Coronary Angiography

Coronary Angiography is a technique that uses medical imaging to view the organs and blood vessels of the patient’s body. This is particularly performed to view the veins, arteries, and heart chambers to diagnose blockages and other problems. It is done by using an X-Ray based technique, like fluoroscopy (Immediately obtains moving pictures using X-Ray). A contrast agent like a special dye is injected in the blood stream via a catheter (thin plastic tube), which highlights the blood vessels. The blood vessels materialize in white on the angiogram as they move. Then a few x-rays are taken and studied.

INDICATIONS

  • Coronary Angiography is performed for various reasons, like:
  • Angina – Chest pain or any kind of discomfort.
  • Unstable Angina – When chest pain becomes worse and occurs more often.
  • Unexplained pain in the chest, arm, jaw, or neck.
  • Coronary thrombosis or Blood clots
  • Congenital heart disease – Defect in heart present from birth.
  • Chest injury or other problems with blood vessels.
  • Unusual chest pain even when all the tests are normal.
  • Problem with heart valve that requires surgery.
  • Heart failure
  • Atypical results of heart stress test
  • After a recent heart attack.

If you are going to have a surgery in which you have a high chance of getting a heart attack or other problems related to heart.

The coronary angiography is performed by a cardiac physiologist (who is trained to carry out cardiac examinations), a cardiologist (a doctor specializing in heart conditions), and a radiographer (a professional who carries out the imaging process). There is also a nurse present who stays with the patient.

PRE-PROCEDURE

To prepare for an Angiography, you should tell the doctor if:

  • You are or might be pregnant.
  • You are breast feeding (Do not feed your baby for a day or two, as the dye might still be in your system)
  • You have any allergies
  • You have asthma
  • You have any diseases (like diabetes) and what medications youare on.

Further, you should:

  • Abstain from eating anything solid after midnight on the day your angiography is scheduled to take place.
  • Avoid drinking any liquid atleast 4 hours before the exam.
  • Stop any ongoing medications if instructed by the doctor a day or two before the procedure takes place.
  • Bring someone to take you home, as you might be under the influence of sedatives.
  • Take certain blood tests (like BUN, creatinine etc.) as instructed by your doctor.
  • Remove jewellery and other accessories before the angiography starts.
  • Empty your bladder as the test might take some time.
  • Ask the doctor if you have any concerns regarding the procedure.

DURING PROCEDURE
Coronary Angiography usually takes 30 minutes to 2 hours to be performed. The procedure is performed in the X-ray room. You will be asked to lie on the X-ray table, that has a few cameras that can move around your chest area for taking pictures. Sedatives will be given to you via the intravenous line (IV) instered in your arm. You will be asked to stay awake during the procedure so that you can do deep breathing, coughing and move your arms. Catheter will be inserted into your blood vessel via arm or groin. Catheter will be tactfully threaded to your coronary arteries. Blood pressure and oximonitor will be used your blood. Anticoagulants will be given to ensure there is no blood clotting on the catheter or coronary artery. You will feel a brief flushing when a contrast material (dye) is inserted in your body through the catheter. The dye moves through your arterties and the doctor observes the flow. X-ray images will be taken continously.

POST PROCEDURE
Post the procedure, the cathether is removed and the incision is closed by applying pressure or using a clamp. You will be asked to lie flat for a few hours and your heart condition will be continously monitored. Furthermore, you might be required to stay in the hospital for up to 4 hours after the procedure is completed. In most cases, the patient is allowed to go home on the same day. Your doctor will recommend you to drink lots of water to flush the dye out of your system. You will be recommend to avoid any strenuous physical activity.

RISK AND COMPLICATIONS
Post the procedure, the cathether is removed and the incision is closed by applying pressure or using a clamp. You will be asked to lie flat for a few hours and your heart condition will be continously monitored. Furthermore, you might be required to stay in the hospital for up to 4 hours after the procedure is completed. In most cases, the patient is allowed to go home on the same day. Your doctor will recommend you to drink lots of water to flush the dye out of your system. You will be recommend to avoid any strenuous physical activity.

MORE INFO
The cost of angiography ranges from Rs. 12000 – 25,000. Angiography is also known as arteriography.The term Angiogram is also used in the place of angiography, but it is actually the image of the blood vessels captured through X-Ray. Angiogram is also known as an arteriogram or a venogram.

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