What is coronarography, and how is it done, should be told by the attending physician cardiologist. Before carrying out the procedure, additional methods of diagnostic examination are prescribed in a planned manner:
- blood and urine tests;
- Ultrasound of the heart;
- samples for viruses;
- consultations of doctors of related specialties (in each case individually, as necessary and to the condition of the patient).
The patient prepares for the procedure in advance: the study is carried out on an empty stomach (it is impossible to take food already in the evening after 18-00 on the eve of the procedure). As prescribed by a doctor, some patients are advised to take special medications. If necessary, the site of the future puncture is shaved.
Coronary angiography is performed by two main methods: invasively or using tomography.
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- Non invasive
- Appointments after the study
- Preparing for the procedure
- additional information
- Indications for use
- Exploratory survey
- List of possible complications
- Artery dissection
- What is a survey?
- The consequences of coronary angiography
- Who is she appointed
- Types of diagnostics
- Is the method safe
- Who is not recommended for examination?
- Heart coronation diagnosis: what is it?
- What is coronary angiography of the blood vessels of the heart and how to prepare for it?
- How much should I pay for the survey?
- In conclusion
The method of selective coronarography involves the introduction through the skin under local anesthesia into the artery (femoral, radiation) of a special catheter, which is carried out to the coronary vessels. Then a special contrast is introduced.
Coronary angiography contrast agent is distributed over all coronary vessels, and with the help of an angiograph, you can see the quality of the distribution and filling of the vessels on the monitor. To make a complete picture of the patency of the coronary vessels, pictures are taken from all sides.
After the contrast medium is introduced into the body, the patient may become hot. The heart rate slows down, which is clearly felt. This is necessary to take a clear picture and direct thorough viewing of the state of the vessels on the monitor of the device. After the procedure, the heart rate is restored.
The advantage of the contact method, if necessary, is the ability to immediately perform balloon dilatation or perform stenting, which are performed after consultation with the patient (is conscious). The disadvantage is ionizing radiation exposure.
The entire coronary angiography procedure takes from 20 minutes to an hour, an average of 30-40 minutes. Patients are in a prone position and do not feel discomfort.
CT method (computed tomography) of coronarography
One hour before the diagnosis, the patient takes a medicine that reduces the number of heart contractions.
Immediately before taking the pictures, the contrast agent is injected intravenously and the heart is scanned from various angles.
With additional synchronization of tomography with electrocardiography, you can take pictures during diastole. This method produces a 3D picture where the state of the coronary vessels of the heart is clearly visible.
A feature of this type of diagnosis is the feeling of rare heart contractions, as well as the need to perform various doctor commands during the examination.
For all incomprehensible conditions, after a diagnostic examination, you should immediately consult a doctor. The consequences of coronary angiography are minimal, but nevertheless they occur:
- the development of a heart attack when a person is too worried;
- arterial injury;
- separation of a blood clot, which can lead to a stroke or heart attack;
- kidney complication;
- with too long a diagnosis of x-ray exposure;
- too thin walls of the heart or blood vessels may break;
- bleeding at the puncture site through the skin or inside when the vessel or tissue of the heart is damaged;
- infection in the body after the procedure (poorly processed catheter or place of its introduction);
- allergic reactions to additional drugs.
Coronary angiography – what is it, should know every patient suffering from a disease of the cardiovascular system. With the help of coronarography, the doctor determines the condition of the coronary arteries, traces the dynamics of blood circulation, diagnoses narrowing or clogging of blood vessels. Angiography is performed using x-rays.
To identify congenital pathologies of the heart vessels, coronary angiography of the heart vessels is indicated. If shunting is prescribed, then using the methodology in question, the doctor determines the area for future operations.
Indications for coronary angiography of the heart are as follows:
- the manifestation of symptoms of narrowing of the vessels of the heart;
- ineffective drug therapy;
- valve replacement;
- open heart surgery;
- heart failure;
- severe chest injury.
