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- Why a coronary angiogram?
- Who should have a coronary angiogram (CAG)?
- What diseases can a coronary angiogram diagnose?
- What is the diagnosis before having a coronary angiogram?
- What is a coronary angiogram procedure at MedPark Hospital?
- What are the benefits of a coronary angiogram (CAG)?
- Cardiac Catheterization Lab (Cath Lab) at MedPark Hospital
Coronary Angiogram (CAG)
Coronary angiogram (CAG) is both a diagnostic X-ray imaging procedure and a treatment for coronary artery disease (CAD), using the cardiac catheterization technique by inserting a 2 mm-diameter catheter along the artery through the wrist, elbow, or groin up to the coronary arteries and injecting a contrast dye to take x-ray images to allow the visualization of the condition inside the coronary arteries to evaluate coronary artery disease, myocardial ischemia, atherosclerosis, or other abnormalities that cause chest pain, leading to an effective and precise treatment plan.
Why a coronary angiogram?
Coronary angiogram is considered the gold standard for diagnosing coronary artery disease, which is caused by accumulated fat, tartar, or blood clots along coronary artery walls, resulting in a narrowed or blocked coronary arteries and occlusion of blood flow to the cardiac muscle. This narrowing causes chest pain, dizziness, profuse sweating, and shortness of breath and eventually leads to a dangerous acute myocardial infraction (acute heart attack) or chronic myocardial ischemia, which results in a heart attack. Concernedly, the vast majority of people with coronary artery disease exhibit no signs or symptoms. With age, the accumulated fat in the arteries will gradually build up, eventually resulting in an acute myocardial infarction and sudden death.
Who should have a coronary angiogram (CAG)?
- Those experiencing chest pain, tightness in the chest, or epigastrium pain, a sense of heavy objects pressing on the chest.
- Those experiencing angina pain radiating to the shoulder, arm, back, neck, or jaw.
- Those who have severe chest pain that prevents them from lying down, sitting, or resting for more than 30 minutes, but the symptoms do not improve.
- Those who have wheezing, shortness of breath, or shallow breathing.
- Those who sweat a lot, sweat profusely, or have sweaty hands and feet.
- Those experiencing fatigue, weakness, dizziness, nausea, heart palpitations, and stomach discomfort.
- Those who experience severe chest pain until losing consciousness, heart-stopping, or having a heart attack.
What diseases can a coronary angiogram diagnose?
- Coronary artery disease (CAD)
- Myocardial ischemia
- Peripheral artery disease (PAD)
- Atherosclerosis
- Intracardiac thrombus
- Aortic valve stenosis
- Congenital heart disease
- Atrial septal defect (ASD)
- Cardiac arrest, Heart failure
What is the diagnosis before having a coronary angiogram?
The cardiologist will make a diagnosis of coronary artery disease, myocardial ischemia, heart attack, or other cardiovascular diseases before a coronary angiogram by taking a detailed history and performing the following physical examinations:
Medical history
- Experience chest pain, palpitations, fatigue, shortness of breath, profuse sweating, dizziness, or fainting.
- Have congenital cardiovascular disease risk factors, such as high blood lipids, diabetes, or high blood pressure.
- Have a family history of heart disease at a young age (under 50 years old) or myocardial ischemia.
- A heavy smoker, long-term smoker, frequent consumption of high-fat foods, excessive alcohol consumption, and lack of exercise.
- Have been diagnosed with various heart abnormalities by a cardiologist using heart screening tests such as Electrocardiograms (ECG), Exercise Stress Tests (EST), Coronary CT scans, or Echocardiograms.
Blood tests
A complete blood cell platelets count, kidney function, and plasma electrolytes, as well as checking for other abnormalities.
Screening for coronary heart diseases
- Electrocardiogram
- Exercise Stress Test
What is a coronary angiogram procedure at MedPark Hospital?
