Coronary Angiography

Hello!

My name is Dr. Gaurav minocha. I am a cardiologist practising in New Delhi. So today I will be talking about coronary angiography which is a common test which is prescribed to patients with heart disease. There are many myths associated with the test. Many people are scared of the test and commonly they come back to us complaining that they might suggest or advice the test but would rather not go for it. So today I will be talking about some integrations, how the test is done and whether it is an actually complicated test or not. Firstly it is important to understand why the test is done? So angiography is a test which is done basically to diagnose heart disease.

So in patients having angima, chest pain heart condition are the patients who are candidates for this test. So mostly we would do a test like ECG, treadmill test, echo-cardiogram to ascertain whether you need an angiography and how soon it should be done. But then there are some conditions like in case of heart attack where we need to do it in an emergency and these patients do not give us much time. So in that situation, you have to realise that we do not have time to wait and discuss too much and we should go ahead with the angiogram because that is the procedure on the basis of which the treatment starts. Now how the test is done- basically we need to inject some contracts into the coronary artery which delineates the coronary artery and helps us to find out the blockages in the coronary artery.

There are two main routes that we use- first is the radial route which is through the hand and the second one is through the leg. Commonly, the femoral route or the leg route has been used but now I along with many other doctors have started using the radial route which is more comfortable for the patient and has fewer complications. We use local anaesthesia to numb the area through which we enter the artery and then we slide 2-millimetre caster through the artery into the heart and then we take injection into the heart recorded with the X-ray equipment.

The test itself takes around 15 to 30 minutes. It gives us a lot of information about the heart artery and according to that, we can decide whether the patient needs just a medical therapy, whether you need a Bypass surgery or in most situations, we can do the angioplasty. So the complications which are associated with the test or what the patients are scared of, but I can reassure you that the complications rates are less than 1%. The risk of dying which is the most common question asked to us is less than 1 per 1000. So it's a fairly safe test and gives us a lot of information so do not be scared of it. The recovery after coronary angioplasty is fairly fast.

We normally discharge the patient on the same day. Staying required is half a day. If we do it through the hand, we can discharge and you can go back in 2 hours and in case it is done through the groin then we need to keep you rested for half a day to 4-6 hours and once the bleeding is controlled then we can send you back to home. The implications of the test are that in case we find blockages in the heart arteries we may advice to go ahead with a coronary angioplasty wherein we may put in a thin wire and over it, we send a stent through the same route.

So it's preferable sometimes to do the angioplasty and stenting at the same stage. Some patients may require a bypass surgery which may be planned over the next few days and if you're lucky enough the arteries are normal then we can discharge you the same day. I would like to wind up by saying that it's a safe gold standard test for the diagnosis and treatment of heart diseases. Please do not be scared of it. It will be useful in your treatment.