Coronary angiography of the heart vessels video ⋆ Heart Treatment

Due to the increased relevance of an effective and accurate examination of heart lesions, patients are interested in the question of what coronary angiography means.

Coronary angiography is a method for studying lesions of the heart and circulatory system. The high accuracy and effectiveness of the diagnostic measure is explained by its technology. Coronary angiography of the blood vessels of the heart is carried out by introducing a special radiopaque substance – urographin, which allows you to take clear pictures of all arteries and walls on an x-ray machine.

The question of what coronarography reveals requires a more detailed consideration. This will be discussed later.

With age, in some patients, plaques form in the right or left coronary artery that clog the lumen. This research method allows you to very accurately evaluate the following indicators:

  • the presence of narrowing or stenosis and its localization;
  • degree of damage to arteries;
  • the presence of angina pectoris, heart attack, cardiosclerosis, the development of atherosclerosis.

Thanks to a good clearance, the diagnostician can carefully examine the affected vessels or arteries and make the correct diagnosis. Coronarography allows you to accurately determine the need for subsequent bypass surgery and stenting of the coronary arteries using the stand.

Coronarography is a very accurate and informative diagnostic measure that allows you to investigate many diseases, so patients are interested in what cases it is done. Her appointment is distinguished by a wide range of indications. Coronary angiography is carried out in two orders – planned and emergency.

A planned procedure is necessary in order to check the coronary vessels in the following cases:

  • if necessary, confirm the diagnosis of “cardiac ischemia” after undergoing an ECG;
  • before heart surgery in all patients younger than 35 years old or after myocardial infarction;
  • pathology of the aorta;
  • the occurrence of symptoms of heart ischemia in people with a predisposition to the development of the disease;
  • after surgery on the heart;
  • with vascular disease – aortic aneurysm;
  • in the absence of effectiveness from drugs in the fight against angina pectoris;
  • to confirm the diagnosis of “infectious endocarditis.”

Emergency coronary angiography is performed in case of acute manifestations of heart disease. The urgency of the procedure is explained by the following conditions:

  1. Suspected acute myocardial infarction. At the first manifestations – causeless angina pectoris, arterial hypotension, shock condition, the doctor directs the patient for diagnosis.
  2. Recurrent angina pectoris after surgery. Coronarography is repeated after stenting if symptoms of ischemia occur.

Coronary angiography by CT has a wider range of indications. In addition, with the help of this method, the diagnostician is able to identify all of the above lesions and pathological conditions, virtual coronarography on a tomograph also allows you to identify aneurysm of the cerebral vessels, making it possible to determine the focus of the stroke.

The restrictions and prohibition on coronary angiography cannot be ignored, as they can lead to serious side effects or even death. Virtual coronarography and angiography procedures are contraindicated in the following cases:

  • during pregnancy;
  • after a stroke;
  • in diseases of the thyroid gland;
  • with complicated diabetes mellitus;
  • with hypersensitivity to contrast medium;
  • with severe pathologies of the kidneys and liver;
  • with pronounced heart failure.

Doctors distinguish several conditions in which the coronary angiography of the heart should be coordinated with a specialist. For example, a patient with SARS and all the accompanying symptoms – a runny nose, fever, you can postpone the procedure and reschedule it for a week. Carrying out is possible in case of emergency with the following relative diseases:

  • arterial hypertension, which is not treated with medications;
  • a slight increase in body temperature against the background of infectious and viral diseases;
  • infectious endocarditis;
  • systemic diseases of internal organs;
  • unstable ventricular arrhythmias.

This method of research is necessary if, with the consent of the patient, a surgical intervention is chosen, the purpose of which is to alleviate the patient’s condition. A survey is recommended for those who plan to do stenting or bypass surgery. Coronary angiography of the blood vessels allows doctors to decide what kind of surgery is needed.

