This presentation will be talking about coronary angiography which is a part of a general group of procedures known as (heart) cardiac catherization .this is performed for both diagnostic and interventional (treatment) purposes

1. CORONARY
ANGIOGRAPHY
Dr mekowulu c.f

3. DEFINITION
• What Is Coronary Angiography?
• Coronary angiography is a test that uses dye and special x rays
to show the insides of your coronary arteries. The coronary
arteries supply oxygen-rich blood to your heart.
• A waxy substance called plaque can build up inside the
coronary arteries. The buildup of plaque in the coronary
arteries is called coronary heart disease (CHD). Over time,
plaque can harden or rupture (break open). Hardened plaque
narrows the coronary arteries and reduces the flow of oxygen-
rich blood to the heart.

4. DEFINITION CONTD….
• This can cause chest pain or discomfort called angina
• If the plaque ruptures, a blood clot can form on its surface. A
large blood clot can mostly or completely block blood flow
through a coronary artery. Over time, plaque can harden or
rupture (break open). Hardened plaque narrows the coronary
arteries and reduces the flow of oxygen-rich blood to the
heart. This can cause chest pain or discomfort called angina

5. OVERVIEW
• During coronary angiography, special dye is released into the
bloodstream. The dye makes the coronary arteries visible on
x-ray pictures. This helps doctors see blockages in the arteries.
• A procedure called cardiac catheterization (KATH-eh-ter-ih-ZA-
shun) is used to get the dye into the coronary arteries. Cardiac
catheterization rarely causes serious complications

6. CATHERIZATION PROCEDURE
• For this procedure, a thin, flexible tube called a catheter is put
into a blood vessel in your arm, groin (upper thigh), or neck.
The tube is threaded into your coronary arteries, and the dye
is released into your bloodstream. X-ray pictures are taken
while the dye is flowing through the coronary arteries.
Cardiologists (heart specialists) usually do cardiac
catheterization in a hospital. You're awake during the
procedure, and it causes little or no pain. However, you may
feel some soreness in the blood vessel where the catheter was
inserted.

8. WHO NEEDS CORONARY
ANGIOGRAPHY
The doctor may recommend coronary angiography if you have
signs or symptoms of coronary heart disease (CHD). Signs and
symptoms include:
1- Angina. This is unexplained pain or pressure in your chest. You
also may feel it in your shoulders, arms, neck, jaw, or back. The
pain my even feel like indigestion. Angina may not only happen
when you're active. Emotional stress also can trigger the pain
associated with angina.
2-Atherosclerosis
3- Sudden cardiac arrest (SCA). This is a condition in which your
heart suddenly and unexpectedly stops beating.
4- Abnormal results from tests such as an EKG
(electrocardiogram), exercise stress test, or other test.

9. WHO NEEDS CONTD…..
• Coronary angiography also might be done on an emergency
basis, such as during a heart attack. If angiography shows
blockages in your coronary arteries, your doctor may do a
procedure called percutaneous coronary intervention, also
known as angioplasty . This procedure can open blocked heart
arteries and prevent further heart damage.
• Coronary angiography also can help your doctor plan
treatment after you’ve had a heart attack, especially if you
have major heart damage or if you’re still having chest pain.
It’s not safe to drive after having cardiac catheterization,
which is part of coronary angiography. You’ll need to have
someone drive you home after the procedure.

10. BEFORE ANGIOGRAPHY
talk with your doctor about:
1- How the test is done and how to prepare for it
2- Any medicines you're taking, and whether you should stop
taking them before the test
3- Whether you have diseases or conditions that may require
taking extra steps during or after the test to avoid complications.
Examples of such conditions include diabetes and kidney disease.
• Your doctor will tell you exactly which procedures will be
done. For example, your doctor may recommend
percutaneous coronary intervention, also known as coronary
angioplasty, if the angiography shows a blocked artery.
• You will have a chance to ask questions about the procedures.
Also, you'll be asked to provide written informed consent to
have the procedures.

11. DURING CORONARY
ANGIOGRAPHY
• During coronary angiography, you're kept on your back and
awake. This allows you to follow your doctor's instructions
during the test. You'll be given medicine to help you relax. The
medicine might make you sleepy.
• Your doctor will numb the area on the arm, groin (upper
thigh), or neck where the catheter will enter your blood
vessel. Then, he or she will use a needle to make a small hole
in the blood vessel. The catheter will be inserted in the hole.
• Next, your doctor will thread the catheter through the vessel
and into the coronary arteries. Special x-ray movies are taken
of the catheter as it's moved into the heart.
• The movies help your doctor see where to place the tip of the
catheter. Once the catheter is properly placed, your doctor will
inject a special type of dye into the tube. .

12. DURING CA CONTD…..
• The dye will flow through your coronary arteries, making them
visible on an x ray. This x ray is called an angiogram.
• If the angiogram reveals blocked arteries, your doctor may use
percutaneous coronary intervention (PCI), commonly known
as coronary angioplasty to restore blood flow to your heart.
• After your doctor completes the procedure(s), he or she will
remove the catheter from your body. The opening left in the
blood vessel will then be closed up and bandaged.
• A small sandbag or other type of weight might be placed on
the bandage to apply pressure. This will help prevent major
bleeding from the site.

13. AFTER CORONARY
ANGIOGRAPHY
• After coronary angiography, you'll be moved to a special care
area in the hospital. You’ll be carefully watched for several
hours or overnight.
• During this time, you'll need to limit your movement to avoid
bleeding from the site where the catheter was inserted.
• While you recover in the special care area, nurses will check
your heart rate and blood pressure regularly. They’ll also
watch for any bleeding at the catheter insertion site. You may
develop a small bruise on your arm, groin (upper thigh), or
neck at the catheter insertion site.

14. AFTER CA CONTD…
• That area may feel sore or tender for about a week.Let your
doctor know if you develop problems such as:
• A constant or large amount of blood at the catheter
insertion site that can't be stopped with a small bandage
• Unusual pain, swelling, redness, or other signs of infection
at or near the catheter insertion site
• Your doctor will tell you whether you should avoid certain
activities, such as heavy lifting, for a short time after the test

15. RISK OF CORONARY
ANGIOGRAPHY
• Coronary angiography is a common medical test. It rarely
causes serious problems. However, complications can include:
• Bleeding, infection, and pain at the catheter insertion site.
• Damage to blood vessels. Rarely, the catheter may scrape or
poke a hole in a blood vessel as it's threaded to the heart.
• An allergic reaction to the dye that’s used during the test.
The risk of complications is higher in people who are older and
in those who have certain diseases or conditions (such as
chronic kidney disease and diabetes).

16. RISK OF CA CONTD…..
• Other, less common complications include:
Arrhythmias (irregular heartbeats). These irregular heartbeats
often go away on their own. However, your doctor may
recommend treatment if they persist.
• Kidney damage caused by the dye that’s used during the
test.
• Blood clots that can trigger a stroke, heart attack, or other
serious problems.
• Low blood pressure.
• A buildup of blood or fluid in the sac that surrounds the
heart. This fluid can prevent the heart from beating properly.
As with any procedure involving the heart, complications can
sometimes be fatal. However, this is rare with coronary
angiography.