Coronary angiography of the vessels of the heart how to do, cost, complications

This is an invasive manipulation that serves to determine the condition of blood vessels carrying blood and oxygen to the heart. They are called coronary. The left and right coronary arteries normally provide muscle nutrition and support the performance of the entire organ.

With an unfavorable development of events, these arteries for various reasons, narrow (stenosis) or clog (occlusion). Blood supply to the heart is significantly limited, or stops at a certain site altogether, which causes coronary disease and heart attack.

To exclude such a defect or, if available, determine its degree, a coronarography is performed.

This is an X-ray examination of the lumen of the coronary vessels using an angiograph and a contrast agent injected through a catheter precisely on the eve of the cardiac arteries. The survey is carried out from different angles, which allows you to create the most detailed picture of the state of the object being examined.

The simplest survey of all presented. A contrast agent is injected directly into the coronary vessels by a specialist. After that, the necessary pictures are taken on the x-ray machine. But even such a traditional method helps to determine a large number of cardiac, vascular pathologies.

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.

Selective coronarography

What is special about this method? In fact, this is a modernized version of the above. During the examination, the doctor does not examine all the vessels, but concentrates on several or even one. Such a selective (selective) approach was reflected in the name.

The procedure requires the installation of a special catheter for the patient – it is through him that the contrast agent is delivered. A special wish for the event is a good film for an x-ray machine. Its poor quality may affect the resulting image. If it is fuzzy, vague, then on its basis the doctor will not be able to make an accurate diagnosis.

A significant plus of the selective method is that it does not require the introduction of large volumes of a contrasting drug. Another feature is the quick passage of the procedure. Moreover, in a short period of time, a specialist can get pictures of vessels that are diverse in locations.

However, selective coronarography also has a significant minus – the procedure cannot be performed on the same probes. Their replacement is required, and this measure can lead to atrial fibrillation. The disadvantage of the method is the fact that the selective variety of coronary angiography is carried out only with the help of sophisticated equipment – such that it is capable of making a large number of frames per minute. It is important to pay attention to the quality of the probes for examination.

Indications for the procedure

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.

Unfortunately, over the past decades, the percentage of people suffering from cardiovascular diseases has increased sharply around the world, and these statistics are growing inexorably. Today we will try to understand how coronary angiography of the heart is done, what it is and how it is performed by highly qualified specialists.

A radiopaque method of conducting an examination, which today is the most reliable method for diagnosing coronary heart disease, allowing you to particularly accurately determine the nature, level and point of the coronary artery. This method is a “platinum standard” in the diagnosis of coronary heart disease and allows you to solve the problem with the volume and preference for further healing procedures such as stenting, PTCA and CABG.

Coronary angiography is used exclusively after a complete examination of a sick person and after identifying the following ailments:

  • With acute cuts in the chest and dyspnea, very often indicating strong vasodilatations;
  • When healing with the help of medications does not give the desired effect, and the symptoms of the disease noticeably increase;
  • If a highly qualified doctor has serious suspicion of congenital heart defects;
  • With serious diseases of the heart vessels;
  • In case complex heart surgery is planned;
  • With AHF (acute heart failure);
  • With severe injuries of the sternum;
  • Before surgery, directly related to the high probability of serious heart problems.

The complex process of preparing a sick person for coronary angiography includes a whole range of examinations.

A sick person is given a referral to a biochemical and clinical blood test and urinalysis. An experienced laboratory assistant identifies the Rh factor and blood type of a sick person.

In some cases, the patient’s blood is examined for the presence of hepatitis and the human immunodeficiency virus.

Before coronary angiography, you must visit the following rooms:

  1. Electrocardiogram;
  2. Ultrasound using a special scan;
  3. X-ray of the internal organs of the sternum;

Before conducting angiography, the patient must follow a number of strict rules:

  • You can not eat and drink a few hours before the coronary angiography;
  • You must take with you to the medical facility all the medications that you drink constantly;
  • Early in the morning on the day of the procedure, before taking medications, you need to consult an experienced doctor;
  • If you have an allergic reaction, be sure to inform your doctor about it;
  • Before the procedure, you need to go to the toilet in a small way;
  • It is necessary to take off jewelry and glasses;
  • If you do not wear glasses, but lenses, then they must also be removed.

