Sigh. I went in this morning expecting to have a contrast cardiac MRI and a chat with the cardiologist.
Instead I ended up sitting with the cardiologist who informed me he's rescheduled and switched my MRI to a cardiac catheterisation (which he also referred to as: a cath, an angio, and a coronary angiogram during the conversation). Three weeks from now. yay
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I have to admit I did have to ask husband what the difference was between a cardiac cath and an angio and got talk through his one from start to finish! Does a cath/angio/angiogram show more than an MRI scan?
Good question. Personally, I would say for immediate interventional purposes an angiogram. Imagery wise, I would say cardiac MRI with contrast.
Thank you, husband has never had an MRI as his ICD is not compatible.
Is it your first angio Sunnie2day?
Yes, and you're right about the angio making an immediate response (stents, I think) possible - and why I'm not looking forward to it.
Although he didn't say so, I think the cardiologist wants the angio instead of the MRI as he suspects I'm going to need at least stents if not a bypass. Obviously I don't want to think I need stents or a bypass. Everyone I know who's had an angio comes home with stents, and several have been shifted from radiology straight to theatre for bypass surgery.
Aack, I'm scaring myself! 'Calm yourself, Mrs, calm yourself' - lol, possibly my new mantra.
I had an angio 4 years ago where stents were tried but for some reason couldn't get it/ them in my poor battered heart so that was that lol I was dismissed with the words 'no bypass' ringing in my ears.
My cardiologist thinks the angio is THE definitive test to track down 'once for all' answers to the why does Sunnie have angina pain question.
'Other sources' (Mayo Clinic, Cleveland Clinic, Harvard Med - all US sites, highly credible but again, all US sites) say non-invasive cardiac MRI is the wave (pun intended) of the future and gives every bit as much and as good information as the invasive angiogram/cardiac catheterisation.
Bottom line is my cardiologist (like me, a Scot come home after years abroad) is considered one of the finest in our little corner of the Kingdom. He's the one with the specialised training, and he's the one with the complete confidence in the procedure (angio).
Would I have preferred to have had the MRI today, absolutely. But do I trust my cardiologist, yes.
Sigh. Not over the moon but if he thinks this is the best way to go then I am not going to argue.
I just hope I don't hear him saying 'Oh. Didn't expect that.' (heard the obstetrician say that during my awake C-section with the youngest, and trust me, what he didn't expect that day turned into quite a complication for me - took me months to recover).
It's a test to look at the plumbing .
It looks to see if there are any blockages in the coronary arteries and the really snazzy Interventional Cardiologists also do measurements to see how the blood flows through the large blood vessels.
There is a debate which is better invasive angio/ cath / angiogram or non invasive CT angiogram. MRI looks the heart muscle and blood vessels in a different way. They give you the devil's chemical adenosine which raises your heart rate to see if the blood vessels dilate in response to the stress and whether the blood flows evenly throughout the heart.
It can pick up some types of Microvascular angina.
Interventional cardiologists say my test is better than your test to Imaging Cardiologists ( MRI and CT angiogram people)
A cardiovascular resonance imaging is much more thorough than an angiogram trust me I have had both.
They can even inject you with a drug that stimulates your heart to think you are exercising... Jesus I have never exercised that much thought they were trying to kill me 😭.
That’s good, though, Sunny. Get it all sorted in one go. The angio gives the benefit of being able to flush the pipes while they’re in there 😉😘
Ok, that made (and is still) me laugh. I lived in America during my working life and they have a sewer flushing service there (or did) called RotoRooter - my late husband (I remarried in 2011 after several years of widowhood) was a surgeon and he used to call angiogram the RotoRooter of the 'cardiac trades'.
He was a bit on the irreverent side. I love my 'new husband' but if I'm honest I miss the irreverent lad, and now I have the RotoRooter jingle in my head
Great reply, thank-you! I think if it's agreeable to you, I'm going to copy/paste your reply to read offline when I go into mini-panic mode (and I know me, I will. No-one will know, but I will be going into mini-panics between now and then).
Sunnie2day
I am not going to tell how my angiograms went nor my 3rd Perfusion MRI in August😬
I love morphine too ....
He ruled out a perfusion MRI today and I was doing the mental happy dance when he did that. I freely admit I'm a coward when it comes to anticipated pain and the thought of deliberately inducing 'an event' really rings all my 'Oh no!!' bells.
Well don't be shy in asking for sedation if necessary during your angiogram.
We will be with you in spirit....good luck and I hope all goes well.
Answers duly delivered upto both you and your Cardiologist
The whole reason he decided to do the MRI was his thinking my angina might be MVA. He said when he scheduled the MRI it would be reliable for MVA. This morning he told me after very careful review of my chart he no longer thinks it's MVA.
That’s interesting, did he expand on why he didn’t think it was MVA ?
He said after careful review he thinks my symptoms aren't consistent with MVA so he really needs the angiogram to find out what is causing my on-exertion angina.
I really hope so....as you know I wouldn't wish microvascular or vasospastic angina on anyone😊
I can't imagine how you cope so well, MilkFairy. I was not unhappy to hear he's decided (for now) it's not MVA. His reasons are my symptoms and results from other tests aren't consistent with MVA.
