How to check the vessels of the heart – All about the heart

Coronary angiography (or coronary angiography) can be planned or it is performed urgently (urgently).

Indications for urgent coronary angiography:

  • worsening in the postoperative period (the appearance of chest pain, visible abnormalities on the ECG, increased marker enzymes);
  • progressive angina pectoris;
  • acute coronary syndrome.

Indications for elective coronary angiography:

  • the appearance of prolonged and periodic pain in the chest area, which is given to the scapula, lower jaw, left arm and shoulder (direct indication);
  • cardiac death;
  • angina pectoris (class III or IV caused by certain drugs, chronic ischemic heart disease in patients at high risk of myocardial infarction);
  • differential diagnosis of heart muscle disease;
  • upcoming open heart surgery;
  • post-infarction pain;
  • professions associated with constant risk (pilots, firefighters, drivers, etc.).

Coronary angiography – operative examination. It, like any intervention, has a number of contraindications.

There are no absolute contraindications to the procedure. However, it is not recommended to carry it out in case of fever or the presence of symptoms of intoxication (nausea, vomiting, weakness, etc.), in the acute course of some diseases (diabetes, heart and kidney failure, lung diseases).

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The injected substance can cause allergies, so the doctor must make sure that the subject does not have such a reaction to contrast.

The above contraindications are relative, therefore, it is possible to conduct such a diagnosis, but after normalizing the condition.

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According to statistics, diseases of the cardiovascular system occupy a leading position for the causes of death in the world. Such ailments affect mainly representatives of the working population, which is associated with constant overload of the body and chronic stress.

In time, the “sprouts” of cardiac pathologies can be detected in a relatively young procedure called coronary angiography of the heart vessels. But before resorting to her help, it is worthwhile to carefully study the consequences of coronarography. This knowledge will minimize the likelihood of an adverse outcome.

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Risk Factors

What is coronarography and what are the consequences of coronary angiography of the heart vessels? This is, first of all, an invasive procedure that allows you to assess the state of the blood vessels of the heart by introducing into the body a special contrast agent that stains the arteries in a special color at the time of the examination. When it comes to “penetration” through the protective membranes of a person (in this case, through the skin), one brief but important rule should be mentioned: “such an intervention is always associated with a risk that is insignificant to health and poses a potential danger to life”.

In some cases, the likelihood of complications increases significantly. A special group of risk factors combines such ailments as:

  • allergic reaction to the contrast injected;
  • serious condition associated with the psyche or somatics;
  • pregnancy;
  • atrial fibrillation (disturbance of the heartbeat with frequent contraction and arousal of the atria);
  • hypokalemia;
  • frequent extrasystole;
  • renal and heart failure;
  • fever;
  • hemophilia, anemia and other forms of bleeding disorders;
  • poisoning with special cardiac glycosides;
  • old age of the patient;
  • diseases of the cardiovascular system;
  • diabetes mellitus and stroke;
  • exhaustion or significant overweight;
  • severe lung disease, such as pulmonary failure;
  • heart ailments;
  • coronary calcification (deposition of calcium salts in valve cusps and near the walls of arteries).

If a patient belonging to a risk group should undergo urgent coronography, then the procedure is carried out under the scrutiny of a team of doctors. Within one day after the diagnosis, special monitoring of the ECG (electrocardiogram) and hemodynamics (blood movement in the vessels) is performed.

It is worth noting that the likelihood of complications is approximately 0,05-0,2%. A fatal outcome occurs in less than 0,08% of cases. More detailed information on risk factors and other indicators of coronography is presented in this article.

In order to mentally prepare for coronary angiography and assess the degree of risk, it is necessary to familiarize yourself with the most common complications according to medical statistics.

Nephropathy

Sometimes a decrease in blood pressure during diagnosis or certain components of a contrast medium provoke kidney damage, which in most cases disappears after about 1–1,5 weeks. Rarely there is an acute failure requiring hemodialysis – blood purification outside the kidneys.

