Express Diagnostics - Coronary Angiography Solution

Coronary angiography

Coronary angiography is a procedure that uses a special dye (contrast material) and X-rays to see how blood flows through the arteries in your heart. Cardiac angiography is also known as Heart Angiography or Coronary Angiogram.

Why is the test performed?

Coronary angiography is performed if you have or you are suspected to have coronary heart disease. It is recommended in conditions like :

Patient is having typical chest pain classical of angina with or without ECG changes.

Patient is having chest pain with ECG changes with or without positive TMT.

Patient is asymptomatic and incidentally detected having ECG changes with strong family history of early heart disease.

Patient is having ECG changes and having predisposing diseases / factors such as High blood pressure, Diabetes, habits like smoking / tobacco chewing etc.

Patient having Acute heart attack.

Patient having Acute heart attackand had treatment to dissolve the clot blocking your coronary artery or you have continuing chest pain.

Patient develop fresh new ECG changes with or without symptoms.

To assess the degree of narrowing of coronary arteries and to decide further line of management such as angioplasty or bypass surgery.

Before surgery of valvular lesions.

Pre preparations

It is a day care procedure and hospitalization will be total of 5-6 hours.Most of the time you will check into the hospital in the morning of the day the test is scheduled for.Pt should not eat or drink anything for 4 hours before the test starts. You will wear a hospital gown. You must sign a consent form before the test. You will be explained the procedure and its risks.The selected site of insertion of the catheter for the test should be cleaned and shaved. Kidney functions are screened prior to procedure as dye may interfere with kidney function. You should inform cardiologist if you have a bad reaction to contrast material in the past or if you are pregnant.

Result

Report can be normal which is indicative ofnormal supply of blood to the heart and there are no blockages.An abnormal result means you are having blocked artery and it will also identify site & severity of blockages.

Risk

Cardiac catheterization carries a slightly increased risk when compared with other heart tests. However, the test is very safe when performed by an experienced team.

Generally the risk of serious complications ranges from 1 in 1,000 to 1 in 500. Risks of the procedure include the following like:

Irregular heartbeats, Injury to a heart artery, Low blood pressure, Allergic reaction to contrast dye, Stroke, Heart attack, contrast dye could damage the kidneys (particularly in patients with diabetes).

What if the blockage is found in the result?

If a blockage is found, you may be advised for Percutaneous Coronary Intervention (PCI) to open the blockage with or without implantation of spring in blocked vessel / aggressive medical management / Coronary bypass surgery.

How the test is performed?

Coronary angiography is usually done along with cardiac catheterization. You are inserted by a catheter from groin / hand after applying local anesthetic agent (numbing medicine). Because of local anesthetic agent, you may feel little pressure at the site of insertion but no pain. You will usually be awake during the test. You might be given a mild sedative to help you relax if you are having anxious personality.

The cardiologist passes a thin hollow tube, called a sheath followed by insertion of catheter up to the heart till origin of coronary artery carefully. You will not feel the progression of the catheter. X-ray images help the cardiologist position the catheter.Once catheter is guided to desired site, dye is injected which will circulate in the coronary arteries and that can be visualized on screen like continuous X Ray imagining. X-ray images are taken to see how the dye moves through the artery. You may feel a flushing or warm sensation after the dye is injected.The dye helps highlight blood flowand will identify narrowing / blockage if any.After the test, the catheter is removed. Tight pressure bandage is applied at the insertion site to prevent bleeding from local site. The procedure may last 10 to 15 minutes.If the catheter is placed in your groin, you will usually be asked to lie flat on your back without moving your leg for few hours after the test to avoid bleeding.