Coronary angiogram procedures at MedPark Hospital are performed using the gold standard in diagnosis and therapeutic, considering the utmost safety of those undergoing diagnosis and the success of treatment. Individuals undergoing the test will be admitted to the hospital for 1-2 days and will be able to return home the next day if no complications are found.
Pre Coronary Angiogram Procedures
- Individuals undergoing a coronary angiogram should refrain from eating or drinking for at least 4-8 hours before the procedure.
- Individuals who have a history of drug allergies or seafood allergies must notify their doctor in advance.
- Individuals who take blood thinners or diabetes medications such as insulin must notify the doctor in advance.
During Coronary Angiogram Procedures
- The medical staff explained the coronary angiogram procedure and obtained patient consent forms prior to the test.
- The nurse cleans and disinfects the skin insertion site where the cardiac catheter will be placed.
- The cardiologist administers local anesthesia before puncturing the radial artery to the wrist, brachial artery to the elbow, or femoral artery to the groin without the need for general anesthesia.
- The cardiologist inserts a catheter, a specialized thin hollow tube 2 mm in diameter, through the artery up into the left or right coronary artery. The patient will remain conscious throughout the procedure but will not feel any pain.
- Once the catheter is in place, the cardiologist will inject a special dye, iodinated contrast material through a catheter up into the heart until it reaches the ostium of the coronary artery at the root of the aorta to help highlight any blockages in the artery wall.
- The cardiologist quickly takes a series of X-ray images of the coronary arteries from various angles to provide a detailed view of the lumen inside of the coronary arteries and to determine the location of narrowed or blocked coronary arteries. The procedure will take approximately 30 to 60 minutes.
- If the cardiologist discovers coronary artery stenosis or blockage, he/she will immediately proceed to perform balloon angioplasty and stent placement to widen the coronary arteries. The balloon inflation pushes the accumulated fat or tartar buildup attached against the artery wall, widening the coronary artery passages, and increasing blood flow to the heart muscle. In addition, the stent abutting against the arterial wall further flattens the fat or atheroma, increases treatment efficacy, and effectively reduces the chance of recurrence. Typically, the procedure takes approximately 45–60 minutes.
- Upon finishing the treatment, the cardiologist will carefully remove the catheter and gently apply direct pressure to the puncture site for about 15 minutes to stop the bleeding without the need to stitch up the wound. The cardiologist and nurses will monitor for bleeding complications and periodically measure vital signs to assess the patient's clinical condition.
- If a cardiologist determines that a patient is unable to undergo balloon angioplasty, The cardiologist will determine alternative treatment options such as coronary artery bypass grafting (CABG) or medication.
Post Coronary Angiogram Procedures
- The cardiologist will advise those who have had a catheter inserted through the groin to rest in the hospital, lie supine, and avoid sitting, walking, and flexing the groin for 6–10 hours. If there are no abnormal symptoms, the patient can return home.
- Those who have a catheter inserted through the wrist, including those who are overweight, obese, or have peripheral artery disease (PAD), will recover by lying supine in bed and refraining from sitting, walking, or standing for 4–8 hours. If there are no signs of complications, they can return home.
- Those undergoing coronary angioplasty are asked to stay in the hospital for one night, and if no abnormal symptoms are found, they can return home the next day, open the dressing, and shower as usual.
- Those undergoing tests and treatment can eat normally. It is recommended to drink 1–1.5 liters of water per day to aid in the removal of contrast dye from the body.
- Refrain from exercising, lifting heavy objects, or exerting force on the catheterized arm or leg for about a week.
- Take the prescribed medication on time and come to the doctor's appointment as scheduled to evaluate symptoms and monitor treatment outcomes.
- Those who take medication to treat chronic diseases, such as blood thinners, can resume taking the medication the next day. Those who take certain medications, such as diabetes medication, should resume taking them after an interval advised by the doctor.
- Those experiencing unusual symptoms such as pain, swelling, chest tightness, nausea, vomiting, bruising, a swollen red, being unable to lie down, or severe pain in any area should seek medical attention right away.