After coronary angiography, a small area of ​​redness appears in the area of ​​puncture of the artery, corresponding discharge from the resulting wound, and in some cases the body temperature rises. Similar infection is observed in less than 1–0,8% of patients. For prevention after medical intervention, avoid getting water at the puncture site for 2-3 days.

Unlike the vast majority of other coronary angiography complications, respiratory failure can occur for a number of different reasons, ranging from an allergic reaction to pulmonary edema.

The cause of the allergy is the preservatives that make up the contrast agent. At the same time, in some people this reaction will be expressed in the form of a skin rash, and in others – in the form of anaphylactic shock. To prevent such an outcome, it is worthwhile to warn doctors in advance of an allergy to any drugs and food products, especially seafood.

Artery dissection

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A rare phenomenon is associated with the penetration of blood into the region located between the shells of the vessel wall. If stratification is not prevented, it will lead to blockage of blood flow, which carries a potential danger to the patient’s life.

This type of effect is considered the most common. It is expressed in the form of profuse bleeding from the puncture site, because the procedure is carried out in the cavity of the artery, in which relatively high blood pressure is observed. Stopping blood from such a large vessel is quite difficult, especially if the puncture was injected into the inguinal artery.

In this situation, we are talking about cerebral hemorrhage caused by the blocking of blood vessels by air particles or blood clots. It is observed, as a rule, in patients subject to high blood pressure, diabetes mellitus and renal failure.

A hematoma is formed when blood leaves the femoral artery to the front of the thigh. The vast majority of formations is not harmful to patients, but large formations associated with severe blood loss sometimes require transfusion.

First you need to choose the specialists who have to carry out the invasive procedure. It is worth examining the information regarding their competence and skill level. This is perhaps the most important point of preparation.

To prevent infections in the area of ​​catheterization, it is recommended to remove hairs in the forearm or groin (depending on the place chosen by specialists) with an electric shaver. Its use will avoid damage to the surface of the epithelial layer.

It is highly advisable to take a shower the day before the diagnostic procedure. After 00:00 hours, immediately before coronography, you should not eat food and drinks. Only a reasonable approach to the upcoming diagnosis will reduce the likelihood of dangerous side effects.

Despite the fact that coronary angiography is one of the most indispensable methods in modern diagnostics and many experts consider this procedure the most safe for the patient, in practice, the various consequences of coronarography are manifested.

The probability of mortality after surgery is 1 -1,5 out of 1000 people. The percentage of possible complications is 0,05% -0,2%.

The risk group for complications after coronary angiography includes mainly elderly people from sixty years old and the younger age group – children under 16 years old.

Despite the fact that the probability is very small, complications after surgery are extremely serious. Coronary angiography complications include damage to the skin, possible allergic reactions (including contrast medium), and other complications more frequent in disease statistics, such as:

  1. Myocardial infarction. Fatal outcome of 0,5 per 1000 people. Older people, overweight patients, smokers and alcoholics, people with high cholesterol, as well as patients with diabetes mellitus are most susceptible to it. Myocardial infarction entails heart failure and arrhythmia.
  2. Disabling complications. Fatal outcome 0,4 per 1000 patients. These consequences of coronary angiography include: heart rhythm disturbances, conduction, vascular and capillary disease; disturbances in the functioning of nerve cells and damage to the human peripheral nervous system.
  3. Vascular complications. Fatal outcome of 0,6 per 1000 patients. The appearance of scars on the vessels, their narrowing refers to this ailment. Vascular complications most often affect the older population. Since in the process of aging of the human body, vessels are more susceptible to various diseases.
  4. Transient ischemic attack. With an ischemic attack longer than a day, it is classified as a stroke. Most often observed in patients with myocardial infarction and disorders of the valvular apparatus of the heart.
  5. Heart rhythm disturbances (arrhythmia). Most often, this disease affects children due to overexcitation or fear. Such a complication can be observed in a person without pathologies, so doctors can not find out about arrhythmia in advance.
  6. Violation of the skin after coronography is not uncommon. Patients complain that they have a sore arm or leg, and a hematoma has formed. With coronarography, the contrast agent is most often administered through the inguinal vein or brachial artery, so the pain is localized by puncture. A hematoma forms on the joints. The most serious is a symptom in which the hand seems to be “taken”. In this case, it is urgent to contact a surgeon for referral to an ultrasound and subsequent procedures. Often, coronary angiography results in bleeding at the puncture site, even after removing the bandage and weight.
  7. Allergic reaction. Most often, the radiopaque substance is iodine. Possible runny nose and sore throat, lacrimation, as well as urticaria or rash.

