s arteries is actually reducing blood flow enough to cause problems. During a coronary angiogram, they slide a very thin wire with sensors into your artery to measure blood pressure before and after the narrowing. If the pressure drops too much, it means the narrowing is serious and may need treatment like a stent. If the pressure is okay, it means the artery is letting enough blood through, and a stent might not be needed. This helps avoid unnecessary procedures and ensures the right treatment is given.

Intravascular imaging is like using a tiny camera or ultrasound from inside your heart arteries to get a detailed look at the walls of the blood vessels. During a stent procedure, it helps doctors see exactly where and how badly the artery is blocked, making sure the stent is placed properly and fully expanded. It also helps spot areas of plaque that may not be causing a blockage yet, but look dangerous—these are called vulnerable plaques and might be more likely to cause a heart attack in the future. This inside view gives much more information than regular angiography (X-rays) alone, helping doctors treat heart disease more precisely and safely.

Electrical cardioversion is a procedure used in cardiology to restore a normal heart rhythm in patients with certain types of abnormal heart rhythms, most commonly atrial fibrillation or atrial flutter. It involves delivering a controlled electric shock to the heart through electrodes placed on the chest, which momentarily stops the heart’s electrical activity and allows it to reset to a normal rhythm. It is typically used when medications have not worked or when a quick return to normal rhythm is needed due to symptoms like palpitations, fatigue, or shortness of breath. Cardioversion is generally safe, especially when the risk of blood clots has been addressed with proper anticoagulation beforehand, and is done under general anaesthesia.