Angio

1. Angiography
BY....KHUSH
BSCARDIOLOGY
KHYBERMEDICALUNIVERSITY

2. What is a coronaryangiogram?
• An angiogram is an X-ray image of blood vessels after
they are filled with a contrast material. An angiogram
of the heart, a coronary angiogram, is the "gold
standard" for the evaluation of coronary artery disease
(CAD). A coronary angiogram can be used to identify
the exact location and severity of CAD.

3. Howis a coronaryangiogramperformed?
Coronary angiography is performed with the use of local anesthesia
and intravenous sedation, and is generally not significantly
uncomfortable.
In performing a coronary angiogram, a doctor inserts a small catheter
(a thin hollow tube with a diameter of 2-3 mm) through the skin into
an artery in either the groin or the arm.
Guided with the assistance of a fluoroscope (a special x-ray viewing
instrument), the catheter is then advanced to the opening of
thecoronary arteries (the blood vessels supplying blood to the heart).

4. Contu...
Next, a small amount of radiographic contrast (a solution containing
iodine, which is easily visualized with X-ray images) is injected into each
coronary artery. The images that are produced are called the angiogram.
The procedure takes approximately 20-30 minutes.
After the procedure, the catheter is removed and the artery in the leg or
arm is either sutured, "sealed," or treated with manual compression to
prevent bleeding.
Often, if an angioplasty orstent is indicated, it will be performed as part of
the same procedure.

5. Whatdoesa coronaryangiogramdemonstrate?
• Angiographic images accurately reveal the extent and severity of all
coronary artery blockages. For patients with severe angina or heart
attack (myocardial infarction), or those who have markedly
abnormal noninvasive tests for CAD (such as stress tests), the
angiogram also helps the doctor select the optimal treatment.
Treatments may then include medications, balloon angioplasty,
coronary stenting, atherectomy ("roto-rooter"), or coronary artery
bypass surgery.

6. Indication
Low ejecton fraction.
Poor exceries capacity.
Non ST segment elevation acute coronary syndrome with high risk feature.
Acute ST segment elevation myocardial infraction.
Symptoms of coronary artery disease, such as chest pain (angina).
 A heart defect you were born with (congenital heart disease).
Abnormal results on a noninvasive heart stress test.
Other blood vessel problems or a chest injury.
A heart valve problem that requires surgery.

7. Contraindication
Coagulopathy.
Decompainsated congestive heart faliure.
Uncontrolled hypertension.
GT haemorrhage.
Pregnancy.
Inability for patient cooperation.
Active infection.
Renal faliure.
Contrast medium allergy.

8. Compications
Vascular complication related to the arterial puncture site.
Allergic contrast reaction.
Worsening kideny function.
Ventricular tachycardia.
Iatrogenic coronary artery dissection.
Heart attack
Stroke
Injury to the catheterized artery

9. • F***o