I have been advised to have this procedure to determine whether I have angina or not. I’ve researched it but have not been able to find answers to all my questions. Could anyone answer any of the following?
1. Is there an alternative procedure to this one to detect angina?
2. How much radiation is used?
3. As I have AF (PAF) I wondered if the procedure could initiate PAF?
4. Is there any chance it could make AF worse?
5. There seems to be some disagreement concerning how aware the patient is of the procedure. Can it be painful or very uncomfortable?
6. How strong is the sedation that is used? That is, are you fully aware of what is going on?
Hi I have had a CT Angiogram & Calcium count test ,very straight forward & painless! Here is a link to a Video on You tube which should help answer some of your questions . Just copy or follow the link to Youtube. Best wishes
Have you asked the cardiologist these questions? As for having an angiogram, it’s not a big procedure and is required to form an accurate diagnosis, you will be sedated and if you need more they will give it to you. Had my 2nd on 27/04/22 and it’s not without a little discomfort but mostly the feeling of pressure on your arm, if I needed another today I wouldn’t hesitate, just ask them questions but remember they can’t treat you without knowing exactly what’s wrong and an angiogram is necessary to find the right treatment for the long term.
It’s pretty much a gold standard test. I had one and they put a stent in at the same time. No sedation, no discomfort they let me watch the procedure on the screens and explained everything as they went along. It was very interesting. Any radiation risk is to the operators who are doing this every day not us patients. Sorted my angina out virtually straight away.
There are two different types of angiograms. They both used to image the coronary arteries in slightly different ways. What your cardiologist is looking for is a blockage in one of your arteries as this is what would be causing angina, if indeed, you have it. Angina is the term used for pain from your heart if a part of it is getting little or no blood supply - normally caused by a blockage. Unfortunately there isn’t another kind of test to show this other than an angiogram.
The first one - a CT angiogram - your in a CT scanner and they use dye that goes in your arm to image your heart to create a 3D model of your arteries. This image is still - think of a picture of a spiderweb. I found this procedure fine, pretty much pain free (the only pain being the cannulas for the dye) it’s a bit weird when the dye makes its way to your groin as it feels all warm and you think for a second you have wet yourself! There would be more radiation from this as they are using X-rays in a CT scanner. You get the results in a few weeks.
The second - a “classic” angiogram is when they insert a catheter (tube) in to your radial (wrist) artery and feed it to you heart. This enables them to see the Coronary arteries “live” in a video format. They are looking there to see how your coronary arteries are filling and refilling with the beat of your heart and it gives an excellent idea of angina as they can see in detail how your heart muscle is being supplied with blood. The cardiologist can discuss your results with you pretty much there and then which is good. You can also watch your images if you would like.
Now, sedation/pain depend on a couple of things. Mostly your age and state of anxiety!
I was only 34 when I had my classic angiogram and so this worked against me. The younger you are the “fitter” your arteries and so they are tighter and more likely to put up a fight to having a tube put through them. So, unfortunately, my angiogram was painful BUT crikey, nothing I couldn’t handle. My arteries basically went in to cramp. Sore but fine, an odd sensation. The actual tube going in your wrist is fine because they give you local anaesthetic.
Sedation wise- the stuff didn’t touch me 🤣 I’ve been more knocked out by wine. The said the lack of effect was because I was super nervous. They gave me more but it didn’t do anything. Again, a big BUT, I reckon I just have a really good liver or something cos I can take 60mg of codeine and be pretty fine - that normally knocks people out completely. Totally depends on how people process these drugs and how anxious they are to start with.
What I will say is that the team I had where so so so lovely. They couldn’t have been nicer. Really chatty and friendly, telling me what was happening and so overall, even though I had a little pain, it was absolutely fine. You’ll be in and out before you know it.
I have had a CT angiogram, easy peasy. They wanted to do the invasive coronary angiogram based on chest pain 6 years earlier (investigated at the time) but I refused as there was nothing to indicate a problem, which was confirmed by the CT angiogram. I may well be advised to have one soon, but if they will give me midazolan that's fine by me.
As others have said, there’s a difference between a CT Angiogram and an Angiogram.
I was referred for a CT Angiogram first. Nothing to it except for a few seconds of a warm flush felt as the dye was injected.
This scan did detect narrowing. I was therefore referred for an angiogram.
The angiogram involved a catheter sent through an artery in my wrist and fed through the arteries in my heart. I felt less flushed from the dye used in the angio. Almost as if they injected more little and often throughout the procedure rather than one bigger amount used in the CT.
I had sedation but fully awake, fully aware, not sleepy, just a little less anxious and it was fine. A stent was placed in my LAD artery. As others have said, they will need to check if it’s blocked arteries causing the problems you’re experiencing. If it is, the CT Angio and/or Angio will detect this. Of course it’s only the Angio that may result in them being able to fix any problems with regards any narrowing. They told me whilst signing the consent form for the Angio that depending on what’s found, they might either stent or suggest heart bypass surgery. This frightened me! Whilst my other arteries have narrowing, they only felt the need to stent my LAD.
