Coronary angiography (performed by KC Vysočina)
Coronarography is a contrast-enhanced radiological examination of the coronary arteries that supply blood to your heart (or heart muscle). It is performed when a narrowing or blockage of these arteries is suspected. The cause is most often atherosclerotic involvement in coronary heart disease (CHD). This is mainly manifested by chest pain and often shortness of breath.
The aim of the coronary angiography is to show the coronary arteries, their translucency and thus reveal any narrowing or blockage. To restore blood flow through the "clogged" or narrowed arteries, depending on the findings and possibilities, catheterization angioplasty can be performed at the same time, or after assessment of the findings, cardiac surgery can be planned at the CKTCH Brno or in České Budějovice (coronary by-pass = bridging of an impassable coronary artery).
Pharmacological treatment is an integral part of the investigation and treatment of IHD (see article - ergometry). Early detection of critical narrowing of the coronary arteries and initiation of appropriate treatment can by the means of coronary angiography save a life.
It is also performed before any planned surgical procedure on the heart and its vessels.
The coronary angiography unit is a combination of an surgery room and an X-ray room. It includes a surgery table and an adjustable stand with an X-ray machine. A radiation source is required for X-ray imaging - the so-called X-ray machine. After passing through the body, the X-rays are scanned and transferred to a screen. Once the cross-section and course of your coronary arteries have been imaged, a contrast medium must be injected, which is done with a catheter inserted to the heart. This is a long, thin, hollow tube. The contrast medium is injected with a pressurised syringe.
The catheter is usually inserted into the artery through the wrist or also through the groin... Under X-ray control, the catheter is passed through your artery to the point where the coronary vessels are separated above the aortic valve. After entering the coronary artery, the doctor injects a contrast agent to show its translucency and course. The doctor repeats the same procedure for the other coronary artery.
Preparation:
- Long term – the indication for the examination is determined by the physician, the patient receives an appointment for the examination and presents to the hospital on the morning of the scheduled coronary angiography. Blood is sampled beforehand, mainly to check for clotting.
The patient arrives at the hospital hungry, but takes his morning medication as prescribed by his doctor.. Diabetics are an exception, they must not inject insulin or take diabetes medication !! They'll stay with an empty stomach!!
It is also necessary to report iodine and mesocaine allergies in time! - Short term
Shaving the forearm or groin.
Insertion of intravenous flexilla.
The cath lab then calls patients individually for the procedure. The nursing staff then take the patient in the bed for coronary angiography.
The process of examination
The patient lies down on the examination table under the movable arm of the X-ray. They can see the screen on the side, which the doctor will watch during the examination. The nurse will stick electrodes on the chest to read the ECG. You will be given a clip on your finger to read the blood oxygen saturation.
The doctor then disinfects the catheter insertion site (i.e. the groin or wrist) and numbs it with a small amount of local anaesthetic. Using a special needle, he or she will puncture the femoral artery and move the catheter upstream to the heart arteries and then inject the contrast agent. He will check the actual position of the catheter and the condition of your arteries by taking x-rays and watching a screen. The entire procedure is performed with only local anaesthesia at the catheter insertion site. You are therefore fully conscious and are always in touch with the doctor, who explains to you exactly what to do. All you have to do is to lie still on your back and occasionally hold your breath when prompted. The doctor can tell you the preliminary results of the examination during the examination. The procedure itself takes from 20 minutes to an hour.
During a coronary angiography, the doctor can perform a so-called PCI (=percutaneous coronary intervention) - this is a technique that can be used to dilate narrowed or closed blood vessels with a special balloon and very often a special spring in the artery, called a stent. The typical pinching pain behind the sternum is likely to occur after the balloon has been inflated. The balloon closes the artery for a while and oxygenated blood cannot flow into the artery.
During inflation, the sclerotic plaques are pushed against the vessel wall, thereby expanding the internal vascular permeability. The doctor then checks the patency of the blood vessel by re-inflating the balloon with a contrast agent and decides whether to re-inflate the balloon or to insert a stent (a tiny spring that leaves the blood vessel stretched).
How to make an appointment?
Tel: 567 157 156 or 567 157 157
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