If the pain syndrome spreads to the stomach, back and neck, then cardiography is performed. It is recommended to make a cardiogram during a routine examination, during pregnancy. Cardiography, in contrast to coronary angiography, reveals hidden cardiac arrhythmias. With the help of these methods, the doctor reveals the coronation of blood vessels, heart attack.
How to make a cardiogram? First, the patient takes a supine position. The specialist attaches electrodes to the area of the arms, legs and chest. Then the heart is recorded. The examination lasts 5-10 minutes. The condition of the patient is analyzed by a cardiologist or therapist.
A similar examination is often prescribed for children. But the normal value of the indicators of their cardiogram differs from the indicators of adults. In children up to a year, fluctuations in heart contraction depend on their lifestyle. Cardiography at the age of 1-6 years displays the normal, vertical or horizontal arrangement of the EOS. From 7-15 years, the position of the EOS is normal or vertical.
Coronary angiography of the heart vessels is contraindicated in the following cases:
- with pathologies of the circulatory system, lungs, kidneys;
- if the patient has bleeding or high body temperature;
- at a diabetes.
What is coronarography, how it is carried out, older people should know. They can undergo such an examination only after consulting a doctor. After coronary angiography of the heart, the following complications may occur:
- heart attack;
- rupture of an artery or heart;
- heart attack or stroke;
- kidney damage;
- heavy bleeding.
How do coronarography? Before the procedure, you need the following:
- pass biochemical and clinical tests;
- go through a coagulogram;
- identify blood type;
- determine the Rh factor.
Checking the blood vessels of the heart requires a preliminary full examination of the patient:
The preparation of the patient for examination includes the following:
- refusal of food and drink 12 hours before the study;
- bladder emptying;
- Before examination, it is recommended to remove jewelry and contact lenses.
A coronary examination can be done in a special cardiology center or in a multidisciplinary clinic. This study is planned. Coronation of the blood vessels of the heart is carried out by the following method: using a puncture, a thin plastic catheter with a contrast agent is introduced into the heart. The screen displays the processes occurring in the heart vessels.
In the absence of the possibility of outpatient coronary angiography, the radiation technique is used. Indications for the study:
- in 1.5-9% of cases (with puncture) complications develop;
- high cost of coronary angiography in case of complications;
- outpatient CAG is indicated.
Coronation of the heart is confirmed by radiation access if there is no possibility of examining the patient through the thigh (the presence of prostheses and stenoses). From the relative indications for the use of radiation access, experts distinguish the following:
- carrying out thrombolytic treatment, taking anticoagulants;
- spinal diseases;
- the patient can not observe bed rest.
Radiation access is contraindicated in the following cases:
- in the absence of a pulse on the radial artery;
- test result (according to Allen) – negative;
- Raynaud’s disease;
- venous arterial shunt;
- stenosis or pronounced bends at the puncture sites.
Previously, the patient is prepared for examination. It is necessary to pass the Allen test, to undergo ultrasound and sanitary preparation of the distal third of the forearm of the right hand. Then the patient is injected into the artery Isoteku and Isoptin (prevention of arterial spasm).
For the examination, the specialist will need a puncture needle, mini-conductor, gateway (removed after the procedure is completed). The patient is discharged home 3 hours after diagnosis. Experts attribute the following to peripheral complications of radiation access:
- the appearance of a hematoma in the puncture area;
- occlusion or spasm of the radial artery.
According to the results of the data obtained, the doctor prescribes conservative treatment in 21% of cases, endovascular treatment in 34%, and shunting in 8% of cases. The advantages of radiation access experts include:
- safety and the possibility of carrying out with other invasive intervention;
- outpatient coronary angiography and CAG are effective and safe;
- low probability of complications.
Before coronarography, the patient is injected with anesthesia, and the hair is shaved in the catheter insertion area. Then an incision is made, a tube is inserted, through which a catheter is then inserted. This procedure must be performed carefully, without causing pain and discomfort.
