Coronary angiography is little short of miraculous
BY DR. KOMOROFF Universal Uclick
Monday, November 26, 2012
11/26/12 at 4:16 AM
Dear Doctor K: My doctor suspects I have heart disease and wants me to have an angiogram. What will happen during this procedure?
Dear Reader: Coronary angiography is the gold standard for diagnosing coronary artery disease, a narrowing of the coronary arteries that reduces blood flow to the heart.
The miracle of coronary angiography is that the doctor can see not just inside your heart but also inside the arteries that feed your heart - without ever cutting the skin of your chest.
In the 1940s, two scientists followed up on a simple idea: Any highway leading from the heart to, say, a leg or an arm is simultaneously a highway leading from the leg or arm back to the heart.
They inserted thin, soft tubes (catheters) into an artery in the leg and pushed "backward" up the artery until the tip of the catheter entered the heart. Pressure measurements and pictures could be taken inside the chambers of the heart. That discovery was honored with the Nobel Prize.
Now to your question about what will happen. First, if you are allergic to X-ray dye, tell your doctor. He or she may need to use an X-ray dye that is less likely to trigger allergies, or you may take medication to reduce the likelihood of a reaction.
A nurse will clean and shave the area of your arm or leg where the catheter will be inserted. You will lie on a flat table under a large X-ray machine and be given medication to help you to relax. An intravenous (IV) line is inserted to deliver fluids and medications.
The doctor will numb your skin and make a small cut to reach a large blood vessel under the skin surface. The doctor will insert the catheter into the blood vessel and move it toward your heart. The procedure usually takes less than an hour. Once the test is finished, the catheter will be removed and the insertion site closed with stitches.
If a blockage is found, an angioplasty and stent may be performed to open the blockage.
Write Dr. K at www.AskDoctorK.com or c/o Universal Uclick, 1130 Walnut, Kansas City, MO 64106