How is coronary angiography done?
The accuracy of the diagnosis and the likelihood of complications depend on how and how professionally a coronary angiography of the heart is performed. Since this procedure is invasive and causes discomfort to the patient, it is done under local anesthesia. The order of execution is as follows:
- after the onset of anesthesia, a puncture is made in a vein (in the leg, in the groin area) and a special tube is inserted into it, through which a catheter is then inserted;
- the catheter is advanced through the veins to the heart;
- an iodine-based contrast agent is supplied through the catheter, which spreads throughout all coronary vessels;
- the entire examination process is displayed on the monitor, the doctor takes pictures;
- After completing the examination, a tight bandage is applied to the puncture site.
Coronary angiography of the heart vessels through the arm
If the abdominal aorta or leg arteries are affected, inserting a catheter into the groin area may be difficult or impossible. In such cases, an alternative method is used - coronary angiography of the heart vessels through the arm. The catheter is inserted through a puncture in the arm and also moves as close to the heart as possible. Then contrast is applied and x-rays are taken.
When the catheter is inserted through the arm, the artery may spasm or a blood clot may develop. For this reason, this method poses a high risk of complications for the patient.
How long does a coronary angiography take?
Coronary angiography can last from 30 to 60 minutes, depending on how severe the condition of the patient's heart vessels is. After the procedure, the patient needs to stay in the hospital for about 2-3 days to fully recover and avoid complications.
How to undergo coronary angiography?
After the procedure, the patient needs a gentle regime. It is necessary to generally limit physical activity and for some time after coronary angiography not to move the limb in which the puncture was performed. It is also necessary to drink plenty of fluids, which will prevent possible kidney dysfunction.
Indications for implementation
The study can be carried out on an emergency or planned basis. In case of myocardial infarction, coronary angiography is usually performed under the compulsory medical insurance policy on an urgent basis: you need to quickly determine the location of the blockage of the vessel and remove the obstacle. Most often, a blood clot (thrombus) or a broken section of a cholesterol plaque is detected. The risk of myocardial infarction increases as the lumen of the coronary arteries narrows: this is why it is so important to fight atherosclerosis and be monitored by a cardiologist. When quickly performing coronary angiography in acute coronary syndrome, it is possible to restore blood circulation in the ischemic zone, or to significantly reduce the area of necrosis of cardiac tissue.
Coronary angiography is routinely performed for:
- insufficient effectiveness of drug therapy for anginal pain;
- unstable angina after myocardial infarction;
- the need to obtain accurate information about the condition of the vessels supplying the heart, which cannot be obtained using non-invasive examination methods;
- preparation for complex and lengthy open-heart surgeries (for example, replacing heart valves) in people over 35 years of age;
- upcoming surgery on the coronary vessels to assess the volume and determine intervention tactics.
Based on the results of CAG, a cardiologist can establish an accurate diagnosis and select the optimal treatment option for the identified disease.
Coronary angiography in the practice of a cardiologist is the best method for diagnosing diseases of the coronary vessels, as it provides accurate information about their condition from the inside. To make an appointment with a doctor, to find out the prices for coronography and the conditions for its completion under compulsory medical insurance, you can call 8-499-266-98-98. At the Clinical Hospital "RZD-Medicine" named after. ON THE. Semashko employs competent specialists who will help make an accurate diagnosis and prescribe effective treatment.
The patient takes the results of the vascular examination with him on a digitally recorded disk. The disk should be stored in case of dynamic assessment of the condition of blood vessels and consultations with doctors of related specialties. When narrowing of the arteries is diagnosed, the doctor decides on further treatment tactics for the patient. He may be offered drug therapy, balloon angioplasty with the installation of a stent at the site of stenosis, or coronary artery bypass grafting.
Possible complications after the procedure
Like any other surgical intervention and violation of the integrity of the vessel, coronary angiography can have a number of complications, even if it is performed by an experienced specialist. Possible complications include:
- heart attack;
- rupture of an artery or heart;
- heart attack or stroke due to a blood clot breaking off from the wall of a vessel;
- arrhythmia;
- bleeding;
- allergies.
Of course, complications do not always arise and are often limited to small hematomas or swelling at the puncture site. However, the possibility of serious consequences cannot be excluded, so before the procedure you need to carefully study the contraindications to it.
Contraindications for the study
Contraindications for cardiac vascular examination with contrast are:
- various respiratory diseases that are accompanied by elevated body temperature;
- anemia;
- open bleeding of various locations;
- low potassium levels in the blood;
- poor blood clotting;
- diabetes;
- obesity or underweight;
- renal, heart failure;
- lung damage.
Preparing for the study
Even before the CAG, the cardiologist talks in detail about the goals and progress of the study, and the necessary preparation. A medical history is required: information about medications taken, allergic reactions, and surgical interventions undergone is important. Some medications need to be discontinued a couple of days before surgery, but this decision is made solely by a specialist after assessing the possible risks. Several hours before a planned coronary angiography, it is recommended to avoid fluid and food intake. For femoral access, it is necessary to shave the groin area the day before.
