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What is a coronary angiogram?
An angiogram is an X-ray image of blood vessels after they are filled with a contrast material. An angiogram of the heart, a coronary angiogram, is the "gold standard" for the evaluation of coronary artery disease (CAD). A coronary angiogram can be used to identify the exact location and severity of CAD.
How is a coronary angiogram performed?
Coronary angiography is performed with the use of local anesthesia and intravenous sedation, and is generally not significantly uncomfortable.
- In performing a coronary angiogram, a doctor inserts a small catheter (a thin hollow tube with a diameter of 2-3 mm) through the skin into an artery in either the groin or the arm.
- Guided with the assistance of a fluoroscope (a special X-ray viewing instrument), the catheter is then advanced to the opening of the coronary arteries (the blood vessels supplying blood to the heart).
- Next, a small amount of radiographic contrast (a solution containing iodine, which is easily visualized with X-ray images) is injected into each coronary artery. The images that are produced are called the angiogram.
- The procedure takes approximately 20-30 minutes.
- After the procedure, the catheter is removed and the artery in the leg or arm is either sutured, "sealed," or treated with manual compression to prevent bleeding.
- Often, if an angioplasty orstent is indicated, it will be performed as part of the same procedure.
What does a coronary angiogram demonstrate?
Angiographic images accurately reveal the extent and severity of all coronary artery blockages. For patients with severe angina or heart attack (myocardial infarction), or those who have markedly abnormal noninvasive tests for CAD (such as stress tests), the angiogram also helps the doctor select the optimal treatment. Treatments may then include medications, balloon angioplasty, coronary stenting, atherectomy ("roto-rooter"), or coronary artery bypass surgery.
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Congestive Heart Failure (CHF) Overview
Congestive heart failure (CHF) refers to a condition in which the heart loses the ability to function properly. Heart disease, high blood pressure, diabetes, myocarditis, and cardiomyopathies are just a few potential causes of congestive heart failure.
Signs and symptoms of congestive heart failure may include fatigue, breathlessness, palpitations, angina, and edema. Physical examination, patient history, blood tests, and imaging tests are used to diagnose congestive heart failure.
Treatment of heart failure consists of lifestyle modification and taking medications to decrease fluid in the body and ease the strain on the heart. The prognosis of a patient with congestive heart failure depends on the stage of the heart failure and the overall condition of the individual.
Coronary AngioplastyBalloon angioplasty of the coronary artery and stents (percutaneous coronary intervention, PCI) is a non-surgical procedure that relieves narrowing and obstruction of the arteries to the muscle of the heart. PCI can relieve chest pain (angina), minimize or stop a heart attack, or improve the prognosis of patients with unstable angina. The availability of stainless steel stents have expanded the spectrum of patients suitable for PCI.
Coronary Artery Bypass GraftCoronary artery bypass graft (CABG) surgery is performed to relieve angina in individuals who have failed medical therapy and are not good candidates for angioplasty (PTCA). CABG surgery is ideal for individuals with multiple narrowings in multiple coronary artery branches. Mortality and complications increase with:
- older age,
- poor heart muscle function,
- disease obstructing the left main coronary artery,
- chronic kidney failure,
- and chronic lung disease.
Exercise Stress TestStress tests are performed by a doctor or trained technician to determine the amount of stress that your heart can manage before developing either an abnormal rhythm or evidence of ischemia. Your doctor uses the stress test to determine if there is adequate blood flow to your heart during increasing levels of activity, evaluate the effectiveness of your heart medications to control angina and ischemia, determine the likelihood of having coronary heart disease and the need for further evaluation, check the effectiveness of procedures done to improve blood flow within the heart vessels in people with coronary heart disease, identify abnormal heart rhythms, and to help you develop a safe exercise program. Preparation for these types of stress tests will vary. Ask your doctor about any specific instructions.
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Peripheral Vascular Disease
Peripheral vascular disease (PVD) refers to diseases of the blood vessels (arteries and veins) located outside the heart and brain. While there are many causes of peripheral vascular disease, doctors commonly use the term peripheral vascular disease to refer to peripheral artery disease (peripheral arterial disease, PAD), a condition that develops when the arteries that supply blood to the internal organs, arms, and legs become completely or partially blocked as a result of atherosclerosis. Peripheral artery disease symptoms include intermittent leg pain while walking, leg pain at rest, numbness in the legs or feet, and poor wound healing in the legs or feet.
Treatment for peripheral artery disease include lifestyle measures, medication, angioplasty, and surgery.
Stroke SlideshowWhat is a stroke? Learn about stroke symptoms like sudden numbness or weakness, confusion, vision problems, or problems with coordination. Discover causes and recovery of a stroke.
Stroke Symptoms and Treatment
A stroke is an interruption of the blood supply to part of the brain caused by either a blood clot (ischemic) or bleeding (hemorrhagic).
Symptoms of a stroke may include:
- double vision or vision loss,
- difficulty speaking or understanding speech.
A physical exam, imaging tests, neurological exam, and blood tests may be used to diagnose a stroke. Treatment may include administration of clot-busting drugs, supportive care, and in some instances, neurosurgery. The risk of stroke can be reduced by controlling high blood pressure, high cholesterol, diabetes, and stopping smoking.
X-rays are a powerful form of electromagnetic radiation that has the ability to pass through solid objects. In medicine, X-rays are used to obtain an image of a part of the body. X-rays are necessary to diagnose many illnesses, for example, tumors, arthritis, dental problems, digestive or heart problems, and bone fractures.
The side effects, dangers, and risks of having X-rays while pregnant or breastfeeding are provided.