Coronary angiography is an invasive procedure to diagnose coronary artery disease. The procedure involves taking X-ray pictures of the heart's arteries (coronary arteries) by injecting contrast (dye) into the blood vessels. The technique is used to help diagnose angina (where chest pain is caused by narrowing of the heart arteries), to plan interventional or surgical procedures – such as a coronary angioplasty, where narrowed or blocked blood vessels are widened or in the treatment of heart attacks.
The procedure is usually performed with local anaesthesia and light sedation and involves passing a long, thin and flexible tube called a catheter into a blood vessel in your groin or arm. Using X-ray images as a guide, the tip of the catheter is passed up to the heart and coronary arteries. Contrast, which is special dye is injected into the catheter and X-ray images (angiograms) are taken. The contrast shows the blood vessels that the fluid travels through and this clearly highlights any blood vessels that are narrowed or blocked. It is also possible at the same time to treat narrowed arteries in some cases by stretching the arteries with a fine balloon and deploying a stent which is a small tube like structure made of thin wire that keeps the artery open.
After the procedure you will usually be able to leave hospital on the same day you have a coronary angiography after a period of rest and observation. Coronary angiography is usually very safe although there are some risks, a few of which can be serious. It is therefore important to be carefully assessed by experts.
Cardiac magnetic resonance imaging (MRI) is a diagnostic scan used to visualize the heart and blood vessels in detail. The scan has the major advantage of being able to obtain images with great resolution without the need for radiation. However, it is not suitable for everyone and at the moment many patients with pacemakers or defibrillators cannot have scans. An MRI scan of the heart can view the heart’s structure including the heart muscle, chambers and valves. The scan is very useful in patients with congenital heart disease, heart valve disease, damage after a heart attack and also to look at the blood supply to the heart.
An MRI involves lying on a flat bed which is then moved into a tunnel-shaped scanner. The scanner is open at both ends and you will be asked to lie still. The scan can take up to 1 hour and is painless although some patients can feel claustrophobic.
Computed Tomography (CT) coronary angiography is a non-invasive scan of the coronary arteries which supply blood to the heart. The procedure involves injecting a small amount of dye through a small vein in the arm and taking pictures with a CT scanner with the patient lying on a table. The scanner is like a semi-circular tube and can take accurate pictures very rapidly to diagnose coronary artery disease. You may experience a brief hot flushed feeling, get a funny metallic taste or smell from the contrast injection. It is also common to feel a sensation in the pelvis or bladder area which can make feel that you need to urinate or that you have urinated. This is just a sensation and you do not actually urinate. The scan will take 20 minutes but the total time including preparation and recovery may take between 2-3 hours depending on the individual.
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