Coronary Angiography… An Option to Check the Fitness of Coronary Arteries
What contrast dye is used in coronary angiography?
The dye here refers to a clear solution that is radiopaque and contains iodine, which is abundant in seafood. Therefore, patients allergic to seafood may also be allergic to the dye and must inform the doctor if they have a seafood allergy. Normally, blood vessels are not visible on X-rays, but when the radiopaque dye is injected, the blood vessels or heart chambers become visible on the X-ray.
What is coronary angiography?
It means inserting a small catheter, about 2 mm in diameter, into an artery starting at the wrist or groin (the groin is most commonly used because it is more convenient and less painful) until reaching the opening of the coronary artery. The doctor injects the radiopaque dye and observes the condition of the heart muscle and valve function.
When is coronary angiography performed and how necessary is it?
If you have chest pain, the doctor will take your history and perform a physical exam. If coronary artery blockage is suspected, the doctor will recommend coronary angiography because coronary artery disease causes heart muscle ischemia, which risks heart attack and eventual death.
Benefits of coronary angiography
- To diagnose coronary artery disease and assess the function of the heart muscle and valves.
- For treatment, if coronary artery blockage is found, it can be treated by balloon angioplasty during the same procedure.
Preparation steps before coronary angiography
The doctor will ask about drug allergies, seafood allergies, underlying diseases, and medications, especially blood thinners, which must be reported to the doctor and brought for review. A general physical exam will be done. The patient and relatives will listen to explanations from the doctor and staff and sign consent forms. The night before the procedure, the doctor will order fasting for at least 6–8 hours before the test. IV fluids will be given. The skin will be cleaned and hair shaved at the catheter insertion site.
Procedure in the examination room
The doctor will inject local anesthesia at the catheter insertion site, usually the groin (wrist is also possible). Antiseptic ointment is applied, and a small hole is made to insert the catheter through the artery to the opening of the coronary artery. The doctor will inject the radiopaque dye and take X-rays from various angles. If a blockage is found, balloon angioplasty can be performed immediately. The patient, relatives, and doctor must have discussed and planned this in advance. On the day of the procedure, a relative who can make decisions should accompany the patient. During the procedure, the patient remains conscious and can communicate with the doctor.
How long does it take?
The coronary angiography procedure takes 20–30 minutes, but if balloon angioplasty is needed to widen the coronary artery, it takes about 45 minutes to 1 hour.
Is coronary angiography dangerous?
Complications are very rare, about 0.01%. Possible symptoms include bleeding, infection, and arrhythmia.
Post-coronary angiography care
Patients must stay in the hospital for at least 1-2 nights. During hospitalization, follow the doctor’s instructions as follows:
- Lie flat on the bed and do not get up, not even to go to the bathroom! Do not bend the leg or arm on the side of the procedure for 6–12 hours or as advised by the doctor.
- Most doctors will allow walking the next day, and if there are no abnormal symptoms, discharge will be permitted.
Care instructions after returning home
- Keep the wound dry and clean.
- Exercise by walking.
- Avoid foods high in saturated fat, such as stewed pork leg rice, stir-fried, and fried foods.
- Take medications as prescribed by the doctor.
- Attend follow-up appointments.
- If you experience chest tightness, see a doctor immediately.
Prevention of coronary artery disease
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Avoid foods high in saturated fat, such as stewed pork leg rice, stir-fried, and fried foods.
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Exercise regularly.
- Avoid stress.
- Quit smoking.
- Lose weight.
- Rest and relax.
