Patient Care - Adult cardiac, endovascular, and thoracic aortic surgery
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Coronary angiography: Also called cardiac angiography. Coronary angiography is performed to detect obstruction in the coronary arteries of the heart. During the procedure a catheter (thin flexible tube) is inserted into an artery in your arm or groin and then threaded carefully into the heart. The blood vessels of the heart are then studied by injection of contrast media through the catheter. A rapid succession of X-rays (fluoroscopy) is taken to view blood flow.
How the test is performed: Coronary angiography is usually performed in conjunction with cardiac catheterization. You will be given a mild sedative prior to the test to help you relax. Coronary angiography is performed to detect obstruction in the coronary arteries, which can lead to heart attack. It may be performed if you have unstable angina, atypical chest pain, aortic stenosis, or unexplained heart failure. The test may also be performed for other reasons.
The study is carried out in a laboratory by a trained cardiologist or radiologist and technicians or nurses. An intravenous (IV) line is inserted into one of the blood vessels in your arm or groin after the site has been cleansed and numbed with a local anesthetic.
A catheter is then inserted through the IV and into your blood vessel. The catheter is carefully threaded into the heart using an X-ray machine that produces real-time pictures (fluoroscopy). Once the catheter is in place, contrast material is injected and pictures are taken.
How to prepare for the test: Food and fluid are restricted 6 to 8 hours before the test. The procedure takes place in the hospital and you will be asked to wear a hospital gown. Sometimes, admission the night before the test is required. Otherwise, you will be admitted as an outpatient or an inpatient the morning of the procedure.
Your health care provider should explain the procedure and its risks. A witnessed, signed consent for the procedure is required.
Tell your doctor if you are allergic to seafood, if you have had a bad reaction to contrast material in the past, if you are taking Viagra, or if you might be pregnant.
How the test will feel: You will be awake and able to follow instructions during the coronary angiogram. A mild sedative is usually given 30 minutes before the procedure to help you relax. The procedure may last from 1 to several hours.
You may feel some discomfort at the site where the IV is placed. Local anesthesia will be used to numb the site, so the only sensation should be one of pressure at the site.
Occasionally, a flushing sensation occurs after the contrast media is injected. Discomfort may also arise from having to remain still for a long time.
After the test, the catheter is removed. You might feel a firm pressure at the insertion site, used to prevent bleeding. If the IV is placed in your groin, you will usually be asked to lie flat on your back for a few hours after the test to avoid bleeding. This may cause some mild back discomfort.
Findings: Coronary angiography shows the following:
- How many coronary arteries are blocked
- Where are they blocked
- The degree of each blockage
Risks: Cardiac catherization carries a slightly increased risk when compared with other heart tests. However, the test is very safe when performed by an experienced team. Generally the risk of serious complications ranges from 1 in 1,000 to 1 in 500. Risks of the procedure include the following:
- Cardiac arrhythmias
- Cardiac tamponade
- Trauma to the artery caused by hematoma
- Low blood pressure
- Reaction to contrast medium
- Heart attack
- bleeding, infection, and pain at the IV site.
- Blood clots could form on the catheters and later block blood vessels elsewhere in the body.
- The contrast material could damage the kidneys (particularly in patients with diabetes).