Ct angiogram for mesenteric ischemia
Common Questions and Answers about Ct angiogram for mesenteric ischemia
angiogram
have you accepted that a CT scan is as effective as the 'gold standard' catheter angiogram?
Which kind of CT please? The 64-slice? That's the latest I have heard of.
My husband had a splenectomy almost 3 months ago. He went in for a liver transplant (MELD was 18) and they discovered that his liver was fine and they aborted the liver transplant. He also has a portal vein clot which was there before the splenectomy and has now extended down to his superior mesenteric vein. His spleen was 5.35 lbs. They also removed his gallbladder which was fine and his bile ducts were fine. Since the splenectomy his ALP has been elevated and has not returned to normal.
The CT scan is angioplasty and a cath angioplasty is unnecessary unless there is going to be a stent implant as a cath would only verify what the CT images show. The CT scan is more inclusive than a cath as it views the anatomy of the vessel, respiratory, aorta, etc. as well as the lumen...the cath only views the lumen unless there is ultra sound attached to the probe.
An echocardiogram would not show any ischemia...
It is the vulnerable soft plaque between the layers of the vessel that is of principle interest and scored by a CT scan. Hard calcified plaque within the lumen presents the risk for ischemia (occluded vessel(s). That is what I was told by the doctor reviewing my CT score and supported by all sources I have read.
From hard copy source!: "Depending upon their composition, plaques can be classified into two types.
1.
Thanks for the response! He is on 40 mg torsemide and Koreg plus another med. he uses a nebulizer for breathing too. Doctor called today and wants a CT Angiogram. Nurse said possibly angioplasty but we won't know until after test on Thursday. To top it off he fell tonight and really banged himself up. We see heart failure clinic PA this week too. Thanks for your response. Praying for an answer that he can handle!
Yes, a ct 64 slice scan angiogram is as good as a cath angiogram to view the anatomy of the vessels. Cath angiogram only views the lumen (cavity) for blockage, but a ct scan views the entire anatomy of the vessel and trhat would include the buildup of soft plaque between the inner lining and the upper layer.
A CT scan evalutes the condition of vessels very quickly as a opposed to a cath angiogram. MTA and CT scan do not evaluate the vessels for ischemia during a stress event.
Nuclear Stress tests, etc. are tests performed by a doctor and/or trained technician to determine the amount of stress that your heart can manage before developing either an abnormal rhythm or evidence of ischemia (not enough blood flow to the heart muscle).
I need your advice. I have been having chest pain for 5 years-unrelated to exercise but sometimes related to stress. I have had three angiograms with varying results. First angiogram: surgeon diagnosed a 70% blockage at the main branch of my left anterior descending artery. Upon followup, my cardiologist read the same xray and diagnosed 50% blockage. Second angiogram (2 years later): the surgeon diagnosed 30% blockage in the same area.
The latter can be diagnosed via an echocardiogram but the former usually requires a left heart catheterization or a CT angiogram of the heart.
Patient underwent Persantine PET protocol for 4 minutes and heart rate rose to 55% of the maximal age predicted heart rate. Stress EKG portion was non-diagnostic for ischemia.
FINDINGS: Stress perfusion images show a mild reduction in uptake in the distal anterior wall and apex with normalization on resting images. This is suggestive of mild ischemia in the distal left anterior descending artery territory. Gated perfusion images show normal wall thickening of all myocardial segments.
We had taken an other ecg recently as part of his health checkup. Before ecg showed poor r wave progression and present one showed flat t wave abnormality for 2 times consistently. What does it mean..
An echo
Non-intervention angiogram CT scan 64/128/256 slice is almost as good and maybe better than the intervention of a cath angiogram. For a successful CT test the heartrate should be below 60 beats and the patient should be able to hold there breath for 20 seconds or so...also an obese patient is not a very good candidate for obvious reasons. More inclusive than a cath as it includes the anatomy of the vessels, respiratory system, the aorta (ascending, arch, and descending.
My MPS showed a small focus of reversible ischemia. I was given the choice of proceeding with a heart cath or not. I'm confused. Wouldn't it be risky to avoid the angiogram?
Have you had an ultrasound of the mesenteric arterys yet? How about an 3d angiogram? Ask for one if you can. Ask for both tests. Lyne 0123, don't give up. I am getting scheduled for surgery soon to aleviate my stomach troubles, and I live in the southwest, I had to travel to Cleveland Ohio, and I am going to Chicago for the surgery. Do your homework. Research...If there's anything I can do Please let me know. I'm here for you.
GI doc ordered endoscopy. Now he thinks this might be mesenteric ischemia? He says he is losing large red blood cells for his type of anemia. He is still having the morning pain, bloating, and cannot function until late in the day. He had been told when they diagnosed the heart trouble that he had a blockage in the kidney artery as well but they would address that later. Could this be a blockage to his small intestine or at least a narrowing?
Went to family physician who was concerned and suggested nuclear stress test or CAT angiogram and gave me a choice. He ruled out blood work to look for enzymes. He told me the CAT would require prior insurance approval and recommended nuclear stress test. Like the EKG's I am sure that nothing will show up on the stress test. Should I save the insurance co pays etc and go straight to CAT angiogram?
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It could also be a periumbilical hernia that has got trapped resulting in small bowel obstruction or mesenteric ischemia. Early appendicitis too behaves this way and so does colitis. It could also be cystitis, urinary tract infection, diverticulitis or inflammatory bowel disease.
It is difficult to comment beyond this at this stage. A clinical examination followed by a CT scan of the abdomen should be done. Do discuss this with your doctor and get yourself examined. Take care!
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