berlysue,
The doctors are concerned that parts of your heart may not be getting enough blood. The doctors will be performing an angiogram to look to see if you have blockages in your coronary arteries (the arteries which supply blood to the heart) which are the cause of your slightly low ejection fraction and wall motion abnormality (which means that part of your heart isn't beating a vigorously as your would like).
A dye is injected into your body so the dr can see the arteries and an incision is made in the groin of your leg or occasionally your arm and a catheter is inserted into your arteries. There might be some discomfort but a good dr will let you know ahead of time so you won't feel afraid. There is usually - I think - a small balloon on the end of the catheter in case a blockage is found.
Except for a minor pricking from the injection of painkiller at the top of the leg I felt nothing whatever, watched the arteries moving on the screen and talked to the doctor while he was maneuvring around them.. As it happened, a stent was put in but again, I felt nothing. I was in truth a bit uncomfortable afterwards when the anesthetic (which is only given to avoid discomfort at the entry point) wore off but I asked for a painkiller and calmed down. Go ahead. Have no fear.
to find if there are blockages in the arteries. A MRI or 64CT / PET scan can clearly show how much of heart muscle or "myocardium" is still viable following a heart attack, of course it does show occluded arteries, if there is significant blockage. If you have / dont have blockages, the aforementioned tests may prove simply prove inconclusiv. Nuclear stress tests often have a 10% false positive. My friend, I too am in the same boat with you.
You will know a lot more about your heart health after the procedure, they will determine your EF factor during the Angiogram. Your heart arteries will be mapped, any abnormalities noted.
I have advanced CAD, and have for close to fifteen years. I wasn't very careful with my health until fifteen years ago. You have an opportunity to have a great snapshot of your heart vascular condition, and can create a baseline for further treatments, if needed.
- Is it typically an interventional cardiologist that does the initial cath and angiogram of lower extremities and legs in the process of treating peripheral artery disease that causes leg or calf cramping? I've had an ultra sound evaluation and the pain of claudication when exercising indicates I have it.
Different people have different layouts of coronary arteries. Sounds strange I know, but there are different groups people are put into, depending which of their arteries are dominant or co-dominant or non-dominant. I for example am Co-dominant where the left and right arteries share equal amounts of the heart, supplying it with oxygen. Some are left dominant where the LAD and LCX supply most of the back of the heart. Some are right dominant where the RCA does this job.
It is important to note that calcification of the coronary arteries is part of the aging process, and all people develop calcium with age. For example, one study looked at calcium scores and coronary arteries using angiography. Almost all patients (95%) less than 40 years old with calcium score of less than 8 had no significant narrowing of the arteries. In patients over 70 years old, this number was much higher.
They then guide it to the left side and squirt a dye into the artery which is picked up by a scanner above the chest, giving images of your arteries. They then do the same on the right side. This is a test to see if you have any blockages in your arteries and the results are used to determine if you require no intervention, just medication, stents or bypass surgery. You will spend a couple of hours relaxing after the procedure before going home.
The first letter of the main coronary arteries designate whether left or right. Such as LCX left circumflex LAD left anterior descending RCA right coronary artery. It would be better to look at a diagram rather than explain it, here's an example for you....
http://www.google.co.uk/imgres?imgurl=http://www.timmcmurry.com/files/coronary_arteries.jpg&imgrefurl=http://www.timmcmurry.com/CVRU_pages/CVRU_Employees.
If there are blockages, a stent implant (usually done at time of angiogram) will increase the diameter of the occlusion/occlusions permitting more blood to the deficit area. Sometimes the area of blockage can not be stented because of location, tortuous segment, too long, etc...then a bypass surgical operation may be the only remedy.
Alternatively, some people find relief from chest pain with medication.
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.
There are a few tests which would detect the efficiency of the bypass, but the most accurate is actually looking inside the arteries with an angiogram. Just as a matter of interest, have they tried her on nitrates to see if her fatigue improves? Many elderly people are put onto something like nicorandil, because with age our arteries do start to naturally stiffen anyway.
How is her blood pressure? and does she feel any discomfort anywhere? is she getting short of breath?
ve finally found a problem as a result of paying for a CT Coronary Angiogram. All I know right now is that I have a narrowing of the left main artery but I don't know the extent or the cause. I am now waiting to have a standard angiogram but I am supposed to be flying to the US from the UK in 3 weeks. Has anyone flown soon after an angiogram? How about after a stent? Appreciate your thoughts.
based on my angiogram, there is a big possibility of a quadruple by-pass. In this case I can't expect to have them all on mammary arteries since they can only accommodate 2. I am still 44 years ol, never smoked and exercise every day. I don't also have a very fatty diet being a Filipino I was told my genes just got the best of me. Heart decease is very prevalent on my mother's side of the family.
s amazing how many people are being given calcium supplements for bone deficiencies to find most of it is being deposited in the arteries. I believe they feel certain types of calcium work better than others (obviously more expensive) but other minerals are also required before it will be used in bone. People have to make a choice between healthy bones and calcified arteries, or neither.
I would consider having an Angiogram, but through your arm and not the leg artery. You have some calcium showing up on the ct scan of which I will translate for you.
Halfway down your left main coronary artery (LAD) you have suggested moderate sized blockage due to the calcium detected. The word 'luminal' is in reference to the open space in the artery which blood flows through.
An Angiogram definitely doesn't see arteries like arterioles, they are the thickness of a hair. I believe it takes a special type of MRI to look at these vessels.
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