What abnormalities can coronary angiography reveal?

The invasive diagnostic method, in contrast to safer species, is characterized by a high degree of visualization and accurate indicators. Diseases diagnosed with coronary angiography include:

  • atherosclerosis (cholesterol plaques) and thrombosis;
  • hypercalcemia (deposits of calcium salts in the vascular wall region);
  • endocarditis (inflammation of the inner heart membrane);
  • cardiac ischemia;
  • arteritis (inflammation of the arterial walls);
  • vasospasm or consequences of a chest injury;
  • diabetes;
  • congenital abnormalities;
  • fibromuscular dysplasia.

Coronarography is a study of the blood vessels of the heart, allowing you to see the inner contour of the blood vessels of the heart on a radiograph. Most often, this method is not used to make a diagnosis, but to determine the tactics of surgical treatment – i.e. doctors can determine if surgical treatment is possible and choose the most preferred type of surgery.

What is ischemia (angina pectoris)? How is angina manifested.

The medical wording of this term can be found here.

Coronarography, a serious procedure, during which no less serious complications are possible, for the convenience of perception, the complications are indicated in the table

Frequency per 1000 studies

stenoz - How to check the vessels of the heart - All about the heart

Disabling Neuralgic Complications

Passing neuralgic complications (transient ischemic attack)

Dangerous heart rhythm disturbances (including life-threatening)

Vascular complications (hematomas, bleeding, etc.)

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After coronary angiography, the patient is transferred to the ward under the supervision of the staff on duty, perhaps there will be a need for observation in the intensive care unit. If there were serious complications during the procedure, then the patient can be placed in the intensive care unit.

In some cases, when there is no confidence in the indications for coronary angiography, the doctor may recommend you to perform a multispiral computed tomography of the heart, where the blood vessels of the heart will be visualized. This study is not a complete alternative to CAG.

Coronary stenting. Indications. Operation description. Os.

Preparation and execution technique

Before coronarography, the doctor explains to the patient the essence, purpose, possible complications and side effects of this procedure. Before performing coronarography, the patient is assigned the following examinations:

  • clinical blood test;
  • determination of blood type and Rh factor;
  • blood coagulation test;
  • blood chemistry;
  • blood tests for hepatitis B and C, HIV;
  • ECG in twelve leads;
  • Echo-KG;
  • Stress Echocardiography;
  • Treadmill test.
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With concomitant diseases, such as diabetes and hypertension, additional examinations and consultations with doctors of other specialties are prescribed.

The patient must inform the doctor about the presence of allergic reactions to iodine-containing drugs, chronic diseases and previously prescribed drugs.

Before coronarography, it is also necessary to shave the wrist areas on the right hand or inguinal region.

The results of coronary angiography of the heart are usually ready on the same day in the form of a protocol and video recording on disk.

In order to reduce the likelihood of a life threat to a possible minimum, you need to pay special attention to the preparatory phase.

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It is allowed to drink clean water until about 4 in the morning, then you should refrain from consuming liquids to avoid the appearance of a “special” desire at the time of the procedure

Doctors strongly recommend that at the time of the consultation with the attending physician inform him of all possible forms of allergies to both products and medications and substances, coordinate the use of medicines with a specialist. 24 hours before the study, increase the amount of clean water consumed to 2,5–3 liters, eat food for the last time until 10–12 o’clock immediately before diagnosis.

One day before the momentous event, take a contrast shower and remove hair from the proposed puncture site; before coronography, various decorations must be removed.

The attending physician can tell about how heart coronarography is done. The procedure is a minimally invasive procedure and requires preliminary preparation. Before hospitalization, a general blood test is required, a blood type and Rh factor are checked, additional examinations can be prescribed.

