  |
|
 
Alternative to Angiogram?
Tweet
|
|
||||||||||||
|
Current Postings on This Page (66): • I would rather have these 4 screenings (Carotid Artery, Heart Rhythm, Abdominal Aortic Aneurysm, & Peripheral Arterial Disease) than an Angiogram. I think the information these non-invasive screenings provide is very important, and necessary. Additionally, will lead to a better result.
• Hi - I'm about to go next week for an invasive angiogram. I had a CT scan that showed a possible significant blockage in my LAD. I have no symptoms, and passed both a stress and a stress echo with flying colors. I run slightly high cholesterol and am allergic to statins although looking at PSK right now. I am very scared to have the angiogram, as I worry that I might get a stent that isn't needed and also side effects/complications of the angio. Two other cardiologists said don't go, the third says I can't take a chance on a false vs real positive. Help!
• My cardiologist wants to do a thallium stress test because of an episode of right sided chest pain after exercise. I requested going straight for a CT angiogram instead and she said she wanted to do the stress test first because of a "T-wave " abnormality on her EKG. This is old and showed up in ekg's years ago, and i had an echo confirming some left ventricular enlargement. Why would she want the stress test over the CT on that basis?
• I am a 61 yr. old female that leads an extremely stressful life! after being under extreme stress for one month I went to my Dr. with a fluttering feeling. He said probably stress gave me some pills and did an ECG. Looked good with something showing on the bottom of my heart possibly old. Went for an echo-stress test just to be safe. Echo at rest was perfect, stress treadmill perfect. Heart rate went to 169, had no pain or any negative symptoms at all, just out of breath and weak legs. Dr. said everything looked fine. BP went where expected during and after. Received a call from Dr. office stating an abnormal stress echo. Abnormalities showed up on the back of my heart. This I was told means blockages and I would need a catheterization next. I feel fine BP has been 108/65 pulse 72 all weekend. The test went fine except for the stress echo. Would a CT be just as good? I am terrified of any invasive procedure. My Dr. said when it's the back of the heart there aren't any symptoms so I could have a silent heart attack. Is this true? With all of the tests and how I am feeling being so good should I agree to a catheterization? I would hate to die from an unnecessary test if another would do the job. • My husband had a stroke 4 months ago, now doctors want him to have a chemical stress test. The medicine rises heart rate, scares me to think he may have another stoke. Is there another test to see if he has stopped up arteries.
• how do doctors detect a heart disease? What are the various treatments available for heart disease?
• My mother is 59 years old, overweight, and has had increasing chest and jaw pain, dizziness and fatigue over the last year. Her recent nuclear stress test showed a blockage in the back of the heart, according to the cardiologist. Her other tests show: cardio CRP is 4.7 (ideal is below 1), triglycerides 116 (ideal is below 100), homocysteine cardiovascular 8.6 (ideal is below 8), and Blood Glucose 105 (Ideal: 60-85. Pre-diabetic: 95-110. Diabetic: Above 110). The cardiologist has recommended "an arterial angiogram," but my mother is terrified of such an invasive procedure and its risks. I know there are some testing alternatives, but are there treatment alternatives for which it is not too late? Thank you!
• My husband has had angioplasty several times since 1991 when he was 39. He had bypass in 1995. In 2001 he was having a heart attack when they put stent in him. I 2005, during angioplasty he had a cardiac arrest and was revived. He had another bypass in 2005. He did not come to senses for over 10days. After that I was told by the doctor that he might need heart transplant. We did not go for it. He has been doing fairly well so far with medication. Now his cardiologist wants to do the routine test of angiography. Should he really go through this? I am scared. • Claret in Canada -- OK. So you got a Cardiac
CT Angiogram. This test is very accurate in eliminating coronary artery disease
(CAD) as a possibility, somewhat less so in showing the extent of narrowing,
especially when there is a significant amount of calcified plaque (calcium
is opaque to the CT and tends to obscure the view of the arterial blockage). The
COURAGE Trial showed that it is safe to defer intervention (stents, etc.)
for patients with stable angina who are getting Optimal Medical Therapy
(meds, exercise,
smoking
cessation, diet, etc.). But if the angina progresses, angioplasty is always
an option for symptom relief. If it gets to that point, we'd recommend reading
our information on Fractional
Flow Reserve, as well, since not all blockages, seen as significant
on angiography, need stenting. Good luck, and let the Forum know how you
make out tomorrow. • Sorry I should have been more specific,
I've been feeling angina like pain in my left arm when exercising although
it
never showed up on a standard stress test. They then sent me for an angiographic
CT Scan (minimally invasive by injecting into an arm vein). They did not
give me any score and when I asked how badly it was blocked he just told
me it was significant. I do see my GP tomorrow and I've created a list
of questions
that I'd like to have answered as outlined in my previous post. • Claret in Canada -- You didn't
say what diagnostic test this picture was from. Was it a coronary calcium
scan (CSC)? If so,
this test only shows calcium deposits in the arteries. Was there a number
score given to you? A CSC can be a measure of risk, but it does not
actually show blockages. The plaque
in
the
artery
causing a blockage is made up of different types of
tissue,
etc.
