Coronary angiography, referred to as coronary angiography, is the only diagnostic method that can directly observe the blood vessels and blood flow of coronary artery, and its accuracy is incomparable with other methods. In addition, coronary angiography can integrate examination, diagnosis and treatment. During examination, it can be used for diagnosis, and when necessary, it can intervene to install stents to complete surgical treatment.
0 1? Who needs coronary angiography?
Middle-aged and elderly people with high risk factors of coronary heart disease (dyslipidemia, diabetes, hypertension, smoking, etc.). ) frequent chest pain and chest tightness. It turns out that patients with coronary heart disease have frequent angina attacks recently, and lighter labor can induce angina pectoris; Patients with angina pectoris often occur at rest even if there is no obvious inducement; Patients with longer attack time, heavier pain and poor effect of taking nitroglycerin under the tongue. Sudden typical chest pain symptoms, severe chest pain for more than 30 minutes, accompanied by sweating and dying feeling.
Coronary angiography can provide a powerful diagnostic basis for atypical angina symptoms that are difficult to diagnose clinically, especially for patients with poor therapeutic effect, as well as patients with dilated heart, severe arrhythmia, heart failure, abnormal electrocardiogram, suspected coronary artery disease or abnormality, but the results of non-invasive examination can not be diagnosed. For non-coronary heart disease patients with long-term clinical suspicion of coronary heart disease, this examination can reduce the mental burden of patients and restore their confidence in life; At the same time, it can reduce the mental burden and economic burden caused by unnecessary drug treatment.
02? Conventional examination methods will miss the diagnosis of coronary heart disease.
The traditional diagnosis methods of coronary heart disease are mainly based on symptoms, electrocardiogram, blood lipid, exercise load test and echocardiography. Their sensitivity and specificity are not high. For example, ECG changes caused by myocardial hypertrophy and myocarditis are often misdiagnosed as coronary heart disease.
However, coronary artery stenosis to a considerable extent (more than 75%) may cause discomfort and ECG changes, and conventional diagnosis methods will lead to many patients with coronary heart disease missing diagnosis.
03? Coronary angiography can observe the morphology of coronary artery.
The coronary artery supplies blood to the heart. Coronary angiography can clearly show the trend, shape and degree of stenosis of coronary artery and its branches, the location, degree and scope of stenosis, and collateral circulation, and can guide further treatment accordingly. Evaluate the changes of coronary artery function (coronary artery spasm); At the same time, left ventricular angiography can be performed to evaluate cardiac function.
Coronary angiography has been widely used in clinic and is considered as the "gold standard" for the diagnosis of coronary heart disease. It is a safe and reliable invasive diagnostic technique.
Mr. Zhang, male, 45 years old, an executive of a company, came to our hospital for physical examination. Height 175cm, weight 98kg, blood pressure 145/88mm, partial diet, 25 years of drinking history, 23 years of smoking history, rarely participate in sports. My father died of coronary heart disease, and my mother is alive and suffering from high blood pressure. Palpitation, chest tightness and other discomforts have occurred repeatedly in recent 1 month, with no obvious inducement and no obvious abnormality in ECG examination. Coronary angiography is recommended, and the results show that the stenosis of left anterior descending branch reaches 90%. Cardiologists should implant stents in time to avoid the occurrence of acute myocardial infarction.
When coronary artery or its branches are diseased, we will suffer from coronary heart disease (myocardial ischemia). In mild lesions, patients have no symptoms of angina pectoris; Severe lesions are at risk of myocardial infarction.
04? Coronary angiography can be completed within 25 minutes.
Coronary angiography is a kind of "minor operation" and a relatively safe and reliable invasive diagnostic technique, and there are even no signs of fatigue after operation. Excluding the preparation time such as disinfection and towel laying, if it goes well, the whole coronary angiography operation can be completed in about 25 minutes. If the patient's blood vessels are thin, no blood vessels can be found by injection, or if the patient's coronary artery opening is abnormal, the time will be appropriately extended.
05? Preparation before coronary angiography
Have an empty stomach or drink a little water before the examination. Those who are allergic to iodine preparations and patients with severe liver and kidney diseases should not be examined. Sign the preoperative conversation and give informed consent. Evaluate the function of liver, kidney, heart, lung and other important organs, and evaluate the risk of operation.