The day before the procedure, it is forbidden to eat food, so as not to cause vomiting and nausea during diagnosis.

The patient is taken to the office of x-ray endovascular surgery. Since the manipulation is done under local anesthesia, the person is conscious. The next step is piercing the artery. Typically, the femoral artery is pierced in the groin area, but in case of difficulties with the administration of the substance, the puncture is performed through the radial artery of the arm.

After this, a catheter is introduced, which is a plastic tube. The surgeon directs her to the coronary arteries. A person has two of them (left and right), therefore two catheters are inserted and a special contrast medium is introduced through them. It fills the entire space of blood vessels, which makes it possible to visualize them. Using a X-ray machine, the doctor takes pictures in various projections and estimates the patency of the arteries using them.

If no further surgery is planned, the catheter is removed. The puncture site is either sutured or glued, and sometimes a special dressing is applied. The duration of diagnostic coronary angiography is 15-30 minutes, and the treatment one is an hour or longer.

The subjects do not feel anything during the procedure. If this is not the first time, there may be an unpleasant feeling in the place where the painkiller was injected, since the drug may act worse. The cost of manipulation is quite high, but in connection with the diagnostic value is quite justified.

After the examination, sparing mode is recommended. The limb into which the catheter was inserted is preferably limited in movement. Contrast agents are toxic, so heavy drinking is welcome.

In general, the effect of this method on the body is not felt, but it should be remembered that in case of a change in the puncture site (redness, pain or other symptoms), you should immediately consult a doctor.

How is coronarography performed.

The femoral artery in the inguinal area is punctured with a needle, alternative access is through the radial artery. A thin wire (conductor) is introduced through the needle into the lumen of the vessel, the needle is removed. A catheter is inserted through the conductor into the lumen of the vessel (the catheter is a thin and flexible hollow tube). A catheter on the conductor is visible during fluoroscopy.

What is acute coronary syndrome (ACS)? Sharp koro.

Under x-ray control, the tip of the catheter is installed at the mouth of the coronary artery, after which a special contrast agent is introduced, visible in x-ray radiation. A number of x-rays are taken in different projections (from different angles), which allows you to see the internal contours of the heart, the place of stenosis (stenosis) or expansion (aneurysm).

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Coronary angiography is done in an X-ray room under local anesthesia.

The technique of coronary angiography is as follows: by puncture of the radial artery on the wrist (in most cases) or the femoral artery, the left and right arteries of the heart are catheterized alternately, then the coronary arteries are filled with an X-ray contrast medium through the installed catheter and the images are taken in different projections.

Are there any contraindications to coronarography?

  • intolerance to contrast medium
  • renal failure, creatinine greater than 150 mmol/l
  • circulatory failure stage 3-4
  • uncontrolled arterial hypertension
  • decompensated diabetes
  • mental disorders
  • peptic ulcer exacerbation
  • polyvalent allergy
  • endocarditis
  • exacerbation of severe chronic diseases

in each case, the doctor will discuss with you the likely risk and the expected benefits of the procedure.

  • hypersensitivity of the patient to iodine-containing substances or drugs to perform local anesthesia;
  • uncontrolled ventricular arrhythmias;
  • uncontrolled arterial hypertension;
  • hypokalemia;
  • severe heart failure;
  • high body temperature;
  • severe renal failure.

After coronarography, the result is correlated with the existing data, and the true history is restored based on the conclusion.

An angiographic study is often prescribed if the patient has: previous chest injuries, Kawasaki disease, angina pectoris, infectious endocarditis (inflammation of the inner lining of the heart muscle caused by infection), myocardial infarction, pain in the heart, pronounced shortness of breath, suspected ischemic heart disease (CHD).

Also, coronary angiography is performed to clarify the causes of the ineffectiveness of medications for malignant arrhythmias, coronary heart disease and angina pectoris.

