Coronary Angiography – commonly performed diagnostic test which is used to evaluate blood supply to heart. Common indications include chest pain, angina , heart attack or cases of heart failure. Test gives us good insights about blood supply of heart, pumping ability of heart, future course of illness and assists in taking decisions about future management with medicines or procedures like Angioplasty / Bypass surgery.
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- When doctor advises to undergo angiography try and understand what are indication and for which cause is angiography advised.
- Indications can be Non urgent as evaluation for stable angina or positive stress test or Urgent indication like Acute Coronary syndrome(heart attack)
- In non-urgent cases before undergoing angiography ensure that you have undergone basic health screening like lipid profile, Blood sugar profile, & Homocystine levels along with risk factor evaluation with cardiologist.
- In high risk cases the individual should ideally undergo 2D Echocardiography test (to know the pumping ability of heart) and stress test (to know functioning capability of heart).
- Make sure to undergo urea and creatinine test before Angiography as dye is which may cause renal failure in already diseased kidney.
- In emergency cases like Heart attack the decision of Angiography is based on nature, seriousness of the attack and clinical stability of patient.
- Once we know why the angiography is performed , it is also equally important to understand technique of an angiography.
- Coronary Angiography can be done under through the radial artery (upper limb) or Femoral artery ( lower limb ) . Angiography is done under local anaesthesia. Procedure usually takes about 5 minutes time. A catheter is used through arterial axis and reaches to coronary arteries ( arteries which supply blood to heart muscles ). Images are taken after injecting contrast.
- Images of angiography gives us an idea about blood vessel size & length of obstruction to blood supply, commonly called as Blockages .
- The interpretation of test gives a clear idea about diagnosis & severity of Coronary Artery Disease. It also tells us about future management plan like treatment with medicines or angioplasty or bypass surgery.
- Angiography is done as day care procedure & patient is discharged on the same day after 6 hours of procedure.
- Thus Angiography proves to be good diagnostic test which if done in time can prevent complication like heart attack, shock or sudden death.
- Decision of angiography should not be delayed as it affects further management of heart disease .
- Tests done as screening , generally helps to detect serious lesions at early stage and helps to prevent complications
- Though angiography gives far idea about the lesions in blood supply , newer techniques like Intravascular Ultrasound IVUS and FFR help to make more accurate diagnosis of the lesions . This is really helpful when there is confusion about to go for angioplasty or not.
- After angiography is done and if patients condition is stable , it is always advisable to have second opinion about further management . It not only helps in better management but also prevents complications and helps to take decisions.
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