Angiogram, Angioplasty and Stents

An angiogram is a procedure done by a cardiologist in a hospital setting. The procedure has been well established over years of practice. It is understandable to be apprehensive when anything is done to the heart. The doctor and nurses have done this a million times and that is no exaggeration. The angiogram is a diagnostic tool used by cardiologists to investigate why someone would have chest pain and if the chest pain is caused by a blood clot in the arteries of the heart. The common term is ACS and it can incorporate a lot many problems and for simplicity the doctors just clump it under one umbrella. For example, the patient, lets say it is you, has chest pain and your cardiac enzymes come back abnormal and your chest pain is gone or mild then the doctors would consider you for an angiogram to see if and where the blockage is and to determine how to fix the problem.

Let’s walk you through the preparation in the procedure. First the doctor orders an the procedure, then they book the appointment and it is booked for a couple of days in the future due to the urgency. The day finally arrives…good thing real days don’t go by this fast…and the nurse needs to shave the groins both left and right to make sure the area can be sterile for the procedure and the nurse also makes sure the right wrist is clear of any problems too like extra hair and so forth. They would get you undressed and lay you on a gurney and wheel you into the procedure room. Greeting you there would be a huge x ray machine and an ice cold table that resembles something from a sci-fi movie. The x ray machine is shaped like a microscope that has an apparatus above and below the procedure table. The machine is used during the procedure to help guide the doctor to the correct artery of the heart. While in this room everyone is dressed in a lead apron since it is the X ray machine everybody needs to be protected from excess radiation.

The doctor prepares your groins with iodine or chlorohexadine or some kind of sterilizing agent. Then inserts a small tube into the groin called an introducer, this of course introduces the cardiac catheter into the artery and up the into the heart. The doctor carefully and skillfully inserts the catheter into the small arteries of the heart and while there inject a radio opaque dye into the artery to determine the extent of the clot if any at all.

While in the vessel of the heart and they determine it is possible they would perform a balloon angioplasty to open the vessels. The angioplasty is exactly the same procedure except that instead of injecting dye they are inflating a small balloon to open the artery. In conjunction to the angioplasty if the damage to the heart is sufficient and the doctors think it is necessary they will leave a cardiac stent behind after the balloon angioplasty to keep it open. Stents usually last about ten years and cause very little problems.

By having an angiogram you can end up having a three in one procedure. They don’t do these procedures all at once all the time. The problem is everyone is different and the anatomy is not always the same. Of course the clot might be too big and so forth. Keep in mind that not every doctor is able to these procedures all at the same time. However it would be a great deal if they could, 2 for 1 deal!


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