Electrodes are fixed on the chest, which will control cardiac activity. During the examination, the patient does not sleep. If necessary, the patient will need to take a deep breath or change the position of the upper limbs. During the examination, the doctor controls the pulse and blood pressure.
Coronary angiography lasts 60 minutes. After the procedure, the patient is monitored by doctors for 3 hours. It is contraindicated for him to get up. Otherwise, bleeding may open. With complications, the patient is hospitalized.
After coronarography, abundant drinking is indicated. In each case, it is individually determined:
- period of taking drugs;
- shower time;
- period of return to normal life.
It is forbidden to do heavy work within 2-5 days after the examination. If the coronary angiography of the vessels is repeated, then the patient may complain of discomfort (due to the weak effect of the pain medication). The doctor chooses the puncture site individually in each case. More often a puncture is done in the groin area, on the leg. This method is as safe as possible for the patient and convenient for the specialist.
If the abdominal aorta or arteries of the lower extremities are affected, then it is more difficult to perform an operation using this method. The minuses of this approach include complete rest – the leg can not be bent for 3-5 hours. It is more difficult to puncture in the hand.
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.
The following sources of information were used to prepare the material.
Currently, there is an active expansion of the network of cardiological centers. The purpose of this process is, as far as possible, to bring planned and urgent care to patients. In particular, this concerns operations of shunting and stenting of damaged vessels. This, in turn, significantly reduces the likelihood of developing a heart attack and subsequent changes of irreversible nature.
Appointments after the study
Coronography is a fairly common method used in cardiology practice. How much the procedure costs depends on a number of factors, including the level of the clinic, the qualifications of the specialist, the practitioner, the amount of consumables used, the choice of drugs for pain relief, the availability of additional services, time spent in the hospital, etc.
In Russia, in state clinics for patients with compulsory medical insurance, coronography of heart vessels is free. For the rest, price fluctuations are in the range of 8000-30000 rubles.
For the same study, foreign clinics will be asked:
- In Germany – from $ 6500 for diagnostics and up to $ 19000 for a treatment procedure;
- In Austria – from 13 thousand to 18 thousand dollars;
- In France – 7000-14000 dollars;
- In Israel – $ 5000-15000;
- In the USA – 7000-22500 dollars;
- In Switzerland, for the full range of services, about $ 27000.
Thus, the patient has a choice where to do a vital procedure. As you can see, its cost varies, and for Russians a free option is quite possible, which makes coronography affordable for almost everyone to whom it is shown.
In any case, you should consult a doctor at the first sign of a disease. Only in this case it is possible to avoid severe, and sometimes irreversible, health consequences.
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.
Preparing for the procedure
Coronography enables the doctor to see on the monitor screen what is happening in the patient’s blood vessels, through which blood is delivered to the heart. This method allows you to track the dynamics of blood circulation, to diagnose blockage of blood vessels, or their narrowing. In this case, the doctor can clearly see the place of narrowing of the artery.
The procedure also helps to identify congenital defects of the heart vessels. If it is necessary to replace the coronary vessel (bypass surgery), an area for future surgery is revealed on coronography.
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.
Indications for use
Coronography of the heart is used:
- For chest pain and shortness of breath, often indicating a narrowing of the vessels of the heart;
- In cases where treatment with medication does not bring results, and the symptoms of the disease are aggravated;
- Before performing an operation to replace the heart valve (to detect narrowing of the vessels of the heart);
- After the bypass surgery to evaluate the results of surgical intervention;
- If there is a suspicion of congenital defects of the vessels of the heart;
- With diseases of the heart vessels;
- In the case when open heart surgery is planned;
- With heart failure;
- With serious chest injuries;
- On the eve of surgery associated with the risk of heart problems.
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 provides confirmation of the need for consultation, a conclusion on the rhythm of contractions, the condition of muscle fibers, the presence of overload in various departments, cicatricial changes after a heart attack. In addition, an ECG reveals persistent ischemia with a presumably poor prognosis.