Before undergoing this procedure, you must seriously prepare under the supervision of highly qualified specialists. Next, we will tell you how to make coronary angiography of the heart, what it is and how to transfer it favorably.

This procedure is given not only in elite centers, but also in ordinary hospitals.

Here’s how this procedure goes:

  1. The femoral artery is punctured accurately in the inguinal zone;
  2. Through it, an extremely thin plastic catheter is introduced into the human heart;
  3. A special substance is slowly introduced into the thin tube – an iodine-based contrast fluid;
  4. This substance allows the doctor, using a special device that transmits a clear display on the display, to see what happens in the arteries and veins of a sick person.

During the study, the physician assesses the condition of the arteries and accurately determines the points of vasoconstriction.

Coronarography provides an excellent opportunity to scrupulously examine any part of the blood vessels and be able to make the necessary conclusions. And this, first of all, depends on the skill of medical personnel.

In the end, the positive result of treatment depends on how correctly the specialist conducts this procedure.

  • Future patients must with all responsibility approach the choice of a medical institution in which they will do this procedure.

It must be understood that, like various other procedures on the arteries and heart, coronography in rare cases can have negative consequences for a sick person. However, serious cases are quite rare.

Serious complications after coronary angiography can occur in the form of:

  1. Heart attack;
  2. Heart rupture;
  3. Separation of blood clots, leading to cerebral hemorrhage;
  4. Various arterial injuries;
  5. Change in heart rate;
  6. Severe allergic reactions to drugs used during the procedure;
  7. Various infections;
  8. Kidney damage;
  9. Strong x-ray exposure;
  10. Heavy bleeding.

There were no absolute contraindications for this procedure by experienced physicians. However, there are some limitations to coronary angiography.

Coronary angiography of the heart vessels is prohibited for people with these diseases:

  • With serious ailments of the circulatory system;
  • With a disease of the genitourinary system;
  • Patients with heavy bleeding;
  • Patients with high fever
  • With serious lung diseases;
  • People with high blood sugar;
  • Examination for elderly patients is prescribed exclusively by an experienced expert.

In the twenty-first century, medicine has taken a step, far ahead just a couple of years ago to science, such studies were unknown, but today thanks to such techniques thousands of lives have been saved. In this article, we described the procedure as detailed as possible under the name “heart coronary angiography”, what it is and with what method doctors conduct it in clinics and hospitals.

In order to prevent sudden troubles that are fraught with cardiovascular diseases, it is necessary to take them under control.

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Timely examinations will help you not to miss dangerous moments and take the necessary measures.

About the consequences, about what it is, coronary angiography of the blood vessels of the heart, its consequences, price and patient reviews about it – all this and not only we will talk in this material.

Coronary vessels are responsible for the nutrition of the heart muscle. It depends on their condition whether this function will be complete.

  • To find out if there are obstacles for delivering food through the blood to the myocardium caused by insufficient functioning of the coronary arteries, a procedure called coronarography is performed.
  • Elena Malysheva will tell in detail about what coronarography is:
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Who is she appointed

The study is done in connection with the acute condition of the patient (myocardial infarction) or in the form of a diagnostic check.

Recommended for patients with such problems:

  • if drug treatment fails,
  • in preparation for the operation,
  • when there are signs that insufficient supply of heart muscle occurs.
  • is there a narrowing of the channel in the arteries,
  • localization of problem areas,
  • the nature of the pathology,
  • the size of the area that has a narrowing: the length and degree of reduction in clearance.

Due to the fact that the patient is under the influence of ionizing radiation during the manipulation, the event is carried out, if necessary, which is determined by the doctor.

