Angiogram

An Angiogram is a diagnostic test that uses X-ray imaging to see your heart’s blood vessels. The treatment is generally done to see if there’s any restriction in blood flow going to the heart. Coronary Angiography is a procedure that is performed to examine the coronary arteries of the patient’s heart. Coronary angiograms are part of a general group of procedures called heart (cardiac) catheterizations. Cardiac catheterization procedures help in both diagnose and treat heart and blood vessel conditions. It is one of the most common types of catheterization procedure. Exceptionally fast scanners are used to find images in this test. Before the test is performed, local anesthesia is given to the patient and a catheter is passed through an artery in the arm or groin, which is then infused with a contrast agent.

INDICATIONS
Your doctor may recommend you to undergo a coronary angiogram test if you have:

• Symptoms of coronary artery disease, such as chest pain or any kind of discomfort. (angina)
• Pain in your chest, jaw, neck or arm that can’t be figured by other tests
• When chest pain increases and occurs more often (unstable angina)
• Defect in your heart from the time you were born (congenital heart disease)
• Unusual results on a noninvasive heart stress test
• Chest injury or other blood vessel problems
• Problem with a heart valve that requires surgery.

PRE-PROCEDURE
Before your angiogram procedure starts, your doctor will review your medical history, including allergies and medications you take. Your Doctor may perform a physical exam and check your vital signs — blood pressure and pulse.

In some cases, the test is performed on an emergency basis. Generally, though, they’re scheduled in advance, giving you time to prepare.

The test is performed in the catheterization (cath) lab of the hospital. Your health care team will give you a few instructions and talk to you about any medications you take. General guidelines include:

• You should not eat or drink anything after midnight before your angiogram.
• Take all the medications that you are taking to the hospital with you and ask your doctor about whether or not to take your usual morning medications.
• If you have diabetes, ask your doctor if you should take insulin or other oral medications before the test or not.
• If you are or might be pregnant.
• If you breast feed (you are not allowed to feed your baby for a day or two, as the dye might still be in your system)

DURING PROCEDURE
During a coronary angiogram test, a type of dye that’s visible by an X-ray machine is injected into the blood vessels of your heart. The X-ray machine quickly takes a series of images (angiograms), offering a look at your blood vessels. If necessary, your doctor can also open clogged heart arteries (angioplasty) during your coronary angiogram. It usually takes 30 minutes to 2 hours to perform the test depending on how complex the examination is.
When the test is over, the catheter is removed from your arm or groin and the incision is closed with manual pressure, a clamp or a small plug. You’ll under continuous observation and monitoring by your healthcare team. When your condition gets stable, you return to your own room, where you’re monitored regularly. Furthermore, the patient is required to stay in the hospital for up to 4 hours after the procedure is completed as he/she might still be under the influence of sedatives.

POST PROCEDURE
Once your Angiogram is finished you’ll need to lie flat for a few hours to avoid bleeding if the catheter was inserted in the groin. During this time, pressure may be applied to the incision to avoid bleeding and promote healing.

You are allowed to go home the same day, or you may have to remain in the hospital overnight. You are advised to drink plenty of fluids to help flush the dye from your body. If you’re feeling up to it, you can then have something to eat.

Ask your doctor when to resume taking medications, bathing or showering, working, and doing other normal activities. You should avoid strenuous activities and heavy lifting for several days.

RISK AND COMPLICATIONS
As with most procedures done on your heart and blood vessels, a coronary angiogram has some risks and complications, such as radiation exposure from the X-rays used. Major complications are rare, though. Potential risks and complications are as follow:

• Heart attack
• Stroke
• Injury to the catheterized artery
• Irregular heart rhythms (arrhythmias)
• Allergic reactions from the dye or medications used during the procedure
• Kidney damage
• Excessive bleeding
• Infection

MORE INFO
An angiogram can help doctors to know what’s wrong with your blood vessels and Show how many of your coronary arteries are blocked or narrowed by fatty plaques (atherosclerosis). Based on the results of the test, your doctor may decide that you would benefit from having coronary angioplasty or stenting to help clear clogged arteries. To prevent needing another procedure it’s also possible that angioplasty or stenting could be done during your angiogram. The cost of angiogram ranges from Rs. 9000 – 20,000 approx.

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