Coronarography in the diagnosis of atherosclerosis

Atherosclerosis is one of the leading places in the ranking of deadly diseases. The key to recovery and preventing the development of vascular complications is the detection of the disease at an early stage. Coronarography is a very accurate way to determine the presence of atherosclerotic plaques and their localization. The study allows us to conclude about the severity and prevalence of atherosclerosis. The conclusion of the results is carried out taking into account the following criteria:

  1. Degree of narrowing. If, according to the diagnostic results, the vessel lumen is narrowed by less than 50%, a conclusion is made about non-obstructive coronary atherosclerosis.
  2. The number of plaques in the arteries of the heart. The number of plaques in one, two or three cardiac arteries allows us to make a conclusion about the quantitative damage to the lymphatic system.

Coronary angiography of atherosclerosis by CT is the most advanced and fastest way to detect plaques in the heart. The diagnosis manages to clarify the degree of atherosclerotic lesion at the initial stage of diagnosis without the introduction of an intravenous catheter.

How do coronary angiography

Vascular coronary angiography is performed by an interventional surgeon in an X-ray – specially equipped room where radiation diagnostics and therapy of heart lesions are performed. At the time of the manipulation, a resuscitator should also be present in case of the need for emergency medical care.

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Before starting the manipulation, the patient is administered sedatives through a vein. Next, the doctor puts electrodes of the electrocardiograph on the hands and feet. Summarizing how coronary angiography of the heart is carried out, several stages can be distinguished:

  1. At the first stage, a catheter is inserted. According to the Jadkins technique, two separate catheters are inserted through the femoral artery. According to Sones, the surgeon must insert one catheter through the artery on the shoulder. All manipulations are performed using a local anesthetic.
  2. At the second stage, the catheter is delivered to the coronary arteries using an angiograph. First, heparin should enter them, and then a contrast agent.
  3. At stage III, the affected area is fixed in the picture. The left artery is shot from five positions, and the right – from two.
  4. At the final stage, the catheter is removed from the vein, and the puncture area is covered with a tight bandage.

When asked about how long the procedure lasts, doctors give an ambiguous answer. The procedure takes about 25-30 minutes, however, the patient is in the operating room for at least an hour. After the diagnosis, the patient is placed in the ward for a day. The first 4-7 hours are recommended to devote to rest and not get out of bed. The patient is allowed to start working only after 24-48 hours after the manipulation.

Virtual coronary angiography on CT is somewhat different from the usual procedure performed on an angiograph. The duration of the procedure does not exceed 1 minute. Diagnostics is carried out in stages:

  1. The patient is measured pressure. The optimal heart rate is 70 heartbeats in 60 seconds. If the patient has a heart rhythm disturbance, sedatives are given to the patient.
  2. Through the peripheral vein, the doctor inserts a catheter where the contrast agent will enter.
  3. Direct diagnostics are performed on the tomograph table in a supine position with arms raised up.

Patients are often interested in what form and when the results are given. They can be obtained in the form of a printed image or in electronic form on a CD or flash drive on the day of the diagnosis. As a rule, a written opinion is issued the next day.

How often can coronary angiography be done? Due to the safety of the procedure, the procedure is allowed to carry out the required number of times. Specialists often choose this diagnostic method as the main one for monitoring the state of blood vessels.

Repeated coronary angiography is prescribed for acute relapses of heart disease, as well as in the absence of the effect of drug treatment.

Preparing for the procedure

The procedure requires careful preparation of the patient. First, the doctor should direct him to undergo some laboratory tests in order to identify possible contraindications in a timely manner. The patient will need to make an electrocardiogram in 12 leads, as well as undergo a comprehensive blood test, which includes the following tests:

  • to possible allergic reactions;
  • for latent infections and HIV;
  • clotting;
  • creatinine;
  • on liver enzymes;
  • on biochemistry.

If the diagnostic results do not reveal contraindications, the cardiologist should give direction and explain the main nuances of preparing for the procedure. Most patients are worried about a lot of questions about how to prepare for coronary angiography – where to shave, what to remove from jewelry, than to eat. Preparation for the procedure of coronary angiography of the heart requires compliance with the following rules:

  • suspension of the use of drugs that affect blood coagulation;
  • depilation of the zone where the artery will be punctured (pubis and inguinal folds);
  • exclusion of food intake on the day of the procedure, this means that coronary angiography is performed on an empty stomach;
  • removal of all jewelry, metal jewelry, glasses, lenses and prostheses.

