JAKAYA KIKWETE CARDIAC INSTITUTE (JKCI)

Cardiac Surgeries

Coronary Angiography

The function of coronary arteries is to supply our heart muscle with blood. They may get clogged from a buildup of plaque, cholesterol or cells resulting in reduction of blood flow to the heart and thus increased risk of heart attack.

Coronary Angiography is a diagnostic procedure in which is a special x ray test is done to find out if coronary arteries are blocked or narrowed.

This helps the doctor in identifying the exact location and severity of coronary artery disease and thus decision regarding line of treatment such as coronary angioplasty (stenting) or bypass surgery (coronary artery bypass grafting) is taken after consulting the patient and his/her family.

Coronary angiography is a day care procedure and is performed with the use of local anesthesia in cardiac catheterization lab.

During the procedure, a small catheter (a thin tube) is inserted through the skin into an artery in either the groin or the arm. The catheter is then advanced towards the opening of the coronary arteries with the help of a special x-ray viewing instrument. After that a small amount of contrast (radiographic) is injected into each artery. The images thus produced through this process are called Angiogram.

The time taken by this procedure is around 20-30 minutes. Post procedure, the catheter is removed and the doctor does suturing or sealing of the artery in the goin or arm to prevent bleeding.

Preparations for Coronary Angiography

Prior to getting admitted for the procedure, your doctor may order some tests that you need to have to help to assess your fitness to undergo the procedure. These investigations commonly include: blood tests, an ECG), and chest X-ray.

You may get admitted to hospital the night before procedure or the same morning. Overnight fasting or at least 6 to 8 hours of fasting is required for this procedure.

You and your family will be then be counseled by the treating doctor about the coronary angiography procedure followed by a brief physical examination and enquiry about your individual and family history of illness. You will also be asked to sign a consent form for the procedure.

You will need to remove any jewellery or accessories that you are wearing and put on a hospital gown.

Shaving in the area where the catheter will be inserted is done before the procedure. You may be given a sedative about an hour before the test in order to help you relax. Though you will be awake during the entire procedure.

Post procedure, your doctor will explain the results of angiogram. This will help your doctor to recommend the best line of treatment for you.

Diagnosis done by coronary angiogram

As mentioned earlier, Our heart receives its blood supply from the coronary arteries. If these arteries get narrowed or blocked, the heart is short of sufficient oxygen and nutrients. The pain that results from this condition is known as angina.

An angiogram not only diagnoses diseased coronary arteries, but it can also diagnose a range of other heart problems like aneurysm (abnormal ballooning of the walls in the heart), eart arrhythmias (irregular heart beat) or birth defects like a hole in the heart.

Types of Coronary Angiogram

Following are the two types of coronary angiography procedures:

Catheter Coronary Angiography: It engages inserting a catheter into a vessel in the groin or arm area. The catheter wire is then guided to the area to be examined. X-rays are then used to produce the angiogram or picture of the vessel.

Non-invasive coronary angiography: This menthod uses computed tomography (CT), or magnetic resonance imagining (MRI) or ultrasound for the production angiogram images. CT involves radiation exposure, whereas MRI and ultrasound methods do not.

Catheter coronary angiography, and in certain cases, non-invasive coronary angiography too, uses a contrast agent called dye. This is administered through an IV (intravenously). The contrast agent helps in improving the quality of the image.

Care to be taken at home

At the time of discharge from the hospital, your treating doctor will give you written advice to be followed at home. The common suggestions include:

Try to take maximum rest possible for you for the initial few days.

Do not stand for more than a few minutes at a time.

Avoid heavy weight lifting.

Consult your doctor if you suspect any infection. Symptoms may include redness, heat, swelling or discharge from the site of procedure.

Diet For Angiography Patients

A heart healthy diet helps in the recovery process. It is essential that you adhere to the diet chart provided by your health care provider/dietician. It is suggestive to follow a personalized diet plan that includes specific food for heart patients. You are advised to eat small meals throughout the day.

Following are a few heart healthy diet tips that you can discuss with your doctor and nutritionist:

Limit your fat intake with a low fat diet, but don't abolish fats altogether. Variety is essential.

Your daily diet should include plenty of fresh fruits and vegetables.

Skinless chicken and lean meats like fish and are healthy if taken in small/medium servings only.

Simply consume low fat varieties of milk and yogurt, and keep away from egg yolk although egg whites are fine.

Significantly reduce your intake of products that are caffeinated and avoid all alcoholic beverages.

Reduce your intake of sugar rich refined foods like chocolates, cakes, and biscuits.

Also, Cut down on your salt intake as much as possible for you.

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