Coronary Angiography

Coronary angiography (coronarography) is a special subtype of angiography, which is examination of blood vessels. The targets of coronary angiography are two main coronary arteries and their branches. These arteries have a vital importance for the heart, because they supply the heart muscle with oxygen and nutrients.

Principle

The examination takes place in horizontal position. First, it is necessary to puncture an artery, for example femoral artery in the groin or radial artery in the forearm. The syringe allows inserting a special probe into arterial system and moving it through arteries towards the heart. The progress of the probe can be seen on an X-ray. When the probe is in position near the place where coronary arteries leave the aorta, the examiner uses the probe to release a contrast agent that flows into the coronary arteries, which shows their shape and any narrowed or occluded areas.

 

The examination ends when the probe is removed. The place of the primary puncture should be compressed for some time, the time and compression method depends on the site (femoral artery must be compressed more and longer the than radial artery).

Preparation

The preparation usually requires some preparations. It is advisable to administer anti-allergic drugs as the used contrast may cause allergic reaction. The skin around the arterial puncture should be shaved and disinfected. Some types of anticoagulant drugs should be discontinued.

Indications

The examination has a significant role in situation where we expect significant narrowing or closure of the coronary arteries, i.e. in various forms of ischemic heart disease. Coronary angiography is indicated in angina pectoris and in acute heart attack. The examination may be also used in patient with heart failure or arrhythmia when we suspect ischemic etiology of these conditions.

 

The main advantage of coronary angiography is the possibility to therapeutically solve the narrowing or occlusion. In such case, the narrowed or occluded area is dilated by special balloon (angioplasty) and the dilated section is supported by a tube-shaped stent, which prevents reocclusion.

Disadvantages

Coronary angiography carries some risks. The commonly used contrast medium may cause allergic reaction. Other frequently present complication is bleeding from the puncture artery and formation of local bruises. In about 1% of cases, the coronary angiography can cause a heart attack and there are even reported some cases of a stroke.

 

The above-mentioned risks, however, must be evaluated reasonably. The coronary angiography should be performed only when having serious concerns about the health and life of the patient and the risks should be more than compensated by potential benefits.

Advantages

Coronary angiography is a great method that can show the actual condition of coronary arteries and it can also solve narrowing or occlusions by angioplasty and stenting. Developed countries with an efficient coronary angiography program have experienced a sharp decrease of fatal heart attacks.