Risks and possible complications

Despite the high level of harmlessness of coronarography, the procedure can not be called absolutely safe due to the possibility of complications. Unpleasant consequences, as a rule, befall patients who do not follow the rules of preparation for the procedure or agree to manipulate despite contraindications.

  • stay in a hospital during the day;
  • food restriction;
  • exclusion of physical activity during the week;
  • temporary abandonment of the bath until the puncture heals.

According to patient reviews, the most common consequences after coronary angiography of the blood vessels of the heart include:

  1. Reactions to a puncture of a vessel in the form of a hematoma, edema, redness after coronarography.
  2. Vascular damage
  3. Allergic manifestations. They occur in case of contact with a potential allergen.
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Thus, complications after coronary angiography of the heart are extremely rare. If the patient is at risk of developing unpleasant consequences, the doctor can offer him an alternative – choose another diagnostic method.

To summarize all of the above, we can conclude that coronarography is an innovative way to diagnose the state of the vessels of the heart. A study of blood vessels for the presence of lesions (for example, stenosis of the coronary vessel or its narrowing) and their localization allows to reveal the development of heart diseases at an early stage.

Events on the eve of the study

The possibilities for the treatment of cardiovascular pathologies that specialists today possess require the precise work of existing and used support services. Before performing the intervention, the doctor must have certain information. In particular, a specialist needs to know the degree of atherosclerotic lesion and narrowing of blood vessels, as well as whether a blood clot is present in them, what size it is and where it is located, how developed the backup blood supply system is.

The answers to all these questions can be obtained by conducting an extensive survey. Such a study today is coronary angiography of the heart vessels. Next, consider what this examination is. The article will talk about who is primarily recommended for coronography of the blood vessels of the heart. How they do, cost, complications – all this will also be discussed below.

The patient is recommended bed rest, and advice is also given to limit the movement of the limb, which was used as an entrance to the artery. Within a few days after the study, a plentiful drink and a light diet are prescribed, which contribute to the excretion of the contrast medium by the kidneys. According to numerous reviews, patients usually recover quite quickly after coronary angiography of the blood vessels of the heart has been performed.

Preparation for coronary angiography of cardiac vessels is carried out in accordance with certain rules. Due to the fact that it is performed in a hospital, the patient must follow all the recommendations of a specialist. The doctor decides which medications can be continued and which ones should be canceled. Before coronary angiography is performed, it is necessary:

  • Refuse to eat in the evening, do not eat on the day of the survey. This will prevent nausea and vomiting in the process.
  • Empty the bladder immediately before the procedure.
  • Remove glasses, chains, rings, earrings. In some cases, a specialist may ask to remove lenses from the eyes.

The physician should know about all medications taken, the presence of allergies or intolerance to any substances.

Overview

What is coronary angiography of the heart vessels? How is the examination done? These questions are of concern to many patients. Coronary angiography of the vessels of the heart is a method for the study of arteries, which is based on the use of x-ray radiation. Another name for this examination is angiography. This method is used to diagnose various pathologies of the cardiovascular system.

The quality of its implementation directly affects the correctness of subsequent treatment. Since coronary angiography of the vessels of the heart is performed in outpatient conditions, it is necessary to pre-register. To carry out the study, special equipment is used. Doctors conducting the examination have appropriate training. Coronary angiography of the blood vessels of the heart is used as a mandatory diagnostic step in medical centers after visiting a cardiac surgeon.

Before the examination, the patient is injected with anesthesia and other drugs. The patient is shaved off the hair on his arm or in the groin area (depending on the site of catheter insertion). A small incision is made in the selected location. A tube will be inserted into it, through which, in fact, the catheter will advance.

The specialist must do everything carefully so that the movement of the elements does not cause pain. Electrodes will be attached to the patient’s chest. They are necessary to control cardiac activity. According to the testimonies of those who left feedback about this procedure, the patient is not in a dream during the study. The doctor talks with the patient, is interested in his condition.

