Cardiology

Coronary angiography is an imaging technique or a radiological test that helps visualize the insides of the coronary arteries. It shows the exact location and severity of any plaque formation and consequent narrowing of the coronary arteries. This helps the doctor to decide on what treatment is needed.

 

The test is commonly carried out within the Cath lab in a hospital set up. The procedure normally takes around 15 to 20 minutes.

The site of the procedure or insertion of the catheter at the upper part of the thigh near the groin or an artery in the arm. is anesthetized using a local anaesthetic injection. This will numb the site of the test.

A thin, plastic tube called a sheath is inserted into an artery. Catheters are passed through this sheath to the coronary arteries of the heart

Via this catheter, under X ray guidance contrast medium or dye is injected through the catheter into the coronary arteries.

As the blood along with the dye flows through the arteries and the chambers of the heart, X rays show the path of the blood and outline the branches of the arteries. A series of x-ray pictures from different angles to check for blockages is recorded

FAQs

What are the preparations for Coronary angiography?

 

Patients who are prescribed this test need to be admitted to the hospital on the day of the test. Sometimes admission on the previous evening and a stay overnight may also be advised. A few hours of fasting with nothing taken via mouth (including water) is recommended.

 

What are the implications of an angiography results?

 

Normal result of coronary angiography means that there is adequate blood supply to the heart. Abnormal result on the other hand means that one or more coronary arteries may be blocked or narrowed in one or more places. The degree or percentage of each block is also reported. If the narrowing of the arteries is mild, it can be treated with medicines alone. If the arteries and their branches are more severely occluded and narrowed, coronary artery bypass graft or coronary angioplasty may be required

Angioplasty is a specialised procedure performed in a Cath lab (cardiac catheterisation laboratory). Since the patients are awake and alert through the procedure, they are given medication before and during angioplasty procedure to help relax

The procedure begins by inserting a sheath into a blood vessel, usually in the upper leg, groin or arm. A hollow tube termed catheter is pushed through this sheath into the mouth of the coronary artery. Through this catheter another small balloon catheter is deployed into the coronary arteries.

Once the balloon is at the blocked or narrowed area in the artery, it is inflated to widen the pathway. In most cases the inflation lasts from 30 seconds upto several minutes, depending upon the nature of the blockage. The inflation of the balloon may cause chest pain in some patients, similar to angina. This happens because the balloon temporarily blocks the flow of blood and oxygen that it carries to the heart. If such pain is experienced, the patient should report the same to the doctor.

Nowadays, a stent is crimped on the balloon and is positioned at the site of obstruction. A stent is an expandable mesh tube. It is implanted to support and widen the artery and keep the vessel open for continuous blood flow. After the block has been opened the balloon is deflated and retracted back through the blood vessel. Stent implant is a permanent one.

FAQs

Q. What are the advantages of placing a stent?

Stent prevents acute vessel closure, means the sudden collapse of the narrowed artery after the balloon has opened it.

It also reduces restenosis, recurrence of blocks after balloon angioplasty

Q. Can I be back to my routine after the procedure?

- You would be kept under observation for 2-3 days. Once home, one can resume full activity within couple of days. Angioplasty is not a cure, but a treatment to reduce the effects of Coronary Artery Disease. Following angioplasty, diet and medications have to be strictly followed to reduce the risk of recurrence. Your health relies on the lifestyle you choose.