Types of diagnostics

  • Intravascular diagnostics that use ultrasound – the method is rarely used.
  • CT coronary angiography is a non-invasive method for checking the condition of coronary vessels. The method is modern, but not every medical institution has the necessary equipment. It is carried out using computed tomography using electrocardiographic synchronization. The method has the ability to give high accuracy results.
  • A method that applies catheterization. The method is called selective interventional. This diagnostic method is the first option that was developed to study the coronary vessels. Today it is widely used. Unlike other diagnostic methods, simultaneous implementation of therapeutic measures is possible. If the goal is only diagnosis, then the invasiveness of the method can be attributed to its shortcomings.
  • MR-coronarography is a method that is not used in medical institutions, but more in scientific research. The methodology for evaluating the results is not developed sufficiently to obtain an accurate analysis.
  • specifying diagnostics of the state of coronary vessels and heart on the eve of surgical intervention,
  • inspection of the status of previously installed stents and shunts,
  • the need for coronary angiography to determine the possible presence of narrowing of the coronary arteries to confirm coronary artery disease;
  • bouts of pain in the sternum,
  • myocardial infarction – the procedure is carried out urgently;
  • comprehensive measures for the diagnosis of heart diseases associated with coronary and other vessels of this area;
  • the presence of symptoms that indicate malnutrition of the myocardium;
  • coronary disease, which manifests itself little;
  • cases when the treatment of angina pectoris by taking medication does not bring the expected result;
  • other heart studies have shown the possibility of coronary artery disease,
  • revealed that the patient has a rhythm disturbance to a dangerous degree;
  • if the patient suffered a heart attack and he has bouts of angina pectoris.

Coronarography is not done in case of:

  • if the patient has a contrast agent that causes allergies,
  • the patient’s condition makes it impossible for him to cooperate with the doctor during the procedure,
  • the patient carries a child.

The following chapter will talk about possible complications and consequences after coronary angiography of the heart vessels.

Is the method safe

CT coronary angiography is a safer way. The listed complications when performing diagnostics in this way are impossible.

MSCT coronarography

The full name of CT coronary angiography is multispiral computed tomography aimed at examining coronary vessels. However, this procedure also helps to examine other important elements of the cardiovascular system – for example, the valves of the main muscle of the body.

The disadvantage of CT coronary angiography of the blood vessels of the heart can be called the fact that not every medical clinic performs the procedure. It is connected with the fact that a high-speed multispiral computed tomograph is needed for the examination. Another condition is that the device must be at least 32-slice so that coronary angiography is possible. Such a specific technique has a corresponding cost.

How is a CT coronary angiography of the heart vessels performed? The beginning of the event is standard – the specialist fills the patient’s test vessels with a contrast agent. In the vast majority of cases, they are various iodine solutions. Then the patient rests on the couch under the tomograph, and the doctor takes the necessary pictures with the help of the apparatus.

As you can see, the study is extremely simple and quick, requiring no specific preparation or hospitalization. If the pictures are relatively good results, then after the procedure, the patient can go home, return to normal life. Because of this, many people prefer computed tomography to the methods listed above.

Prepare

High-quality equipment and contrast medium are the main conditions for successful CT-coronography of blood vessels. However, special preparation of the patient for the procedure is no less important.

Judging by the reviews of CT coronary angiography, these are completely uncomplicated events:

  • A blood test taken no earlier than two weeks before the date of the CT scan. The doctor needs indicators for creatinine and urea to determine the possibility of using a contrast medium.
  • The CT procedure itself takes place on an empty stomach.
  • Before the examination, the patient must remove all metal objects – jewelry, clothing items, piercings, etc.
  • If he takes any medications, it is necessary to notify a specialist about this before the procedure.
  • If the heart rate exceeds 60 ular / min, then medication will be required, which will slow it down. Otherwise, this fact will be a serious obstacle to conducting a qualitative study.
  • Although CT coronary angiography in most cases is a fairly complete procedure for planning heart treatment, other examination results may still be required. For example, ultrasound, magnetic resonance imaging of an organ.

Before the appointment of coronarography, it is necessary to undergo a series of examinations in order to exclude or confirm the presence of factors that do not allow using this diagnostic method. Training Program:

  • blood tests (total, for sugar, for hepatitis B and C, bilirubin and other liver indicators, for HIV, for RW, for group and Rh factor);
  • urinalysis for renal pathology;
  • ECG in 12 leads;
  • examination and conclusion of specialists in existing chronic diseases.

Assuming manipulation, direct preparation is carried out before the procedure:

  • the doctor cancels certain medications in advance, for example, reducing blood clotting;
  • exclude food intake on the day of diagnosis – in order to avoid complications in the form of vomiting, the study is carried out on an empty stomach;
  • the doctor collects an allergic history, conducts a test with a contrast agent.

Immediately before coronarography, it is recommended to take a shower, shave hair in the groin, remove jewelry from the body (earrings, rings, piercings), glasses, removable dentures, lenses, use the toilet.