At some point, the doctor may ask you to change the position of the hands, take a deep breath or hold your breath. During the examination, blood pressure and pulse are measured. Usually the procedure lasts about an hour, but in some circumstances it can last even longer. For several hours after it, the patient is not allowed to get up.

This is necessary to prevent bleeding. On the same day, the patient can go home. In some cases, he is advised to stay in the clinic. According to the state of a person, the specialist will determine when it is possible to return to the usual life: take a shower, take previously prescribed drugs again, etc. For several days after the examination, physical activity is not recommended.

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Exploratory survey

A consultation with a heart surgeon will require some tests. In particular, the following are needed:

  • KLA with formula and platelets.
  • Biochemical indicators of the state of the heart muscle.
  • Blood clotting.
  • Lipidogram. It is necessary to confirm the pre-established degree of the atherosclerotic process. In this case, the study of low and high density lipoproteins, total cholesterol.
  • Sugar in urine and blood.
  • Electrolyte balance.
  • In some laboratories, a calculation is made of the degree of probable complications of atherosclerosis.
  • Studies of hepatic and renal activity.
  • Other tests, excluding chronic infectious diseases and AIDS.

The results of the following hardware research are also required:

  • Fluorography. This study allows not only to assess the condition of the lung tissue, but also to determine the contours and sizes of the heart.
  • ECG An electrocardiographic study in dynamics prov >

All the above studies can significantly reduce the waiting time for results after consultation with a specialist cardiology center.

What is a survey?

Coronary angiography of heart vessels, the price of which varies in Russia, is performed not only in specialized centers. In large cities, research can be found in multidisciplinary clinics. As a rule, the examination is planned. First, a puncture is performed. Typically, the site is the femoral artery in the groin area.

A plastic catheter is inserted into the heart through it. A contrast agent is introduced into the tube. Thanks to his presence, the specialist on the angiograph, which displays the image on the screen, sees what is happening in the patient in the coronary vessels. During the study, the doctor assesses the condition of the network, determines the areas of narrowing. Coronary angiography of the heart vessels allows you to carefully examine all areas.

Events on the eve of the study

According to reviews of the doctors’ procedure, complications after coronary angiography are noted in approximately 2% of patients. An easy side effect can be considered itching, a rash on the skin, swelling of the tongue and parts of the face. All this is an allergic reaction to a contrast medium. Shock is extremely rare. Local complications, manifested in the form of thrombosis, hematoma, and vessel damage, are likely.

All this is eliminated in stationary conditions. Among the serious consequences, it is worth noting a stroke or a heart attack. However, experts, as a rule, do not associate the development of an acute condition directly with the study in the presence of arterial stenosis and an atherosclerotic process of a pronounced nature. As practice shows, a fatal outcome is recorded in one case out of a thousand.

Patients who have ever been allergic to a contrast medium are not prescribed coronary angiography of the heart vessels. Complications in this case can be quite serious, up to anaphylactic shock. It is not recommended to perform a study with an increase in temperature, severe anemia (anemia) or insufficient blood coagulation.

How much should I pay for the survey?

In Russia, coronary angiography of the heart vessels is considered to be one of the most common diagnostic methods used in cardiological practice. The cost of research depends on many factors. The amount of payment is affected by the level of the clinic, the qualifications of the diagnostician, the amount of consumables, the type of anesthetic, the need for additional services, the length of stay in the hospital, and so on. For those with CHI policy, the study is free. For other people, the price is in the range 8000-30 000 rubles.

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Svetlana Borszavich

General practitioner, cardiologist, with active work in therapy, gastroenterology, cardiology, rheumatology, immunology with allergology.
Fluent in general clinical methods for the diagnosis and treatment of heart disease, as well as electrocardiography, echocardiography, monitoring of cholera on an ECG and daily monitoring of blood pressure.
The treatment complex developed by the author significantly helps with cerebrovascular injuries and metabolic disorders in the brain and vascular diseases: hypertension and complications caused by diabetes.
The author is a member of the European Society of Therapists, a regular participant in scientific conferences and congresses in the field of cardiology and general medicine. She has repeatedly participated in a research program at a private university in Japan in the field of reconstructive medicine.

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