Coronary Angiography in India
The coronary arteries supply your heart muscle with blood. They can become clogged from a buildup of cholesterol, cells or other substances (plaque). This can reduce the flow of blood to your heart. If a blood clot forms and blocks blood flow through that artery, a heart attack may occur. A coronary angiogram is a special X-ray test. It’s done to find out if your coronary arteries are blocked or narrowed, where and by how much. An angiogram can help your doctor see if you need treatment such as angioplasty or stent, coronary artery bypass surgery (CABG) or medical therapy. It is a is a technique of medical imaging where an X-Ray is taken of the heart to visualize the inner opening of the arteries, veins and the four heart chambers, right atrium, right ventricle, left atrium and left ventricle..During the coronary angiography, a contrast dye will be injected into your arteries through a catheter (thin, plastic tube), while your doctor watches how blood flows through your heart on an X-ray screen.
This test is also known as a cardiac angiogram, catheter arteriography, or cardiac catheterization
cardiac catheterization procedure
Cardiac catheterization involves passing a thin flexible tube (catheter) into the right or left side of the heart. The catheter is most often inserted from the groin or the arm. The nurse will clean a site on your arm, neck, or groin and insert a line into one of your veins. This is called an intravenous (IV) line.
A larger thin plastic tube called a sheath is placed into a vein or artery in your leg or arm. Then longer plastic tubes called catheters are carefully moved up into the heart using live x-rays as a guide. Then the doctor can:
- Collect blood samples from the heart
- Measure pressure and blood flow in the heart’s chambers and in the large arteries around the heart
- Measure the oxygen in different parts of your heart
- Examine the arteries of the heart
- Perform a biopsy on the heart muscle
- For some procedures, you may be injected with a dye that helps your doctor to visualize the structures and vessels within the heart.
If you have a blockage, you may have angioplasty and a stent placed during the procedure.
How long does the Cardiac catheterization procedure take ?
Simple Coronary Angiography usually takes about 30 minutes to 60 minutes to complete
Symptons of heart disease
- Chest Discomfort
- Nausea, Indigestion, Heartburn, or Stomach Pain
- Pain that Spreads to the Arm
- You Feel Dizzy or Lightheaded
- Throat or Jaw Pain
- You Get Exhausted Easily
- A Cough That Won’t Quit
- Your Legs, Feet, and Ankles Are Swollen
- Irregular Heart Beat
Who should consider Coronary Cardiac CT Angiography ?
The single most important step for patients trying to determine whether they should have a Coronary CTA is a consultation with the cardiologist. Appropriate use of Coronary CTA is important as the scan carries a very small risk from X-ray exposure and contrast dye exposure.
The strength of Coronary CTA is its ability to confidently exclude significant coronary stenosis and therefore avoid the need for invasive angiography. The careful use of Coronary CTA is important for patients who have:
- Symptoms of chest pain
- Unclear or inconclusive stress test (treadmill, stress echocardiogram or nuclear stress test).
- Ongoing chest pain despite negative stress test.
- Unexplained shortness of breath or fatigue during physical activity.
- Suspicion of an underlying coronary artery anomaly
- Evaluation for possible presence of coronary artery disease in patients undergoing non-coronary cardiac surgery
Who should not have Coronary CTA?
Patients who are highly likely to have blockages are better investigated with coronary angiography since angiography is required to confirm and treat (stents or bypass surgery) any significant stenosis detected on Coronary CTA. Such patients include those with a clear history of chest pain during heavy physical activity at high risk of a cardiovascular adverse event, strongly positive stress-test results and known history of coronary artery disease or heart attack..
Coronary CTA is contra indicated in patients with severe kidney impairment or prior severe allergic reaction (anaphylactic) to contrast (dye).
Benefits and risk of Coronary Catheterization
|Potential benefits||Potential risks and complications||Alternatives|
|••Useful information for diagnosis. Cardiac catheterization gives your doctor more detailed information than other tests.••Faster recovery. The procedure doesn’t require a major incision (cut) or general anesthesia (medication that makes you sleep).||••Leg numbness or weakness for a few hours after (rare)••Bleeding or infection where the catheter was inserted (rare)
••Bad reaction to the contrast dye (very rare)
••Reduced kidney function (kidney failure in rare cases) — tell your doctor or the imaging technician if you have kidney disease or diabetes
••Exposure to x-ray energy, which can slightly increase your lifetime cancer risk (for more information, see Intermountain’s Guide to Understanding Radiation)
••Damage to the artery or heart muscle (extremely rare)
••Heart attack or stroke (extremely rare, and not typically caused by the procedure itself)
|Cardiac catheterization is the best way to get accurate informationabout your arteries or heart valves. Other tests include:••Electrocardiogram
••Cardiac stress test
••Cardiac CT scan
If you have any concerns about your cardiac catheterization, discuss them with your doctor
What to Expect After Coronary Angiography
You’ll be moved to a recovery unit. You may need to lie flat for up to 4 to 8 hours.
- The insertion site may be held under pressure to prevent bleeding.
- In case you have temporary numbness or weakness in your leg, special steps will be taken to make sure you’re safe when you first get up. If you need to urinate and your leg is numb, it may not be safe to walk to the bathroom. You will use a urinal or bedpan instead.
- In the first few hours, you may want to drink plenty of fluids to flush the contrast dye out of your body
- The first 48 hours: Watch for swelling or bleeding. The site will be bruised, but this should go away in a week or so. Avoid bending or squatting. Avoid intense activity such as climbing stairs, running, or lifting anything over 20 pounds. Take short walks (5 to 10 minutes) four or five times a day. Avoid constipation
- Care for the puncture site: Avoid hot baths, hot tubs, or swimming pools for the first 5 days or until the wound is closed. Showers are okay after 24 hours, but don’t let the spray hit the site. In some cases, you might need to remove a dressing or pad.
- Returning to work: When you go back to work depends on your physical condition and the nature of your job. Check with your doctor
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