Heart not only pumps blood to all body tissues like brain, liver, kidneys and limbs, but also pumps blood to its own tissue via coronary arteries (arteries feeding the heart).
Surely you have noticed while you are running, your respiratory rate increases, showing the increased demand of oxygen in body. With the same mechanism, heart starts pumping rapidly to compensate the required blood flow to tissues. In fact, it adjusts the heart rate with an autoregulatory mechanism either in resting or exercising mode regarding to the tissue demands.
Imagine as you are breathing rapidly after an excessive exercise someone asks you to breathe through a tiny straw!
How would you feel?
Exactly! You will get shortness of breath! An unpleasant feeling of drowning!
Now, imagine as your heart rate is increased after an exercise, which means your heart needs more oxygen and more blood, the feeding vessels which are known as coronary arteries get tight or narrow!
What will happen?
Bulls eye! You have the same feeling of shortness of breath as well as drowning. However, this time it will manifest as chest pain. It means that you are probably suffering heart attack!
It important to consider that any pain or discomfort in the upper trunk should be considered as heart origin until proven otherwise.
Furthermore, the severity of symptoms deeply depends to the severity of strictures in the vessel.
Symptoms can occur when you are active like while you are jugging or doing exercise or can happen when you are at rest, indicating the stenosis is more severe.
Angiography or arteriography is used to identify the location and severity of stenosis in high risk patients, ideally before being the victim of heart attack. It is the advanced study of your heart vessel’s anatomy and architecture.
Angiography is a procedure which should be done by skilled cardiologist, ideally interventional cardiologist, in tertiary hospitals. This is unlike the other tests which we have discussed so far, like electrocardiogram, echocardiography and exercise stress test which could be done safely in office as an outpatient.
To undergo an angiography, you need to be admitted in cardiology or “Cath lab” ward, visited by the specialist and if your blood tests come out to be good enough, then you are suitable for the procedure.
The specialist after numbing the area will insert a catheter from either your wrist or groin arteries and push it all the way to your heart vessels and with help of contrast-injections will take various short videos from different aspects of three major vessels of your heart and their branches to make sure all the vessels are covered and checked thoroughly!
In case of presence of any stricture, the interventional cardiologist will decide to intervene by inserting a tiny stent or dilating the vessel by a balloon which is called angioplasty.
In severe multiple vessel strictures often, open cardiac surgery is required; known as coronary artery bypass graft surgery (CABGS).
Medical treatment – thrombolysis – could be another option regarding patient’s condition.
Angiography will not take more than 30 minutes in most of the cases. However, every individual patient is unique and has his/her own conditions and circumstances.
The procedure doesn’t need general anesthesia and patient is alert throughout whole procedure.
It worth mentioning that using wrist arteries is generally more preferred than groin arteries because they have less side effects and patients can return to daily activity as soon as possible.
On the other hand, complications might occur in which the most common one is the local hematoma.
As a conclusion both angiography and angioplasty should be done in a tertiary hospital with advanced care unit and Cath lab by an interventional cardiologist who can do all the procedures of angiography along with stenting, ballooning etc. in one go.
Dr Hajizade as a skilled interventional cardiologist is honored to offer wide range of bulk build cardiac care for all patients in his private clinic and various hospitals of Tehran, Iran. Book an appointment.