Do coronary angiography live long? Why did the doctor ask you to do a coronary angiogram? Mainly look at 4 conditions
Mr. Li is a patient with coronary heart disease. He went to the hospital because of repeated chest pains and wanted to have a heart examination. He first went for a routine electrocardiogram and other examinations. After that, the doctor suggested him to do a coronary angiography.
But Mr. Li was very puzzled. He had heard that coronary angiography had a great impact on the body and had side effects. A stent should be placed after it was done. Many people around him did not recommend doing this. And why are there so many hospital checks? After the electrocardiogram and echocardiography were done, there were coronary CT and coronary angiography.
Finally, after careful consideration, Mr. Li still refused the inspection.
1. What is the difference between ECG, echocardiography and coronary angiography?
ECG is mainly used to diagnose arrhythmia, acute myocardial infarction, and premature contraction. It is also the simplest and most commonly used method for diagnosing coronary heart disease . However, the ECG also has disadvantages. For example, when there is no chest pain, it may not capture the image of myocardial ischemia.
Echocardiography does not require opening the chest to see the internal structure and size of the heart, as well as the blood flow and pulsation of the heart. However, some patients with thoracic deformity and severe emphysema will affect the quality of the image. In addition, echocardiography cannot diagnose changes in the electrical activity of the heart, such as arrhythmias.
Coronary angiography is a "gold standard" for diagnosing coronary heart disease .
However, coronary angiography is expensive and requires hospitalization, which is an invasive test.
2. Why do doctors sometimes ask you to do coronary angiography?
For patients with coronary heart disease or suspected coronary heart disease, coronary angiography can not only confirm the diagnosis, but also find the degree of vascular disease and guide treatment. Generally speaking, coronary angiography is mainly used in these four situations:
Patients who are preliminarily judged to be coronary heart disease, and the drug treatment effect is not good, and agree to perform interventional treatment for some lesions during angiography;
Patients with acute myocardial infarction requiring emergency interventional treatment;
Patients with severe lesions on coronary CT or clinical judgment, who may need coronary artery bypass grafting;
No obvious abnormality was found in coronary CT examination, but the patient's symptoms did not match with coronary CT.
Some people say that coronary CT can also be used clinically. Why do some doctors not use it?
In fact, it is mainly based on symptoms. Some patients have obvious coronary heart disease from the perspective of symptoms, and there must be problems. At this time, the direct choice of coronary angiography can be used to determine whether to place a stent or bypass.
In short, the doctor will choose the most suitable examination method according to the patient's condition.
3. Coronary angiography, how much impact does it have on the body?
Many people think that coronary angiography is an invasive examination, which is harmful to the body, and it is not long after coronary angiography.
In fact, coronary angiography does have some impact on the human body. After angiography, there may be some related complications , such as hematoma and bleeding at the puncture point after surgery, and the excessive use of contrast media leads to complications such as contrast media nephropathy after surgery. .
In addition, the contrast agents commonly used in clinical practice currently contain iodine, so these three types of people should pay special attention:
People allergic to iodine: Because the contrast agent contains iodine, the most common side effect may be allergy, which may cause vomiting, gastrointestinal reactions, itching, rash, etc., and even lead to shock and life-threatening in severe cases.
People with renal insufficiency: Contrast media needs to be metabolized by the kidneys, so patients with renal insufficiency should pay attention, especially those with severe renal insufficiency should avoid using contrast media; patients with mild to moderate renal insufficiency should also try to reduce contrast as much as possible dosage of the agent.
Patients with hyperthyroidism: Because the contrast medium contains iodine, it may induce the risk of acute exacerbation of hyperthyroidism symptoms in patients with hyperthyroidism, so it should be used with caution.
In fact, it is very rare to die from coronary angiography in clinical practice now, and the probability of occurrence is extremely low. The safety of coronary angiography has been tested for a long time . The incidence of complications is less than 1%, and most The risks are all minor and can be avoided and corrected.
Clinically, some patients feel chest pain and have no typical symptoms. They just want to have a coronary angiography to seek peace of mind. Some patients already meet the indications for coronary angiography, but they are unwilling to do it. This is inappropriate. . Coronary angiography is not something you can do if you want. Similarly, the lesser of two evils, if you blindly refuse the examination, it may also delay the disease.
Some patients worry that stents will be placed after coronary angiography, but this is not necessarily true .
However, if the degree of vascular blockage is greater than 70% during the examination, and the patient's condition meets the conditions for stent placement, stent surgery can be performed at this time. This can prevent the patient from doing secondary intervention to increase the damage to the blood vessel, and can also reduce the contrast agent and X-ray radiation, reduce the patient's economic burden, and improve the patient's quality of life.
Fourth, after the operation, do 3 things to pay attention to
Coronary angiography is an invasive examination. In order to recover better, patients should do the following 3 points after the operation:
· Rest in peace after surgery
Some patients are too emotional after surgery, which can easily lead to the occurrence of angina pectoris and even another myocardial infarction. Therefore, it is very important for the patient to rest quietly after the operation.
· Drink plenty of water
After coronary angiography, doctors usually ask the patient to drink plenty of fluids to facilitate the expulsion of the contrast agent from the body. The specific amount of water you should drink depends on your blood pressure and urine output . If the postoperative urine output and blood pressure are stable, you can increase the amount of water you drink than usual; but if you drink more water but do not urinate, you should report to the doctor in time; Patients with heart failure should follow the doctor's instructions on how much water to drink.
· Follow the doctor's instructions for appropriate activities
Coronary angiography is a puncture of the radial artery or femoral artery. The wound surface is very small. The patient does not need to worry too much about the healing of the wound. After the operation, the wound should be compressed in strict accordance with the doctor's requirements. However, prolonged bed rest may increase the risk of blood clots, so patients can exercise appropriately under the guidance of a doctor.
In short, heart disease needs to be analyzed according to the patient's situation. Different examinations have different effects on the heart. The purpose is to detect problems and treat them in time. It is best for patients to follow the doctor's advice for examination.
References:
[1] "What is the difference between ECG, color Doppler ultrasound, and coronary angiography? This explanation is easy to understand". China Medical Tribune. 2021-12-18
[2] "When should coronary angiography be done? ? ". Fuwai said the heart. 2021-07-28
[3] "The authoritative answer to which examination is better, coronary CT or angiography? ". Fuwai said the heart. 2018-11-01
[4] "Who needs coronary angiography? These 3 types of people should be paid special attention". Medical Cardiovascular Channel. 2022-10-01
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