Why Angiograms Are Necessary

Having been the rather unwilling participant in four procedures, you might think it odd that I believe that angiograms are necessary.  

In the end, however, it was a specific type of angiogram that ultimately confirmed my diagnosis of Coronary Microvascular Disease.  I was given a Coronary Reactivity Test which is an angiography procedure specifically designed to examine the blood vessels in the heart and how they respond to different medications.

Recently, both the Wall Street Journal and NPR posted some very convincing arguments as to why the traditional angiogram is no longer the ‘gold standard’ in heart testing.  And quite frankly, from my experience, I would have to agree.  

I had my first angiogram in 2005.  Having been rushed to the ER with chest pains, I was given the full range of testing.  However, when my angiogram came back ‘clear’, I was sent home rather unceremoniously; almost made to feel bad that I put them through the trouble.  

My second and third angiograms happened under much the same circumstances.  Continued chest pain, trips to the ER and confounded doctors who could offer no explanation of continued chest pain without clogged arteries.  

However, my fourth angiogram was the one that made the difference.  This specialized take on the traditional angiogram proved to be the breakthrough needed to finally diagnose my condition.


How It Affects You
While risk factors for men and women are the same, women tend to have more coronary microvascular disease.  This dysfunction of the small arteries lies in the heart muscle itself and cannot be seen on a traditional angiogram.

Perhaps the problem is not in how often angiograms are ordered, but in the way in which they are administered.  

For many women, the road to diagnosis is a long one.  It would be a wonderful thing to leave the cardiologist’s office with a correct diagnosis on your first visit.  Since that’s not going to happen, we must prepare ourselves for the gamut of testing bound to be in our future.

What better way to prepare yourself than to know what your testing options are?

[ed34]

Very interesting post, thank you for that. Do you know if they diagnose the microvascular disease accurately and medication no longer helps, is there an alternative treatment? Those vessels are just too tiny for any kind of intervention apart from medication aren't they?

[RebeccasHeart]

Thanks, Ed.  From my experience discussing the same questions with my doctor, it would seem that the microvessels are just too small for any surgical repair.  I was told medication is the only way (currently) available for treatment.  However, if you find yourself in this predicament, I would highly recommend talking to your doctor about switching up your meds.  I've been mixing and matching my meds now for three years and have finally come up with a dose that works for me.