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If the prescribed treatment for angina pectoris, coronary heart disease and arrhythmias did not have an effect, the doctor sends the patient for coronary angiography: in the case of a detailed study of the cause, it may take a longer amount of time

It is very important to remember that coronary angiography is highly not recommended for people with severe chronic illness, acute ulcers, cardiac, renal and pulmonary insufficiency, decompensation of diabetes mellitus, and blood coagulation, for example, with anemia.

  • pregnancy;
  • allergy to contrast medium;
  • diabetes;
  • hepatic or renal insufficiency;
  • uncontrolled cardiac arrhythmia (after its treatment, the procedure can be performed);
  • pathological bleeding disorders;
  • high body temperature;
  • intoxication;
  • heart failure;
  • infectious heart disease.

In acute life-threatening conditions, some contraindications are conditional (at the discretion of the attending physician and the patient’s condition). After a treatment course of certain types of pathological conditions and stabilization of the patient’s health, a study can be carried out.

Is there an alternative to CAG?

In the arsenal of modern medicine there are various methods of intravital study of the vessels of the human heart. Among the most informative are:

  • ultrasound dopplerography of blood vessels (USDG);
  • cardiography of the blood vessels of the heart with a contrast agent;
  • magnetic resonance imaging (MRI);
  • angiography of blood vessels of the heart;
  • MSCT of coronary vessels (with and without contrast).

The basis of two Dopplerography and cardiography is an ultrasound scan of the heart (ultrasound). MRI is a scan of blood vessels using a magnetic field and radio frequency pulses. The essence of angiography is in a contrast x-ray examination of the blood vessels of the heart. MSCT examination is carried out using a multispiral computed tomograph.

Coronary angiography

The method is part of angiography. The name was given because it can be used to study the coronary vessels of the heart. In the medical literature you can find another name – coronary angiography.

Coronarography is often used for coronary artery disease, because it has earned a reputation as a reliable vascular test for this disease.

In this regard, many cores and their relatives have a well-founded interest in how coronary angiography of affected vessels is performed in coronary heart disease. They are interested in the possible negative consequences that such a diagnosis of arterial vessels of a sick heart can have for human health.

Coronary angiography consists of two stages:

  • preparatory;
  • diagnostic procedure.

Prepare

The doctor should tell the person who is to undergo coronary angiography about the goals of diagnosis, the procedure for performing, and possible complications. The patient should inform the doctor about all diseases.

  1. The patient is given an electrocardiogram (ECG).
  2. It is necessary to take blood tests:
  • common;
  • biochemical;
  • clotting;
  • for the presence of a number of infections (HIV, hepatitis B and C, syphilis).

Be sure to make tolerance tests of the radiopaque drug and the drugs used in the procedure.

contraindications

With a number of diseases, coronarography can not be done:

  • It is contraindicated for people with uncontrolled hypertension, in whom stress during the coronary angiography procedure can cause a hypertensive crisis.
  • Not performed after a recent stroke to avoid repeated damage to the brain.
  • Another ban is associated with decompensated diabetes mellitus, when there are serious lesions of the internal organs and the possibility of a heart attack is not ruled out.
  • Internal bleeding or very low blood coagulation is another reason for refusing coronary angiography.
  • Renal lesions due to various diseases do not allow coronary angiography, since a sharp deterioration in the patient’s condition after administration of an X-ray contrast drug is possible.
  • High temperature also makes coronarography impossible.
  • Intolerance to the substance used for contrast during the procedure.

The procedure is performed in the operating room.

Procedure

Coronary angiography is performed on an outpatient or inpatient basis in the cardiology ward of the hospital.

  • It is done on an empty stomach, before it you need to go to the toilet to empty the intestines and bladder.
  • Shaving of those places in which a puncture (puncture) of the vessel (wrist, armpit, groin, etc.) is performed.
  • In addition to the surgeon performing the operation, a resuscitator and anesthesiologist are present in the room.
  • Before the procedure, the patient takes a sedative, so as not to worry too much and keep the heartbeat in normal mode.
  • During the operation, the patient lies on the operating table (on the back), his body is fixed, so that as a result of involuntary movement, damage to the vessel does not occur.