What are the complications of a coronary angiogram?
Complications from coronary angiograms include mild allergic reactions to contrast dye, bleeding from the puncture site, etc. Serious complications from coronary angiograms are extremely rare (less than 1%) and include arrhythmia, heart attack, kidney failure, paralysis, or death.
What are the benefits of a coronary angiogram (CAG)?
- CAG aids in determining the location of narrowed or blocked coronary arteries, as well as the overall condition of the coronary arteries.
- CAG is both diagnostic and therapeutic. If coronary artery disease is discovered, the cardiologist can immediately proceed to balloon angioplasty and stents.
- CAG can detect low cardiac output by measuring the blood flow rate through the heart, as well as measuring intracardiac pressure to check the heart valve function.
- CAG aids in assessing atherosclerosis burden by gauging the amount of fat, cholesterol, or plaque accumulated in the artery walls.
- CAG aids in the diagnosis of congenital heart disease or an atrial septal defect.
- CAG assists in the evaluation of heart surgery outcomes.
- CAG is regarded as safe, with low risks and complications.
- CAG is a quick procedure, requires little downtime, and allows you to resume normal activities quickly.
Coronary Angiogram at MedPark Hospital
Cardiology Center at MedPark Hospital is led by a team of experienced cardiologists who are ready to diagnose and treat difficult and complex coronary artery disease, utilizing coronary angiograms to dilate narrowed arteries with balloon angioplasty and stents using state-of-the-art medical technology and equipment to provide effective, fast, and precise treatment, as well as follow-up and evaluation after the treatment to help reduce complications, allow for a quick recovery, and enable the patient to have good physical health and a strong heart for a long time.
Cardiac Catheterization Lab (Cath Lab) at MedPark Hospital
MedPark Hospital's Cardiac Catheterization Lab (Cath Lab) is a sterile cardiac catheterization lab equipped with a high-performance X-ray fluoroscopy C-arm that can rotate in various planes and angles depending on the cardiologist's needs to assist in taking and processing coronary artery or blood vessel images in various regions of the body. When an x-ray is taken, the images are projected onto a screen and digitally recorded, allowing the cardiologist to see the area of coronary artery disease, coronary artery blockage, or other abnormalities of the coronary arteries, leading to effective and precise treatment and enabling the treatment of acute heart attacks or myocardial infarction promptly.
FAQ
- What are the risks of a coronary angiogram?
Coronary angiogram is considered a safe procedure. However, minor side effects such as pain, swelling, bleeding, or itching may result from an allergic reaction to the contrast dye. Individuals with any type of underlying disease should consult their cardiologist before undergoing the procedure. - What is the recovery time for a coronary angiogram?
Those who had the catheter inserted through the groin should rest in the hospital for 6–10 hours, while those who had the catheter inserted through the wrist should rest for 4–8 hours. Those who underwent balloon angioplasty and stents will spend 1 night in the hospital recovering. - Does a coronary angiogram require fasting?
Individuals undergoing coronary angiograms to diagnose coronary artery disease should fast for at least 4–8 hours before the procedure. - Does a coronary angiogram require hospitalization?
Coronary angiogram is diagnostic x-ray imaging procedures used to detect coronary artery disease that can be completed within 1 day without the need for hospitalization. Except for those who have had balloon angioplasty and stents, the cardiologist will ask you to stay in the hospital for one night. - How long does a coronary angiogram procedure take?
Typically, a coronary angiogram takes approximately 30–60 minutes for the procedure. Those who have had balloon angioplasty and stents will require approximately 45-60 minutes for treatment. - What is the success rate of a coronary angiogram?
Coronary angiogram is a procedure that has a high success rate of 97.6% in diagnosing coronary artery disease and myocardial ischemia, leading to a timely treatment of balloon angioplasty and stents, which can ultimately save the lives of those with coronary artery disease.