Good luck with whichever procedure you go on to have. Try not to allow your thoughts to cripple you. The procedure is so much more comfortable and straight forward than we fear 👍
I am having a Angiogram on Thursday after a having a stress MRI which showed reasonable blood flow but Cardiologist is concerned that the two stents I have in my LAD are maybe to small, in his words "Small Calibre stents in a very diffusely diseased LAD " (which was bypassed using my LIMA to LAD in 2015 ) he put the stents in March 2018, so is looking at possible re-stenosis
I don't really present with Angina my problem is shortness of breath so Cardio just wants to be sure of what is going on, in his words only thing that can confirm if this Short of breath is coming from lack of blood supply or if it comes from my Diagnosed Heart Failure is by Angiogram !!! So as someone said earlier it is the ultimate Gold Standard of Diagnostic Tools and I think I would be correct in saying it is the last and final test for the majority of Heart Patients.
Last time I remember Part one was meeting a very nice young nurse who introduced herself as Amanda who said I will be with you all the time you are here and she was. Part two She introduced me to the " Team " of Radiographers as this is Mr Smith who is here for a Angiogram. His weight is 95kg and is 1.82m tall and then any questions Mr Smith on the procedure or anything you are concerned about No OK on the table and lets go.
Only once did I feel discomfort was when the Cardiologist opened up the stent Amanda asked on a scale of 1 to 10 how is your pain about 6 I replied as the pain went away. I did hear Amanda tell the whole team Mr Smith has pain of 6 on the scale and that was about it.
I have had Angios through both Left and Right Femoral and through my Right Wrist I think I would now always opt for Wrist if I had a choice. Hope this helps a little if you have any other questions just ask and I am sure between us we can answer a lot of your concerns
Regards
ps don't think I have had sedation I like to see what's going on, It is interesting to see the wires they used to reconnect the sternum after having bypass surgery !!
It's all been said. I had two angiograms; one right after my heart attack when they fitted two stents and one a couple of months later. I never even thought about radiation. I was given sedation; more the second time for some reason but I was aware of what was being said. The only thing I felt was when they put the canula into my wrist. ( I hate injections and such things). I asked to watch the screens but they were at the wrong angle for me to see . Apart from the canula going in I felt absolutely nothing either during or after. I had bad bruising up my arm after the first one because the nurse loosened the pressure bandage a bit too early but didn't even see a pin prick mark after the second one. It's a very straightforward, every day procedure for them and nothing to worry about.
1. The procedure is to detect blocked arteries, so I don't think there's any alternative.2,3,4 sorry don't know
5. 6. I've had three angiography. Never had any sedation. So I was fully aware. Absolutely no pain or discomfort. I found it interesting to watch the xray screens. I could see the blocked arteries before they told me. There's one point at the end of the procedure where they inject something which gives you a sort of pleasant warm sensation. It feels like your going to wee, but you don't.
I'm not sure it's all been said but angiograms (not ct angiograms) are the gold standard for detecting blockages in the arteries around the heart. Before I had one about 15 years ago, a stress ecg (an ecg when you're exercising) had revealed from the signals that I was likely to have ischaemic heart disease (blocked vessels). The angiogram confirmed this, and owing to the severity of the blockages in 4 arteries, I needed a heart bypass operation a few days later. A lot of people need stents and they may or may not put these in while you're having the angiogram. Check with your medical team.
Obvs. they are very common and safe procedures, but catheterisation (putting thin lines to inject radio-opaque marker 'dye') is not risk free. This is worth discussing with the doctors before consent.
In general I think procedures like angiograms are helpful in understanding what is going on in your body.
I've had both types of Angiograms. The CT which is a dye injected and is scanned. Not painful & quite straightforward.
I e also had an Angiogram to investigate my heart further (this is the one called Gold Standard) in my case the probe was inserted into my femoral artery in my groin, it can be done through the wrist but it depends on the cardiologist as to how they want to proceed.
I found it a bit uncomfortable but certainly not painful. I was apprehensive beforehand but TBH I needn't have worried.
My PAF was triggered during my last angiogram by a drug called Adenosine which was being used to measure the blood flow through my LAD. It's a known side effect of this drug and my heart went back into rhythm a couple of days later. That was six months ago and it hasn't had any long term effect on me. My two previous angiograms they didn't use Adenosine and the first angiogram I was already in fast AF. So I wouldn't be concerned about increased AF problems.
The worst pain is normally the local anaesthetic being injected. There's not much flesh around the wrist for injections. The only pain you may possibly get during the procedure can be when a stent, if needed, is placed in the artery and the artery is further blocked. If you do get any discomfort you it will only last seconds from my experience. During my first angiogram the consultant deliberately caused angina pain so I knew what it felt like as I'd been admitted with no pain symptoms just breathlessness.
I've never been offered sedation so can't answer that one but unless you are really nervous I wouldn't say there is any need for sedation.
Many thanks!
Thanks to everyone who has replied. I have read all the replies and appreciate them. I haven't thanked everyone individually simply to avoid clogging up the list.
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