Access is via the femoral or radial artery on the arm

  • After applying local anesthesia, a puncture of the vessel is made, through which access to the coronary arteries will be provided.
  • An introducer is introduced into the puncture site – a tube made of plastic. A hemostatic valve is built into it to prevent backflow of blood, an additional channel for blood sampling for analysis and drug administration.
  • Through the introducer, the surgeon inserts a catheter, which moves into the area of ​​the artery to be examined.
  • After reaching the desired position, a catheter is injected with a radiopaque preparation containing iodine isotopes.

The study is displayed on a computer monitor

  • The computer on the monitor shows a shadow image of the vessel in which the radiopaque substance is present.
  • The study is done in several ways to get the most information about the state of the vessel or vessels of the heart.
  • Survey results are recorded on digital media.

A picture of blood vessels obtained during coronary angiography

  • After completing the procedure, the surgeon removes the catheter and introducer from the patient’s circulatory system and imposes a special bandage on the puncture site, which stops the blood.

Depending on the volume of the study, the duration of the procedure ranges from 20 minutes to an hour.

Modern high-tech methods for studying the blood vessels of the heart are quite safe. However, coronary angiography of the blood vessels of the heart can also have undesirable consequences, since the human body is difficult to construct, and it is impossible to foresee and calculate everything even with an experienced surgeon and perfect medical equipment.

Hematoma after coronary angiography

The most serious consequences for the heart, brain and blood vessels are:

  • myocardial infarction;
  • stroke;
  • perforation of blood vessels or the cavity of the heart.

The likelihood of a heart attack is estimated at a ratio of 1: 1000. The risk of heart attack during or after coronary angiography is higher in patients with severe lesions of the coronary arteries.

Lower probability of stroke (7 per 10000). It can occur in a patient if the movement of blood to the brain is blocked by a blood clot, a cholesterol plaque, and air.

In 3-6 cases out of 1000, perforation or stratification of the coronary vessels or aorta is possible. The likelihood of damage to the iliac or femoral artery is estimated at 4: 1000.

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Vascular injuries are dangerous in that retroperitoneal bleeding can form, in which blood gradually accumulates in the retroperitoneal space. Moreover, blood loss occurs without visible external manifestations.

Complications that do not pose a direct threat to human life are more common.

People with diabetes mellitus, with narrow lumens of the vessels on the leg, when introducing an inappropriate vessel of the size of the introducer and catheter, can develop thrombosis of the vessel of the lower extremity. In this case, additional treatment will be required – either an operation to remove a blood clot, or drug therapy.

With simultaneous needle damage to arteries and veins, arteriovenous fistula may form. Probability is 1: 100. To eliminate it, surgical intervention is required.

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Often occur at the site of a hematoma puncture. If they are small, then absorb by themselves.

Perhaps a violation of the heart rhythm during diagnosis. More often, the rhythm decreases (bradycardia). Less common are cases of increased heart rate (tachycardia) and uneven rhythm (arrhythmia).

Another common complication is a drop in blood pressure, which can cause various reasons associated with the functioning of the cardiovascular system.

It is possible that an allergy will develop in response to the administration of an X-ray substance, sedative drugs, anticoagulants or antiplatelet agents, anesthetics. Therefore, preparation for coronarography includes a thorough check of the patient’s response to all drugs prescribed for the procedure.

If the check is not done properly, anaphylactic shock is possible, which threatens the patient’s life. This happens very rarely, but more often a skin reaction (rash, itching, redness) is observed.

An organ that can be affected by coronary angiography.

In people with chronic renal failure, diabetes mellitus or advanced age, the kidneys may not respond to the radiopaque drug in the best way.

Acute renal failure may develop. Severe complications require medical attention, with a slight dysfunction, heavy drinking after coronarography is recommended.

Respiratory system

The most severe consequence is pulmonary edema. May develop due to heart failure and a severe allergic reaction. The likelihood of pulmonary edema is negligible, especially with good preparation.

