Angiography Or Cardiac Catheterization
Angiogram: The Reasons For, The Risks Of And What The Results Show
Nov 29, 2008
More than one million Americans annually have a cardiac angiogram (also called a cardiac catheterization) and of that million, more than one half will go on to have angioplasty or bypass performed.
Three Top Reasons That A Doctor May Request an Angiogram
- To evaluate possible disease of the aorta (the largest artery in the body).
- To look for evidence of coronary artery disease (especially obstruction).
- To seek evidence of heart valve disease.
How is a Catheterization Performed?
A cardiac catheterization is performed at the hospital but may not necessarily require an overnight stay. It is performed as follows:
- The patient is dressed in a hospital gown and is taken into a softly lit treatment room with monitors above and beside the table.
- An IV line is started.
- A catheter is inserted into a cleaned site either on the arm at the elbow bend (this is referred to as a “brachial approach”) or in the groin (referred to as the “femoral approach”).
- Sterile drapes are used around the site of incision to prevent infection.
- A catheter for urine may be inserted.
- Adhesive electrodes are placed on the chest.
- A mild sedative is administered to help the patient relax during the procedure.
- The site of incision is numbed.
- A sheath is inserted and a catheter (a very thin tube about 2 mm.) is threaded through the sheath, the patient may experience a slight sensation of pressure during the insertion. The catheter will painlessly make its way to the arteries in the heart.
- The lights in the treatment room are dimmed and the patient is able to view the catheterization on monitors above him/her if he/she opts to.
- Dye is injected through the catheter and allows the display of the cardiac structures (vessels, heart chambers and valves). The patient may feel a hot and/or flushed sensation at this point which is normal and will quickly vanish.
- The physician takes x-rays of pertinent structures and may instruct the patient to deeply breathe, hold the breath or cough while taking the films.
- The catheter is removed and the incision is closed with stitches, a collagen seal and/or pressure application (the method of closure depends on where the incision was made).
- If the incision was made in the arm, the patient will be required to keep the arm straight for a minimum of one hour; observation will continue for a few hours.
- If the incision was made in the groin, then a sterile dressing will be applied and the patient will be asked to lie flat for 2 to 6 hours under close observation.
- Clear liquids will be forced to help flush the dye from the patients system.
- Patient instructions include the avoidance of strenuous activity and heavy lifting for several days.
- An overnight stay may be required and is not unusual.
How Long Does an Angiogram Take?
The catheterization itself takes less than one hour.
What are The Risks Of Cardiac Catheterization?
The physician has ordered the catheterization to diagnose present and to prevent future cardiac events. As with any medical procedure, the benefits of the test must be weighed against the risks; the physician will review all risks in detail prior to the procedure including the following:
- Air embolism
- Death
- Heart attack
- Perforation of the heart or blood vessels
- Stroke
- Reaction to test dye
- Infection
- Blood clots
- Bleeding
- Abnormal heart rhythms
- Kidney damage
- Radiation exposure
What Do The Angiogram Tests Results Show?
An angiogram provides the physician with precise measurements of the following:
- Blood movement and flow patterns through heart and vessels
- Number of coronary arteries blocked
- Exact locations of blockages (if present)
- Extent of blockages (usually described in percentages)
- Previous coronary artery bypass procedure results and current status
Sources:
New England Journal of Medicine
WebMD
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