Angiogram unnecessary
Common Questions and Answers about Angiogram unnecessary
angiogram
I meant to say and said the cath angiogram was unnecessary unless it was agreed and understood that there would in all probablity be angioplasty (stent, balloon) with a cath angiogram. there is a higher than expected probability there would be a stent implanted with a cath angiogram ...there are statistics available).
To go from an ekg to angiogram seems unnecessary based on the information posted. A stress test is a less invasive procedure, and usually shows any occluded vessels. Why is that test avoided?
An angiogram can be with a cath (invasive...probe the coronary arteries) or an angiogram can be the Modern CT angiograms that uses multiple detectors to capture images from different rotations of the CT scanner.
A nuclear stress test is about 85% accurate in finding CAD whereas a angiogram is 100% accurate. The angiogram also carries a 1 - 3% risk of complications, the most common risk, although very rare, is having an artery dissected during the procedure which results in emergency bypass surgery. Having said that, if I was told I needed one I would do it without hesitation. It is the gold standard of heart tests to determine if CAD is present.
I have to have a valve replaced and am having an angiogram to see if there is blockage to be treated at the same time. The physician doing the angiogram has indicated he will put in a stent if he finds blockage. My feeling is that this is unnecessary as the major advantage of angioplasty (less invasive than bypass) is totally irrelevant since I'm having a valve replaced anyway.
Thoughts?
Was it an angiogram other than a cath angiogram? The doctor is not a prognosticator for future heart events and it is unnecessary anxiety if so stated. You indicated a case conference...was the conference with a primary care doctor, cardiologist and surgeon? It seems unusual to have stents now and predict a bypass 2 years from now?
Yes, a CT scan 64-slice angiogram is an alternative to the intervention of a cath angiogram. Because there has been too many unnecessary stent implants, there are quidelines for treatment of angina and suspected CAD.
If angina (chest pain) can be controlled with medication, then treat medically. If angina is not controlled, then stent occlusions greater than 70%. In the event there is an emergency with an occlusion then a by pass.
I'm having a CT angiogram Thursday. It avoids an interventional procedure that has some risk. X-ray exposture presents some risk for cancer, but my non-interventional cardiologist feels a CT angiogram is sufficient and I'm not disputing his recommendation. I had a cath angiogram and a stent 4 years ago, there was no problem as I was in a hospital setting for 3-4 days. However, some people experience a bleeding problem at the site of the cath insertion and pain that lasts several days.
The angiogram will show the cardiologist where the blockage is and give him a good idea of the best way to treat it. Maybe it will be an easy job of inserting a stent, or maybe he will decide a better option is a bypass. The overall picture of all your coronary arteries will be seen and a long term decision will be made on those images.
The angiogram shows that your major coronary arteries are clear. The two tests may lead to the same conclusion, or the nuclear scan could have given inaccuracies when trying to penetrate body tissue to reach the heart. Let me explain how both tests could be correct.
An Angiogram can only look at fairly large vessels, the small vessels do not show up.
When you get one opinion from a Cardiologist and one opinion from your GP, in general the Cardiologist is the one you should listen to regarding heart conditions.
The Holter test (unless the lead placement is identical to the leads with ST-depression and T-wave inversion) is mainly used to detect arrhythmias, and is not as good as an EKG with 12 leads to evaluate the heart muscle.
Is it really necessary for me to have an angiogram after finding out I have small aneurism in my head? The aneurism is 3 mm, I am a healthy 37 year old female. Should I get a second opinion? It really seems unnecessary for me to have a cath and camera into my brain for an aneurism they say is small and not to worry about it???
I realize numbers are not as well as the patient along with the Echo, but please - some answers. I do not want to spend $$$$ if it is unnecessary. The cardiologist ALWAYS called me the day after he read it , which was 2 days or 3 at the most. I don't know what to do. I am afraid. I don't want to tell my family because I do not want to worry them unnecessarily. I am going to make the appt. with the pulmonologist. Do you feel I also need to make an appt with another cardiologist?
A calcium score uses relatively little radiation, but the radiation dose may be considerable if combined with a CT-Angiogram. Secondly, there has not been any large study proving that patients treated based on calcium scores have better outcomes. A calcium score may also lead to unnecessary procedures that also have risks. For example, a patient with a moderately elevated calcium score and no symptoms may be referred for an invasive procedure.
You do not need to subject yourself to the risk of an interventional preocedure, and I will add if you have an interventional cardiologist doing a cath, the likelihood of a stent implant is high (more money). There is printed documention that evidentially supports unnecessary stent implants and given that fact one can conclude there are unnecessary cath intervention as well.
I have a completely blocked LAD and 72% circumflex blockade for the past 5 years, and medication serves me very well.
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Serial caths are absolutely unnecessary and the interventional risk out weighs any benefits especially when there are no symptoms!. ACC/AHA guidelines do not recommend stenting blockages less than 70%. If one has uncontrolled angina not corrected with medication, then it is recommended to stent implants less than 70%.
It is estimated about 33% of angiograms (cath) was unnecessary. Based on your information posted you do not need a cath angiogram.
Also, if you are still having symptoms after a normal Thallium stress test, normal protocol would be to proceed to an angiogram. Remember, a nuclear stress test has a 97% specificity meaning that 97% of patients with negative or normal results are actually negative, so someone with a normal result is pretty safe. False positives are much more common.
I wanted to give an update on what happened to me in case any of else finds themselves worrying about unecessary biopsies from MRI readings. I went in for my MRI guided biopsy surgery. the radiologist put me into the MRI for 30 minutes and could no longer locate any unusual areas. I had waited 30 days from the first MRI to the biopsy due to a vacation I had already scheduled.
I believe that the amount of radiation exposure is much higher with ct over a standard angiogram. Everyone talks about risks, but if you want clear results, an angiogram is the best option. If your CT shows a blockage, you will have to go for an angiogram anyway. The risks are very small indeed with an angiogram.
Will it one day be used to clean out blood vessels around the heart, making bypass unnecessary, or is that too risky? My dad died of a MI a couple of days after an angiogram, probably because a piece of arterial plaque broke loose during the procedure. But as I understand it, the SilverHawk collects plaque, so pieces won't break off. If I ever need some "clogged pipes" cleaned out, I'll be in touch! I am grateful for your time and advice.
My vote is for number 2. In my case they didn't even do an Angiogram (invasive procedure) - never mind Angiography - because they didn't detect any problems during Echocardiogram and/or Nuclear Stress test. The cardiologist told me: "Unless your arteries are at least 70% blocked, we won't do anything." How did he know? He didn't, it was just a guess based on not finding anything other than some valve regurgitation.
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