The main advantages of the procedure

Now we know what it is – CT coronary angiography. We highlight its important advantages that patients note in their reviews:

  • Almost complete absence of invasiveness – procedures associated with any medical penetration through the protective barriers of the body – mucous membranes, skin integuments.
  • The ability to conduct a comprehensive detailed examination of the coronary vessels without hospitalization.
  • Relatively fast procedure.
  • The ability to identify hidden pathologies. Such, for example, as a vascular stenosis.
  • The ability to determine the type of atherosclerotic plaques at an early stage in the development of pathology is soft or calcified formations.
  • Evaluation of the correctness of the imposition of shunts, walls, control over them after some time after the operation.

It is noted that CT coronary angiography of the heart is periodically prescribed to specialists whose work is associated with constant nervous overvoltages, loads on the heart – without consequences for their health. In addition, this event is not prohibited to carry out even with an acute form of myocardial infarction.

MRI coronary angiography of the vessels of the heart – indications of how

  • Contractility assessment
  • Evaluation of perfusion alone
  • Stress perfusion assessment
  • Delayed contrast assessment

MRI coronary angiography for heart attack is impractical, because if a heart attack occurs, urgent diagnostic and therapeutic measures are needed, and MRI is a lengthy study, unacceptably long in this case. CT angiography, which takes only a few seconds, is ideal in this case.

The purpose of MRI is to assess the state of the arteries of the heart, their stenosis and spasm, structural features, variations in location and branching, as well as a change in their condition after exercise and / or a combined violation of the blood supply to the heart muscle under exercise conditions.

Advantages of non-contrast research in cinema mode:

  • Visualization of myocardial movements
  • Visualization of turbulent and pathological blood flow
  • High contrast between the tissue and the cavity structures of the heart
  • No need to use contrast media
  • Obtaining functional data (PV, LV volume, myocardial mass and others)

The benefits of contrast research:

  • evaluation of delayed myocardial contrast accumulation
  • identification of myocardial akinesis zones (lack of movement)

MRI is a completely non-invasive procedure, most often it does not even require the use of gadolinium-containing contrast.

Most often, coronarography is performed without preparation and there are no contraindications to it. Difficulties can occur in patients with an unstable heart rate or heart palpitations.

The fact is that in order to avoid artifacts from heart contractions, scanning should be carried out at the moment when the heart is at rest. Such a moment occurs in diastole, and it is then that the tomograph makes a cut. For this, an ECG is performed in parallel, which is synchronized with the scanner.

If the patient has the wrong rhythm or pulse more than 65 beats per minute, then ECG synchronization becomes impossible.

In cases where an assessment of delayed contrast is necessary, a paramagnetic contrast agent, for example Omniscan, is administered at a dosage of 0,2-0,4 ml / kg with a bolus (simultaneous) injection at a rate of 2-4 ml per second.

MR studies are contraindicated in the presence of the patient:

  • Pacemakers and lead wires of pacemakers, hearing aids
  • Vascular clips
  • Artificial heart valves made of ferromagnetic materials
  • Other prostheses and metal implants (stents, knitting needles, shrapnel, intrauterine devices, reinforcement with gold threads, metal particles in the eyes, etc.)
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The likelihood of complications during an MRI scan is greatest in the following patients:

  • Claustrophobic prone or epilepsy-prone
  • With increased risk of heart failure
  • Those who have taken strong doses of sedatives or who are insane or unconscious with whom it is not possible to maintain contact

When choosing a center where coronography is done in St. Petersburg / Moscow, select centers only with high-field scanners.

Reliably accurate vascular examination is available only on devices with a capacity of at least 1,5 T.

Coronography can be done on an open device, but in this case, the mandatory use of a contrast medium is necessary, but even in this case there is no guarantee of a full assessment of the features of perfusion.

The patient lies on a special table. Heart sensors are attached to his chest. In the area of ​​catheter insertion, local anesthesia and skin disinfection are performed. In Vienna, a micro incision is made through which a catheter is inserted.

A catheter is passed through the vessels under the control of an angiograph to the mouth of the coronary arteries. Alternately, a contrast agent is introduced into each of them, which outlines the inner space of these vessels. Shooting and fixing from different positions. The place of stenosis or occlusion is determined.