- Ultrasound of the heart. Ultrasound indicates the image and visually the activity of certain heart departments, the functioning of the valve system between the ventricles and atria, large vessels. Ultrasound reveals hypertrophy (thickening in the wall) of the organ muscle.
All the above studies can significantly reduce the waiting time for results after consultation with a specialist cardiology center.
List of possible complications
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.
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.
Infection can also occur as a result of using non-sterile instruments by doctors, it is worthwhile to get acquainted with specialists in advance and make sure of their competence and shyness
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.
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.
You should know that, like many other procedures performed on the heart and blood vessels, coronography in some cases can have negative consequences for the patient. However, serious problems are not common.
Complications after coronography can occur in the form of:
- Heart attack;
- Rupture of the heart or artery;
- Separation of blood clots from the walls of blood vessels, leading to a heart attack or stroke;
- Artery injuries;
- Changes in heart rate (arrhythmias);
- Allergic manifestations of drugs used during the procedure;
- Kidney damage;
- Excessive x-ray exposure;
- Heavy bleeding.
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.
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.
The consequences of coronary angiography
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.
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:
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.
The patient should tell the specialist about the diseases that he suffers. It is also necessary to provide information on whether there is an allergy to the drugs.
Preparation for the procedure:
- The patient is warned in advance that the manipulation is performed on an empty stomach. The patient in the evening stops eating.
- The puncture site, if necessary, is shaved.
- Taking medicines a few days before the procedure and immediately before it.
For CT coronary angiography:
- it is analyzed whether there is good venous access to the heart, which can provide the required rate of entry of contrast medium into the coronary arteries in order to obtain a study of the proper quality;
- the condition of the patient is evaluated in terms of the possibility of his cooperation with a specialist during the procedure.
Who is not recommended for examination?
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.
Heart coronation diagnosis: what is it?
Coronation, or coronary heart disease, is called ischemic heart disease (IHD). All these names have the same meaning. The statistics on this disease is very sad, according to the WHO, it affects women aged 40 to 70 years, for men aged 40 to 49 years, the frequency of detection of the disease is three times higher than for women aged 50 to 60 years – twice, further indicators are approximately the same.
There are contraindications to this surgery. First of all, this is the presence of cancer and other incurable diseases, the patient’s serious condition before surgery. Also, a successful outcome of the operation is unlikely with past strokes, arterial hypertension and critically low rates of left ventricular myocardial contractility. If available, other treatment methods are selected.
How does coronation of the heart develop? The first stage of the disease is atherosclerosis of the coronary arteries. The reason for its appearance is narrowing and clogging of the arteries with cholesterol plaques, as a result of which the blood flow to the heart is very difficult. Cholesterol enters the human body with food. In the coronary artery system, a complication of blood supply occurs, so the heart muscle suffers from an acute lack of oxygen and substances necessary for the proper functioning.
Most often, in the early stages of development, coronation of the heart does not make itself felt, and the disease progresses over several years. You should be wary of discomfort in the heart or back during physical and psychological stress, as well as normal activities and walking, especially if it disappears at rest.
Another characteristic sign of the development of coronary heart disease is the removal of discomfort after taking nitroglycerin. The opposite situation can also happen – in some cases, patients with coronary heart disease do not feel anything even with myocardial infarction. If at least one of the above symptoms is detected, it is urgent to contact a qualified cardiologist.
Before taking a doctor, you can’t do anything yourself, especially taking medications on the advice of relatives or friends. The cardiologist will conduct an examination and prescribe all the necessary studies. These include an electrocardiogram, Holter ECG monitoring and various stress tests. One of the most effective diagnostic methods for coronary heart disease is coronary angiography.
At the moment, medicine is fighting this common disease. Unfortunately, therapeutic methods alone are not enough for its treatment. In most cases, cholesterol plaques increase over time and lead to myocardial infarction. Forms of coronary heart disease may vary and, accordingly, require different treatment tactics. All currently used methods can be divided into several groups.
Non-drug tactics include the correction of lifestyle and daily routine, an elaborate low-calorie diet with minimal salt and liquid intake, as well as limited physical activity. The patient should be under the constant supervision of a specialist.