Thrombocytopenia

With coronarography, heparin is used, which reduces blood coagulation. After a few days, thrombocytopenia provoked by heparin may develop. Thrombocytopenia is a pathology characterized by a decreased platelet count in the blood and increased bleeding.

Инфекции

  • The ingress of pathogenic pathogens into the patient’s body occurs at the site of the puncture of the vessel.
  • To reduce the likelihood of infection, it is better to use an electric razor for shaving before diagnosis, rather than razor blades that can leave small scratches.
  • For medical personnel, strict adherence to hygiene requirements in the operating room is mandatory.
  • After diagnosis, the puncture site can not be wetted with water for at least two days.

The easiest form of coronarography is considered when a catheter is inserted through the radial artery. If there are no complications, a person returns home in a few hours.

When access is via the femoral artery, the patient remains in the hospital for a day.

A person who has undergone coronary angiography should control well-being. If there are alarming symptoms (pain, weakness, decreased blood pressure, swelling at the puncture site), you should consult a doctor, and not expect that it will pass by itself, and not self-medicate.

Contrasting of coronary vessels is the most reliable way to choose the treatment tactics for patients with myocardial ischemia. Complications with this procedure are quite rare.

Diagnosis is associated with the introduction of a catheter into the vessels of the heart, the supply of a contrast agent through it, so it can be a potential danger to the patient.

A thorough examination and preparation is necessary to prevent undesirable consequences.

  • Since the diagnosis of coronary blood flow involves puncture of the peripheral artery of the thigh or shoulder, insertion of a catheter through it, its advancement through the aorta and coronary vessels, supply of a contrast iodine-containing substance, this may be accompanied by a negative reaction of the body.
  • The risk of complications increases if the patient suffers:
  • Depending on the stage of coronarography, it can cause such complications:
  • peripheral artery puncture – bleeding, hematoma, false aneurysm, fistula between artery and vein, stratification of the wall, thrombosis, embolism, vascular spasm, infection, allergy to painkillers;
  • contrasting – allergy, anaphylaxis, intoxication, kidney damage;
  • the introduction of heparin – a decrease in the coagulation ability of the blood and, as a result, bleeding;
  • catheter insertion – arrhythmia, embolism with parts of a cholesterol plaque, dissection of the aorta or coronary vessels, heart attack, stroke.

Risk Factors

conclusions

Coronarography makes it possible to assess the patency of arteries, and therefore is the primary method in the diagnosis of cardiac ischemia.

The method also allows you to determine the percentage of vasoconstriction, which is very important for the right treatment choice. The procedure helps to differentiate coronary diseases from myocardial pathology; without it, stenting of arteries is impossible.

Coronarography has a wide diagnostic spectrum, is a less traumatic manipulation and has a minimal risk of negative consequences, which makes it convenient to use.

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.

  • 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.

Coronary angiography

additional information

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.

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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.

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 >584712 - How to check the vessels of the heart - All about the heart

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.

How much does coronary angiography cost?

The spread in prices in commercial and state medical institutions is quite large, from 14 to 45 thousand rubles. The formation of value depends not only on the procedure itself, but also on a number of related factors. In a number of regions, coronary angiography is included in the list of services provided under compulsory health insurance.

Contrasting of coronary vessels is the most reliable way to choose the treatment tactics for patients with myocardial ischemia. Complications with this procedure are quite rare. Diagnosis is associated with the introduction of a catheter into the vessels of the heart, the supply of a contrast agent through it, so it can be a potential danger to the patient. A thorough examination and preparation is necessary to prevent undesirable consequences.

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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.

Conclusion

Each intervention in the human body has its own risks. The possibility of developing complications decreases when the patient clearly performs all the preparatory steps for a diagnostic examination.

Despite contraindications and a minimal risk of complications, coronary angiography remains one of the most informative methods for the diagnostic study of heart vessels, which saved a lot of lives.

According to experts, a doctor should be consulted when the first signs of pathology appear. It is precisely timely visits to the doctor can often avoid serious, and in some cases irreversible consequences. It should be borne in mind that the study can not be called absolutely safe. In this regard, to reduce the risk of patients need to listen to the recommendations of doctors.

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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