During the operation, the patient is conscious, his condition is monitored by observing the appearance,

and his verbal behavior.

Upon completion of monitoring, the catheter is carefully removed from the vein. The wound is carefully sutured. The patient still remains for some time, and the doctor writes a conclusion. It indicates the size of the smallest gaps in the vessels, the degree of narrowing, and the recommended method for correcting the situation – stenting or heart bypass surgery. In the absence of problem areas, a general description of the coronary arteries is given.

Coronary angiography: appointment and indications for

When conducting diagnostics, a special contrast is introduced into the vessels to obtain a clear radiograph.

A coronary angiography is prescribed for diagnosis in cases of suspected coronary heart disease, pain in the sternum, heart attack, heart failure, angina pectoris, ischemic pulmonary edema, ventricular arrhythmias, cardiopulmonary resuscitation, before surgery for heart defects.

Before coronary angiography is performed, the patient is prescribed to donate blood for a general analysis, to establish its group, to exclude HIV, hepatitis B and C viruses, to undergo an electrocardiogram and an echocardiogram. In addition, a cardiologist collects an anamnesis, identifies concomitant diseases and their symptoms. If necessary, the patient is recommended to undergo additional studies before the study, prescribe a course of tranquilizers, drugs against allergies, analgesics.

Immediately before coronary angiography, local anesthesia is performed, after which a catheter is inserted through the artery on the thigh into the coronary artery and the contrast is carried through it and they become visible on the angiograph – special equipment that allows large-format high-speed imaging and subsequent computer processing of the obtained results. Having determined the size of the vascular lesion, the patient is diagnosed and prescribed treatment.

When conducting coronary angiography of the vessels, the condition of the patient is monitored by an anesthesiologist, a cardioreanatologist, who, if necessary, can provide emergency assistance to the patient. The risk of complications during coronary angiography of the heart is minimal, but there are still known cases when bleeding in the puncture area was discovered during the procedure, the heart rhythm was disturbed, coronary artery thrombosis, heart attack, allergy to contrast (itching, swelling, rash, breathing problems, decrease in pressure, anaphylactic shock).

In some cases, the doctor, after consultation with the patient, decides to do a coronarography simultaneously with the treatment procedures: stenting and balloon dilatation.

The patient is restored after coronary angiography of the heart only one or two days, because the procedure is less traumatic.

Most often, coronary angiography is performed in a hospital as part of a routine examination for coronary artery disease. In this case, all tests are taken here, a few days before the intervention.

Diagnostics is also possible on an outpatient basis. But the patient must first independently go through all the examinations on the list, get a cardiologist’s opinion on the possibility of coronary angiography and referral to it indicating the purpose of the study.

On an outpatient basis, the introduction of a coronary angiography catheter is most often performed through the wrist vein and in the arm, in the postoperative period, the load on it, unlike invasion through the femoral vessel, can be minimized in order to avoid dangerous bleeding.

Puncture for coronary angiography of the heart vessels

The procedure is performed under local anesthesia. The average duration of the procedure is about half an hour, during which the patient is conscious. For the study, one of the 3 arterial approaches is usually used: the radial, brachial, or femoral artery. First, aseptic access processing is performed and local anesthesia is performed in the puncture area.

The introduction of contrast is necessary so that the coronary vessels are clearly visible on x-ray or computed tomography. The inner lumen of the artery is stained with this drug, supplied with a blood stream, so that the doctor sees the place and degree of narrowing of the vessel. Already at this stage, the cardiac surgeon determines whether there are indications for coronary stenting surgery.

For example, if critical stenosis is detected as a result of coronary angiography of the heart vessels, a stent can be implanted right away and patency of the coronary arteries can be restored. The results of coronary angiography are displayed as a series of images or videos on the monitor, which are then stored on any digital medium. Coronary angiography of the blood vessels of the heart can be performed both on an X-ray machine, and on a more modern, progressive computed tomograph.

Preventive examination

We have examined the above cases in which computed tomography of the coronary vessels of the heart is mandatory. For example, for making an accurate diagnosis, assessing the patient’s condition, eliminating the fact of pathogenic changes, planning a specific treatment.

However, there are a number of cases where this procedure is not required, but is advised in the form of effective prevention of serious diseases. After all, the fact is that this examination is able to determine the pathology at an early stage, when it can be completely cured without harm to the body.