Therapeutic methods include the prescription of drugs according to the formula “ABC”. These are antiplatelet agents, beta-blockers and hypocholesterolemic agents. In the absence of contraindications, nitrates, diuretics and antiarrhythmic drugs are administered.
In the absence of visible results, surgery can be performed – surgical myocardial revascularization, or coronary artery bypass grafting, popularly called coronary heart disease, what is it? During the operation, a kind of “workaround” is created around the clogged section of the artery using the saphenous vein or the internal thoracic artery.
Coronary artery bypass grafting is performed under general anesthesia using a mechanical ventilation apparatus. Like all abdominal operations, it refers to high-risk surgical interventions, and requires high skill and responsibility from the surgeon. But even such a radical method of combating coronary heart disease does not give a % guarantee. To avoid relapse, the patient will need to completely change his life.
At risk for the development of coronary heart disease include smokers with experience, people who often drink alcohol, suffer from high blood pressure, diabetes. Inactive lifestyle, overweight and unbalanced diet can also be provoking factors. Increased attention to your health will not be superfluous with frequent stresses and a hereditary disposition to heart diseases.
Health is not everything, but without it other areas of life are unlikely to bring pleasure. Coronation of the heart, a diagnosis that has recently been made very often, is one of the most dangerous diseases that take lives every year. You need to take care of yourself and try to lead a healthy lifestyle, and then you can avoid it.
What is coronary angiography of the blood vessels of the heart and how to prepare for it?
Coronary angiography is a radiopaque examination of the blood arteries that cover the heart like a crown, or corona – therefore they are called coronary, or coronary vessels. They supply the heart muscle with oxygen, and if they contract, the heart suffers from oxygen starvation. This condition is called coronary heart disease – CHD. By surgically expanding the coronary arteries, the doctor normalizes blood flow, and the symptoms of coronary artery disease disappear.
There are other methods for diagnosing heart diseases: cardiography (ECG) and echocardiography (ultrasound), MRI, X-ray examination (scintigraphy), ECG test under load (bicycle ergometry). But only coronary angiography of the heart vessels helps the doctor to clearly see the causes of the disease – their narrowing, blockage, thinned sections of the walls (aneurysms). Angiography can also diagnose congenital heart defects in children and adults.
Instrumental examination of the heart vessels is prescribed less frequently than other diagnostic methods, since it carries more risks than non-invasive diagnostic methods. It is recommended for shortness of breath, chest pain, heart rhythm disturbances, the cause of which is unclear, as well as:
- when treatment with tablets and injections does not help, and the symptoms intensify,
- with serious chest injuries,
- if a heart attack is suspected or in the first hours after it – to see the place of blockage of the vessel and remove the blood clot.
Coronary angiography of the vessels of the heart is the most reliable and most accurate way to diagnose coronary artery disease. Having identified the disease in time, the doctor determines with the treatment tactics: whether stenting, coronary artery bypass grafting or angioplasty is necessary. On the eve of operations, it helps to more accurately identify the area of surgical intervention and see the state of the vessels of the heart, in the postoperative period it is carried out to assess the results of the intervention.
The procedure is not done for people with severe diseases of the circulatory system, kidneys and lungs, patients with reduced blood coagulation or bleeding, at elevated body temperature. It is not recommended, but in some cases it is allowed to conduct for diabetics and (with caution) the elderly.
Before coronary angiography, the patient is prescribed a urine test and blood tests – general, biochemical, coagulation, HIV and hepatitis, group and Rh factor. In addition, cardiography, ultrasound of the heart with dopplerometry, chest x-ray are performed.
If you come for an examination from home, and do not wait for him during hospitalization, you will have to remember a few simple rules. They largely coincide with the recommendations for preparing for any surgical procedures:
- On the eve and on the day of the procedure, you can not eat and drink, otherwise, nausea and vomiting are possible during it.
