The cardiac catheterization requires the passage of a small catheter through an arm or leg vessel into the heart, in order to permit the securing of blood samples, determination of intracardiac pressure, detection of cardiac anomalies, and injection of contrast media for angiography.

Three tissue layers called tunicae, or coats, surround the lumen of an artery. The adventitia (outer coat) is the outermost layer of an arterial wall and is composed of connective tissue containing elastic fibers and another layer of protein called the external basement membrane. Smooth muscle cells comprise the tunica media, or middle coat. The muscle cells contract or relax to constrict or dilate the artery.

See also Coronary Angiogram, Angiography, Angioplasty, and Cardiac Catheterization.

A coronary angiogram (or cardiac catheterization) is the radiographic visualization of the coronary arteries after the introduction of a contrast agent. A coronary angiography can be performed for both diagnostic and interventional (treatment) purposes.
A catheter, inserted into a major blood vessel has to be maneuvered up to the coronary arteries to inject a blood compatible iodinated contrast material (dye). The x-ray visible catheter allows injecting a small amount of contrast agent selectively in the coronary arteries or the heart chambers. Continuous images are recorded (movies or cineangiogram) in multiple views from different angles are in order to ascertain the precise location and severity of coronary artery blockages. Digitized images are also saved on computer and replayed onto a video screen as needed.
A coronary angiogram is more invasive and requires more patient recovery time than coronary CT angiography. In the past, the gold standard for detecting atherosclerotic plaque was a coronary angiography and intravascular ultrasound. Today, the American Heart Association considers CT scanning to be one of the most effective, non-invasive methods for the detection of calcification in the coronary arteries.

See also Interventional Radiology.

(CCTA) Coronary computed tomography angiography is a diagnostic imaging procedure to visualize the coronary arteries. CCTA is a non-invasive angiogram that allows the assessment of narrowed and clogged arteries that can cause heart attack and stroke.
Coronary CTA is a non-invasive alternative to traditional angiography that offers detailed images of heart function, resulting in faster, more accurate diagnosis. It helps stratify cardiac risk in patients with low to intermediate likelihood of coronary artery disease. For some patients with chest pain, coronary CTA can rule out the need for cardiac catheterization.
Coronary imaging requires a very fast CT scan, because the coronary arteries and other cardiac structures move rapidly during the cardiac cycle. The current 'state of the art' 64 slice multi-detector row CT systems rotate around the patient in less than 500 ms. The data must be acquired monitored by an electrocardiogram, which allows the computer to reconstruct retrospectively slices at different small segments of the cardiac cycle. This cardiac synchronization reduces motion artifacts in the coronary arteries and provides movies of the beating heart and valve motion.
See also Coronary Angiogram, Calcium Score, Cardiac Phase, Cine Mode and Defibrillator.