CT coronarography in this case is shown to patients, which belong to the so-called risk groups:

  • By age. Men over 40 years old, women over 45 years old.
  • In the way of life. Obesity, weight problems, poor diet, constant emotional stress, nervous strain, hard (physically, emotionally, mentally) work, smoking, addiction to alcohol.
  • For diseases in the medical history. Past stroke, consistently high blood pressure, diabetes mellitus, high levels of “bad” cholesterol, vascular disease, hereditary predisposition to cardiac pathologies.

Contraindications to coronarography

Here is a list of those for which the survey is strictly prohibited:

  • Pregnancy at any stage – both waves and contrast are harmful to the baby.
  • Calcification affecting the coronary vessels.
  • Individual intolerance to iodine – the main component of a contrast medium.
  • Hepatic, renal failure.
  • Severe stage of diabetes.
  • Arrhythmia.
  • Tachycardia.
  • A number of thyroid diseases.
  • Ventricular arrhythmia of an uncontrolled type. A specialist allows CT to be performed only when the disease is transferred to the category of controlled ones.
  • A history of cardiac glycoside intoxication.
  • Hypokalemia of an uncontrolled form.
  • High body temperature.
  • Uncontrolled hypertension.
  • Endocarditis is an infectious form.
  • Pathological processes associated with poor blood coagulation.
  • Some diseases of the internal organs.
  • Decompensated heart failure.
  • uncontrolled arterial hypertension – the intervention can provoke stress, as a result, a hypertensive crisis is possible;
  • post-stroke state – excitement can cause a repeated attack of the disease;
  • internal bleeding in any organ – with invasion, blood loss may intensify;
  • infectious diseases – the virus can contribute to thrombosis at the incision site, as well as exfoliation of areas on the walls of blood vessels;
  • diabetes mellitus in the stage of decompensation is a state of significant kidney damage, high blood sugar, the possibility of a heart attack;
  • fever of any origin – concomitant high blood pressure and heart palpitations can lead to heart problems during and after the procedure;
  • severe kidney disease – a contrast agent can cause organ damage or aggravate the disease;
  • intolerance of a contrast medium – on the eve of diagnosis, a test is performed;
  • increased or decreased blood coagulability – can cause thrombosis or blood loss.

With preliminary preparation, all these conditions are detected, and treatment is prescribed to compensate for them. There are no absolute contraindications to the procedure. After stabilization is achieved, the procedure can be carried out in stationary conditions.

With caution, coronary angiography is prescribed for elderly patients, with significant fluctuations in weight, untreated renal failure, diabetes mellitus, serious lung diseases.

A contraindication to coronarography is the presence of an allergy to a contrast medium, therefore, before surgery, it is advisable to undergo an allergic test for the dye used.

In addition, it should be noted that a side effect of using contrast on coronarography can be not only allergies, but also impaired renal function, which is necessarily taken into account when examining patients with heart failure, chronic renal failure, and severe diabetes mellitus. This group of patients is recommended to prepare for the procedure in a hospital setting.

Coronary angiography of the heart vessels: price, consequences, patient reviews

A pre-procedure examination is designed to prevent these conditions, but sometimes this happens. Doctors participating in the examination cope with the situation, the procedure stops at the first adverse signs, the patient is taken out of a dangerous condition and transferred to a hospital for observation.

Appointments after the study

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

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.

Coronary artery stenting

This research method is recommended for patients who have problems with the vessels of the heart, when necessary:

  1. Confirm the presence of heart disease: angina pectoris, heart attack, other forms of ischemic heart disease;
  2. Determine the function of the vessels and their patency in order to choose the most correct tactics of the proposed surgical treatment on the vessels of the heart, as well as before performing any heart surgery. In addition, minimally invasive interventions, for example, stenting, can be performed during coronarography, if necessary. Any suspected interventions should be performed only with the consent of the patient;
  3. Coronary angiography is performed in case of acute myocardial infarction, in which thrombolysis is ineffective if less than 12 hours have passed from the onset of myocardial infarction, with severe hemodynamic disturbances of unstable angina
  4. Repeated resumption of angina pectoris, its relapse, after CABG surgery, stenting.