Interpretation of coronary angiography
How coronary angiography of the heart vessels is performed and what it is is clear. The main thing is not just to take a picture, but to interpret it correctly, that is, decipher it. For the most informative and accurate result, several specialists are involved in decoding: a radiologist, a cardiologist, a vascular surgeon and others.
The thickness of the vessels, their length and width are assessed from the images. Compactions and darkening are revealed. An alarming signal is a violation of the boundaries of blood vessels - blurriness and indistinctness. The pathology of the vessels will also be indicated by their incorrect location.
Make an appointment with a doctor at the research facility at the Federal State Budgetary Institution National Medical Research Center for Cardiovascular Surgery named after. A.N. Bakulev Ministry of Health of Russia
Alena Smirnova
10/31/2019 my daughter at the Central Sports Agricultural Center named after. Bakulev underwent an operation: ASD repair with a xenopericardial patch under conditions of IR, hypothermia and PCCP. Firstly, I would like to express my deepest gratitude to the entire team that saved our Sonya’s life, namely: Surgeon Sergey Sergeevich Volkov, our gratitude to you cannot be fully expressed in any words! You are a Doctor and a Person with a capital P! Thank you for your professionalism and golden hands!!! May God grant your family good health and all possible blessings! Also, huge thanks to assistants Nikiforov A.B., Narmaniya I.T., anesthesiologist Solovyov N.A., perfusionist Fionova N.A. Huge gratitude to our treating doctor Andrey Aleksandrovich Okhlopkov!!! Our whole family is deeply grateful to you! Low bow!!! Thank you all - everyone for your professionalism, for your good deed, we are very glad that we are in your hands!!! Sonechka is recovering, periodically looks at her stitch and says “sibo, uncle”, this is how she thanks Sergei Sergeevich!) I can’t find specific words, I just want to thank everyone from the bottom of my heart for the millionth time! I also express my gratitude to all the staff - nurses, orderlies, everyone we met at the Center! We thank Svetlana Lenardovna Storchak, who received us at the clinic. Special thanks to sisters Yulia and Tatyana) I apologize if I forgot anyone, we are sincerely grateful to everyone! Now information for those who may soon be planning to visit this Center. There is a lot of nonsense and untruth written in the reviews, so, simply - just don’t read bad reviews, my advice to you! The entire staff is very polite, sociable, kind, they are real professionals in their field! At your request, you can stay in shared wards, or in private ones (we took a separate one, it had 2 beds, a refrigerator, a TV and DVD player, a microwave, a table and 2 chairs, a washbasin. The children are fed very well, food is delivered to the wards . Also, if you need anything, there is a large shopping center not far from the Center, where everyone knows Auchan and other stores. The department has a toilet, a bathroom (2 baths - for children and adults), a kitchen and a playroom. The department is very clean , the orderlies regularly clean up. Regarding the operation: we arrived on October 29, the operation was scheduled for October 31, after the operation the child was in intensive care (don’t be alarmed by this word, the child is simply under the supervision of specialists), then on November 1. at about 11:00 the child was transferred to me to the intensive care unit, we stayed there for a day, then we were transferred back to the ward. We had abdominal surgery, so our stay in the center was longer than those who had surgery through a tube (such children are discharged much faster). If you wish, you can stay for rehabilitation at the rehabilitation center, which is also located on the territory. Who plans to travel with a “support group” - no more than 2 accompanying persons per child, one with the child in the department, the second can be accommodated in the rest room (the DRV department is located on the 2nd floor, the rest room is on the 4th) or same in the hotel at the Center, but there are problems with places). Perhaps I missed something, there is a lot of information in my head. If I remember something important, I’ll add to the review. I really hope that this review will help some people. People, the main thing is to believe in a good outcome of events! And behave decently with the staff, if you come there for help and treat everyone with human respect, then you will be treated the same way! I really hope that one of the employees of the Center for Agricultural Affairs will read the review and just know that thanks to you, Sonechka Smirnova is doing well! Once again huge, bigger than our entire universe, THANK YOU!!! May God grant you all all the best, kindest and brightest!!! Sincerely, Alena Pavlovna Smirnova and our whole big family! (ward No. 5)
Risks associated with CAG
Coronary angiography is considered a safe procedure, but like any other medical procedure, it has complications and risks. When it is carried out, the following may occur:
- hematoma in the area of arterial puncture - it usually disappears on its own within a couple of days after the manipulation;
- allergy to contrast agent - its symptoms are rash, headaches, bronchospasm with a feeling of lack of air and the development of suffocation;
- arterial damage that may require emergency care;
- kidney damage, as they remove contrast from the body.
The risks of complications due to coronary angiography are extremely low, amounting to less than one case in a thousand.
Coronary angiography in Moscow under compulsory medical insurance or on a paid basis can be performed in the department of X-ray surgical methods of diagnosis and treatment of the Clinical Hospital "RZD-Medicine" named after. ON THE. Semashko. You can perform the procedure for free if you have a compulsory medical insurance policy, a referral from a doctor, SNILS and a passport. You can ask your questions, find out about the possibility of undergoing coronary angiography for a fee or under a compulsory medical insurance policy by calling 8-499-266-98-98.
Normal coronary angiogram
