The relevant problems that the test deals with most commonly occur as a result of advanced atherosclerosis – atheroma activity within the wall of the coronary arteries.

Coronary artery luminal narrowing reduces the flow reserve for oxygenated blood to the heart, typically producing intermittent angina.

He took an x-ray to prove his success and published it on November 5, 1929, with the title "Über die Sondierung des rechten Herzens" (About probing of the right heart).

[citation needed] In the early 1940s, André Cournand, in collaboration with Dickinson Richards, performed more systematic measurements of the hemodynamics of the heart.

For their work in the discovery of cardiac catheterization and hemodynamic measurements, Cournand, Forssmann, and Richards shared the Nobel Prize in Physiology or Medicine in 1956.

In 1960 F. Mason Sones, a pediatric cardiologist at the Cleveland Clinic, accidentally injected radiocontrast in a coronary artery instead of the left ventricle.

Although the patient had a reversible cardiac arrest, Sones and Shirey developed the procedure further, and are credited with the discovery (Connolly 2002); they published a series of 1,000 patents in 1966 (Proudfit et al.).

Since the late 1970s, building on the pioneering work of Charles Dotter in 1964 and especially Andreas Gruentzig starting in 1977, coronary catheterization has been extended to therapeutic uses: (a) the performance of less invasive physical treatment for angina and some of the complications of severe atherosclerosis, (b) treating heart attacks before complete damage has occurred and (c) research for better understanding of the pathology of coronary artery disease and atherosclerosis.

[citation needed] Death, myocardial infarction, stroke, serious ventricular arrhythmia, and major vascular complications each occur in less than 1% of patients undergoing catheterization.

The equipment and installation setup to perform such testing typically represents a capital expenditure of US$2–5 million (2004), sometimes more, partially repeated every few years.

When the physician is ready to record diagnostic views, which are saved and can be more carefully scrutinized later, he activates the equipment to apply a significantly higher X-ray dose, termed cine, in order to create better quality motion picture images, having sharper radiodensity contrast, typically at 30 frames per second.

Though not the focus of the test, calcification within the artery walls, located in the outer edges of atheroma within the artery walls, is sometimes recognizable on fluoroscopy (without contrast injection) as radiodense halo rings partially encircling, and separated from the blood filled lumen by the interceding radiolucent atheroma tissue and endothelial lining.

As much hydraulic brute force is applied as judged needed and visualized to be effective to make the stenosis of the artery lumen visibly enlarge.

The balloon is initially folded around the catheter, near the tip, to create a small cross-sectional profile to facilitate passage through luminal stenotic areas, and is designed to inflate to a specific pre-designed diameter.

[citation needed] As opposed to bare metal, drug-eluting stents are covered with a medicine that is slowly dispersed with the goal of suppressing the restenosis reaction.

Instead of a catheter being inserted into a vein or artery, CT angiography involves only the injection of a CT-visible dye into the arm or hand via an IV line.

That said, one advantage retained by Catheter angiography is the ability of the physician to perform procedure such as balloon angioplasty or insertion of a stent to improve blood flow to the artery.

[8] Imaging in coronary angiograms is performed via fluoroscopy using X-rays, which pose a potential for increasing the patient's risk of radiation-induced cancer.