Coronary angiography methods

  1. General coronary angiography,
  2. Selective coronary angiography,
  3. MSCT coronary angiography.

Let’s talk about how the same method of checking heart vessels differs from each other in essence.

General coronary angiography is a classic diagnostic method for all heart vessels. And selective – only one or more vessels. Selective coronarography is a kind of modification of the general, it studies specifically a specific section of the vascular bed.

MSCT coronary angiography is performed only in diagnostic centers equipped with the necessary equipment – a special multi-helical computed tomography scanner.

This examination method has many advantages:

  • administering only an intravenous catheter to administer contrast. The integrity of the arteries is maintained, which ensures minimal interference with the structure and integrity of the vessels;
  • MSCT coronary angiography does not require hospitalization of the patient, it is possible to conduct an outpatient study;
  • the heart and blood vessels are visible in a three-dimensional image, which makes it easy to study all kinds of disorders from any position.

This research method is an alternative to standard coronarography, but has certain limitations and contraindications. Namely:

  • pronounced arterial calcification (calcium “illuminates” a section of an artery on the device, which makes it difficult to diagnose heart vessels);
  • intolerance and allergy to contrast, which includes iodine;
  • high heart rate, arrhythmias.

This method is widely implemented in large medical centers and, I want to believe, will become more accessible even for small clinics and district hospitals.

According to the conclusion of the doctor who conducted the study, the cardiologist determines the treatment of the patient. If there is evidence, the time for stent placement is assigned (in the same way as coronary angiography using a catheter).

Sometimes this procedure is carried out directly during the diagnosis, if there is prior consent of the patient. A cardiologist may also prescribe an outpatient treatment or coronary artery bypass surgery.

Diagnostic cost

Coronary angiography of the heart vessels

Many patients are afraid to undergo coronary angiography of the heart vessels. For many of them, this procedure is associated with heart surgery. It should be clearly understood: coronarography is a diagnosis of the coronary vessels of the heart, not an operation! She should not be afraid. In the hands of an experienced doctor, this diagnostic procedure becomes quite safe, affordable.

Coronary angiography of the heart vessels gives maximum information about the real state of the patient’s blood vessels at a given time. This research method is rightly called the “gold” standard for the diagnosis of heart vessels, and if the doctor recommended coronary angiography, you need to do it without fear and keep up with 21st century medicine.

If there is a compulsory medical insurance policy, coronary angiography according to indications is free. But the equipment of most hospitals does not allow everyone to be reached with this diagnostic method in a short time. Usually the queue lasts for months, as survey quotas are limited. It is possible to go through this study on a commercial basis.

Cost in Russia is in a wide range – from 10 to 45 thousand rubles. Abroad, this intervention is also not always covered by insurance and is also not cheap – from 300 dollars to 2500 euros.

Coronarography is included in the mandatory list of diagnostic procedures to determine the degree of damage to the heart vessels. The procedure has been worked out and standardized for a long time – this serves as a guarantee of patient safety. The level of cardiology in the country allows you to identify pathology at an early stage and take measures to eliminate it or prevent development.

How is the procedure?

Thus, non-invasive computed tomography of the coronary arteries can be performed in any medical clinic with 32-slice (for more accurate results, of course, better with 64-slice) equipment.

The approximate sequence is as follows:

  1. One hour before the event, the patient takes a drug that will somewhat slow down his heart rate. This is necessary to obtain more accurate pictures.
  2. The patient is given an intravenous catheter through which a contrast agent is injected.
  3. A man on a couch is placed under the examination area of ​​a computer tomograph.
  4. At a time called diastole (a relaxed state of the heart muscles), the equipment takes the necessary pictures. The period necessary for this is monitored using an electrocardiogram.
  5. During the examination, the patient must clearly comply with the recommendations of a specialist, because this method is extremely sensitive to the frequency of heart contractions.
  6. At the end of the procedure, the patient is given a disc with pictures recorded on it. The specialist gives advice on pathologies identified during the diagnosis.
  7. With a conclusion on the procedure, a disc with recorded information should contact your doctor.

Thus, CT coronary angiography is today the most comprehensive, safe and fastest method among such diagnostic methods. Another plus is the ability to detect cardiac, vascular pathologies at an early stage. The disadvantage of the procedure will be the non-proliferation of the necessary equipment in clinics, the price is from 8000 to 25 rubles.

Appointments after 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.

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.

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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