The angiography image enhancement technology has the potential to enhance the vascular structure in the image while suppressing the background and nonvascular structures simultaneously. This technology has the ability to enhance the result as close to the real structure of blood vessels as possible. Angiographic image processing is one of the essential contents in the field of medical image processing and analysis. However, the existing cardiovascular angiography schemes suffer from various issues. In this paper, the detection process of cardiovascular angiography is studied by combining the Internet of Things and rough set technology. Firstly, this paper designs the architecture design of the cardiovascular angiography process combined with the Internet of Things technology. Secondly, this paper uses a rough set algorithm to optimize the background noise and boundary shrinkage because of the sensitivity of the contrast background noise and boundary shrinkage. Simulation results verified the applicability and efficiency of the proposed model in the cardiovascular angiography scheme. The model has been optimized during implementation. Compared with the traditional algorithm, the same image data processing speed is significantly improved to ensure the enhancement effect.