- Take all the medicines you take with you, but consult your doctor before you take the pill on the day of the coronary angiography. This is especially true of insulin. Since you can’t eat on the day of the procedure, you probably don’t need insulin: without food, the blood glucose level drops sharply and a hypoglycemic coma is possible.
- Tell your doctor about a drug allergy, if you have one.
Before the procedure, you need to empty the bladder. Also, the doctor will ask you to remove the rings, earrings, chains, glasses and remove contact lenses.
Before you go to the procedure, it makes sense not only to learn about what coronarography is, but also to ask how it is done. The study of blood vessels of the heart is more often carried out in a cardiology hospital, less often – on an outpatient basis, in specialized multidisciplinary clinics. The procedure lasts from 20-40 minutes to an hour:
- The patient’s hair is shaved off in the groin area (if the catheter is inserted into the femoral artery) or on the arm (when it is inserted into the radial artery) and local anesthesia is performed. Then the skin over the artery is incised and a thin plastic tube is inserted. The thinnest flexible probe with a catheter at the end is inserted through it and it is advanced through the vessels to the lumen of the coronary arteries.
- A special contrast agent is injected into the bloodstream through a catheter, and while it moves along the bloodstream with the blood, the doctor conducts an x-ray with an increase. The results are recorded in digital format, and in the future the “picture” can be viewed on a personal computer.
- At this time, the patient’s cardiac activity is monitored using electrodes attached to his chest. At the same time, his pulse and blood pressure are measured.
General anesthesia during coronary angiography is not done, but it is not needed. There are no nerve endings inside the vessels, so you will not feel pain or experience other unpleasant sensations. From time to time, your doctor may ask you to take a deep breath, hold your breath, and change the position of your hands.
After the examination, you will have to lie for a rather long time without bending your leg, and the doctor will forbid you to get up for 12-24 hours. To quickly remove the contrast agent from the body, you need to drink more. Before discharge, they will tell you when it is allowed to resume taking medications, whether dietary restrictions are needed, and so on. For several days after the intervention, you can not do heavy physical work and train in the gym.
Nowadays, coronarography is done by two methods: through the femoral or through the radial artery. In the first case, the patient must be in the hospital, in the second they come to the procedure in the morning, and in the evening you can return home. What is the reason for this difference?
- The peripheral (femoral) artery is one of the largest vessels in our body, lying at a depth of 2-4 cm under the skin in the groin area. Bleeding from it is very dangerous, so after the procedure you can not move a lot and do not rush home.
- The radial artery is a relatively small vessel that approaches the surface of the skin on the wrist. Doctors call this access radial. A puncture of a vessel in this place very rarely causes life-threatening bleeding, the procedure itself lasts only 20 minutes and less often gives complications. The patient’s home is released after 4-5 hours, in rare cases it is delayed until the morning.
If the house at the puncture site has swollen and reddened, a large bruise has appeared in this area and sharp pains have arisen, you should immediately consult a doctor. Sometimes at the same time the pressure drops, a sharp weakness is felt and shortness of breath begins – in this case, immediately call an ambulance.
Serious complications after coronary angiography are rare (on average in less than 2% of cases), but they are, and you need to be prepared for them. First of all, these are allergic reactions to a contrast medium: skin allergy, shortness of breath, anaphylactic shock. The second group of complications is mechanical damage to the heart and blood vessels and the consequences caused by the complex effect of the procedure:
- death from bleeding due to rupture of the heart or artery –
- acute heart attack – from 0,05 to 0,1%. Arrhythmias and heart attacks are a little more common.
- stroke – from 0,07 to 0,2%,
- very rarely – the introduction of infection into the blood, damage to the kidneys with a contrast agent, an overdose of excessively intense x-ray radiation.
Approximately one and a half percent of patients have less dangerous consequences of the procedure: local, at the site of puncture of the artery. These are small or massive bleeding, less often – blood clots or aneurysm at the points of catheter insertion. If necessary, the patient is given a blood transfusion or surgical treatment is performed.
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.
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.
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.
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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.