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Coronary angiography, as the most objective method of investigation in cardiac pathology

  • Coronary angiography, as the most objective method of investigation in cardiac pathology

    The most important study of the functional and anatomical features of the heart vessels is coronary angiography. It is very helpful in diagnosing serious diseases such as ischemic disease and myocardial infarction. Especially relevant is its use to address the question of surgical intervention, its feasibility and methods of conducting.

    Since angiography is an invasive technique, the decision to perform it should only be done by a doctor. For this, there are a number of indications for the implementation of such a procedure, among them:

    1. The absence of symptoms of coronary heart disease with the growth of signs of heart failure.
    2. Long-term treatment of IHD with various drugs, not bringing relief.
    3. Sharp deterioration of the condition, the occurrence of unstable angina, with a history of an infarction.
    4. The decision on the need for heart surgery in persons older than 35 years.

    Coronary angiography of the heart can be emergency( with ACS, done within 6 hours), urgent( from 6 to 12 hours) and scheduled.

    Emergency investigation is necessary if the patient's condition worsens after coronary artery bypass grafting or other operation on the heart vessels!

    Stages of

    Despite the fact that the first coronarography was carried out in the 60s of the last century, it remains the most popular among specialists from a diagnostic point of view.

    Initially, the patient is examined by a doctor and assigns certain mandatory examinations. If necessary, it is consulted by other specialists. The patient is explained the principle of carrying out and the likelihood of complications during this procedure. Then he must sign his written consent.

    The patient undergoes coronary angiography on a special table, while in a horizontal position. Initially, he is given a local anesthetic to remove discomfort during the diagnosis, but he remains fully conscious. For the introduction of contrast media, the femoral or brachial artery is used.

    Through the incision, a thin tube of special plastic is under the control of the X-ray chamber from the place of catheterization to the very mouth of the coronary artery. After that, there is introduced a contrast, which allows you to clearly see on the screen a vascular picture of the heart, their branching, the presence of stenosis or blockage. If he has the patient's consent, he can simultaneously undergo stenting - an operation to expand the lumen and normalize the flow of blood through the problematic area of ​​the vessel.

    Because coronary angiography is a rather complex study, it is necessary to conduct it only to a highly qualified specialist, then the probability of complications of this manipulation is minimized.

    CT angiography of coronary arteries is currently underway. The advantage of this study, despite the high cost, is a lower radiation load, since it is carried out much faster. The introduction of a contrast agent is carried out intravenously, which reduces the incidence of complications. After the procedure there is no need for a rehabilitation period. Often, this type of diagnosis is assigned to determine the need for referral to a more accurate, but more invasive study of the heart vessels.

    Contraindications to angiography of the heart

    Coronary artery angiography is not performed if the patient has an allergic reaction to a local anesthetic or contrast agent. To reduce the likelihood of developing allergies, the patient before angiography sometimes takes antihistamines. In the presence of problems with the kidneys or the heart, measures are first taken to stabilize the acute condition.

    If the patient has blood clotting disorders or signs of anemia, this also requires special training and enhanced monitoring during diagnosis.

    It is impossible to use such a technique in the presence of diabetes, acute infectious processes, fever, severe hypertension, non-correctable drugs, peptic ulcer, psychic abnormalities.

    Possible complications of

    One can not ignore the probability of complications that accompany angiography. These include:

    • Bleeding in the place where the puncture is performed. In order to provide timely assistance, the patient before the study is assigned a blood group and the Rh factor is determined.
    • Heart rhythm disturbances.
    • Disturbance of the integrity of the inner shell of the artery.
    • Myocardial infarction.

    Recommendations

    Before the study, it is necessary to exclude the intake of any substances that can contribute to the acceleration of the pulse - coffee, strong tea, cigarettes, potentiants. If there are drugs that are prescribed for permanent use, then this should be reported before the angiography.

    If the angiography of the coronary vessels is carried out in the morning, then the last meal should be the day before lunch. Compliance with bed rest is compulsory within 3 hours after the puncture of the radial artery, and throughout the day, if the contrast is introduced through the femoral artery.

    You should choose a clinic for angiography with the most innovative technique and high-level professionals, only in this way it is possible to avoid complications and get the right conclusions.

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