angiogram

[rustys888]

I had a simple stress test two weeks ago they found a little abnormalty. Then had a ecco and persantine stress test
which found an abnormalty. the doctor called me today on a saturday and suggested that i now have a angiogram
and if there was blockage in the arteries because this test would be more accurate. they would then have to do surgery. my question is can you tell me exactly or roughly what an angiogram tests are mostly looking for.

[ed34]

If there is an abnormality and they feel an angiogram is necessary, then I wouldn't argue. They know what they are doing. Imagine you have a 10 meter length of copper pipe which has a blockage somewhere. You can't see where the blockage is, so a radioactive contrast dye is injected into the pipe so it can flow through with the water. An x-ray is taken at regular intervals to see inside the pipe, because it picks up the dye. This way you can easily see where the blockage is, and how big it is.
An Angiogram is pain free, I've had 6 now. They use a local anaesthetic to numb your upper/inner thigh and make a tiny incision to access your femoral artery. A catheter is passed through your arteries up to the heart and from the Aorta they can access all your coronary arteries. They inject dye into them and look at an image produced by the scanner above your chest. You are awake and you can see the images. When they inject the dye you can feel a little sensation of warmth flowing through your body, but it really is nothing uncomfortable, it's quite a nice sensation really. If they find a blockage causing problems which is easy to resolve at the time, they will probably stent it. This is where a tiny collapsed metal mesh tube is fixed at the end of the catheter with a tiny deflated balloon inside it. It's pushed into the blockage and the balloon is inflated, expanding the metal mesh tube into place. During those few seconds, blood is obviously stopped in the vessel and you can feel a bit of an ache in the chest. But, again, nothing terrible or they wouldn't be using this technique. The balloon is then deflated leaving the stent in place and your artery is open again, and the catheter+balloon is removed. If the blockages are severe and there are many of them, then they will probably recommend bypass surgery.

[kenkeith]

Angiography after the stress test, echo, etc. in all likelihood is to do stent implant. The stress test involves viewing the perfusion of blood flow (contrast agent injected), and apparently there was some vessel occlusions that effected blood flow. The perfusion is viewed with exertion and at rest.
If these tests indicate you have coronary artery disease or you have severe symptoms, your doctor may recommend a coronary angiogram to evaluate the severity of coronary artery disease and the exact location of any narrowing or blockages.

Do you have severe chest pain (angina)?. Is medication ineffective to treat symptoms?  You may want to google COURAGE study before you have a discussion with your doctor.  It will give you an insight of the appropriate treatment for coronary artery disease.  

Thanks for sharing, and if you have any further questions feel welcome to respond.  Take care.