I have a very special and supportive family.
I have established a good relationship with my Cardiologist of 7 years.
I have the support of the Head of Cardiology and the nurses on the ward.
I go any cry and laugh with the Cardiac psychologist.
I have my secret weapon of a very respected Cardiology Professor at St Thomas's who I email if I have been admitted and need him to talk to the on call Cardiologist.
I love everyone's good humour and support on the forum and oh where's the gin...oh no it's only Tuesday a dry day.
I've had both and honestly the cath lab is pretty painless. I have to say the MRI perfusion scan was actually worse than my heart attack. It is fascinating in the cath lab - the team is amazing - it is like watching a well choreographed ballet. If you can bring yourself to watch the big screen the progress of the bog brush and, if you need one, the stent opening is terrific entertainment.
Some tips (learn from my mistakes) : do not make jokes and don't sigh loudly (you get told to "keep still")
Do not ask the cardiologist the next day why the morphine had very little effect and how disappointed you are that it wasn;t as good as everyone said. I was very quickly told "because we don;t give you street grade stuff".
I managed to resist the temptation to burst into an Elton John number "Don't go breaking my heart" as I can't sing in tune and I was trying to behave myself and embrace my inner geriatric.
If you need a stent the next day is a very strange experience - you feel like you are 16 again.
Everyone, without exception, was incredible. If I hadn;t been so ill I think it could have been a really interesting experience. You;ll be fine.
Morphine (and its synthetic derivatives) I don't get along. The cardiologist didn't mention morphine, oh dear. Oh dear.
Otherwise, thank-you. Your tips are noted and I will restrain myself (that EJ number is going to be hard to resist at least mentally humming). I will also restrain myself from dancing down the halls post-procedure when I feel 16 again. Those were good years, I think I might enjoy feeling that way again.
ETA: Calmer now - I've just recalled my very bad reaction to morphine and derivatives is noted in my chart. I'll remember to bring it up pre-procedure, but it is noted. Phew!
I had a large dose of diazepam at the start of my angiogram which was really quite delicious 😋.
My tip is to go to the loo just before you go to the cath lab because the time you come back to the ward your tonsils are floating ☺️
Very good advice about the loo trip.
They did my angiogram through the groin which meant bedrest for hours afterwards.
It is not womanly possible to do a wee flat on your back uphill into a bed pan ...sorry no just not possible.
No sedation for me at first I didn't get my morphine until I started with my vasospasms. IV though nice and quick.
I have IV morphine through a Patient controlled analgesia pump when I am in hospital. Hey but I am special😁
Lots of anti puke medicine too.
IV diazepam is very useful to reduce anxiety. Anaethetists have some very clever drugs up their sleeves.
Morphine reduces your blood pressure, reduces your severe pain and does a good job of making you feel less anxious.
I went a bit foggy when he explained why he'd cancelled the MRI in favour of booking the cath - I should have asked if he was going in through groin or wrist. Too right about lying flat and trying to use a bedpan.
Oh the lovely dignities of being a woman in hospital. Between those gowns, wards, and the bedpans all I want to do is avoid hospital.
Hoping I'll be in and out in the one day. Oh I hope I hope I hope!
I will keep everything crossed for you🤞
It is usual practice to use your wrist for access these days.
So all being well you should be in and out no delays no bedpan or commode moments😉
You may not get the morphine - that was administered in the ambulance by the paramedics......
Ah. Hopefully there are no blue lights in my immediate future, at least. I understand a planned procedure involves a 'mild sedative to relieve anxiety' but your morphine in the ambulance must have been owing to considerable pain. Did it at least relieve anxiety?
have sent you a private message.
So sorry to hear this Sunnie2day (love that name btw) It must have been unnerving for you.
My mums cardiologist changed tack like this, did angio and no stents needed. My mum wasn’t presenting as he expected hence changing procedure at 11th hour! Good luck, hope all goes smoothly.
WOW does your reply make me feel better, thank-you so much!
I'm SO curious, did she have angina (as the reason for the angio being ordered) and what did your mum end up being diagnosed with when the angiogram showed she didn't need stents?
I love she came through the angio without needing stents (I'm hoping that's my result, I think) - but now I'm wondering what they were able to work out from that.
Straight to the gold standard, then. At least they haven't wasted any time!
That's exactly what my cardiologist said!
Oh well all I can say is that they obviously don't feel that you are priority which is a good thing! Means you are not in their eyes in danger zone.
Angiograms seem to be priiriterised.
Cri is not a joy, I'm still waiting to speak to the cardiologist re results.... Bonkers too many people in this country the NHS can't cope.
Omg I've had 2 angiograms the first traumatised me, the second was very uncomfortable even painful as the doctor said my arm went into spasm... I expect it did ffs. I didn't really get answers on the latest angio, so had cardiac mri still waiting for full results 2 months on.
Oh. My. Your arm went into spasms...thank-you for adding to my nightmares of things that could happen. Oh. My.
Seriously, though, that must have been awful for you! I hope you get your MRI results soon. (oh. my. arm spasms, oooohhhh...)
Best wishes - are you going to ARI? Hubby was in there - no complaints!
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