These
plaques
often
have calcium
associated
with them. Having a high calcium score means you're more at risk and
that you should do everything you can to bring risk factors under control
(meds,
exercise, diet, smoking cessation, etc.). An actual Cardiac CT Angiogram,
which is done non-invasively with an IV contrast injection, can more
clearly show blockages. An actual invasive angiogram, done in the cath
lab, is
the most accurate, especially when intravascular imaging measures, such
as IVUS
or
FFR are used. One potential downside to all this early testing is
if it leads to unnecessary interventions or unnecessary anxiety. The
best
course
is to discuss the findings with your cardiologist and get help from him/her
or elsewhere in risk modification. • I received the news I had been dreading, as
I knew that the picture the technician was looking at was mine and her comment
of "WOW" perked up my ears. I have major calcification of the coronary
arteries. At this point they tell me the risks associated with either angioplasty
or
bypass outweighed the risk associated of leaving things as they are. How
can this be? Do I actually have to have a heart attack before something
is done? I'm not on any statins as I form an allergic reactions to them,
including
muscle weakness. I was just told that if my condition changed then to call
the cardiologist back. What defines
major and significant calcification? • Claret -- we would assume the
opposite. If there had been a problem, the doctor might have wanted to explore
further.
But it's hard to say. Did you ask the doctor why he stopped? It may be
that he in fact did get a good image and there was no reason to expose you
to
more radiation than was necessary. Please let us know what you find out. • Today I had a CT Angio and the prescribed procedure was to have 5 passes
through. The first two without dye and the last 3 with increasing amts of dye.
After the third pass the procedure was stopped as the Dr. said he had all he
required, and I was up and told to go home. Why would they not have completed
the five pass throughs? They now have me wondering if something really overt
was shown. • My father is 83 and was due to have a cardio
angiogram in order to assess the viability of a biventricular pacemaker.
As result of his poor kidney function it has been decided not to take
this course of action. Is there an alternative test which can assess
the viability
of a BV Pacemaker without the resultant damage to his kidney? Many Thanks
- James • Srividya
from India -- the contrast dye used in angiograms can cause damage to
the kidney. Cardiologists whi perform angiograms
have a number of things they can do to minimize this issue, such as hydrating
the patient, using specialized and low concentration contrast solutions,
etc. Cardiac CT scan also use contrast dye. Has your grandfather had
a nuclear
perfusion stress test? This can show if his heart is getting enough oxygen
and contrast is not used here. • my grandpa with ailment in kidney is advised
to undergo angiogram for suspected blocks but cautioned damage to kidney.
kindly advise patient with an
alternative • The diagnostic pathway for diagnosing coronary
artery disease (blocked arteries) has been under much discussion within
the cardiology community -- whether a CT Angiogram should be the initial
test, or whether it should be done in place of a standard invasive angiogram
when the patient's other indicators show him to be at low risk -- in other
words, why do an invasive procedure with the added risks (although low
in percentage) if the likelihood of CAD is low. The downside an doing an
unnecessary CT, of course, is the additional radiation -- although again
in centers that have the latest equipment and training, these scans can
be done with "low dose protocols". If a patient has a high
likelihood of CAD, they are going to have to go for an invasive angiogram
ultimately.
These are complicated decisions and the answers differ from patient
to patient. We suggest talking with your cardiologist and having him/her
explain to you why they feel the diagnostic path they are recommending
is the correct one. Also read the various articles, interviews and news
items in the Imaging and Diagnosis
Section on Angioplasty.Org. • I am 34 in good health. I did the stress test
for 15 min. with no pain or shortness of breath. I did the nuclear stress
test same results (no pain
etc.) I also did the echocardiogram everything looked healthy. On the nuclear
stress I had a difference on the front lobe in color. Dr. said could be a false
positive. However, to be sure of no blockage he wants to do a angiogram. Should
I do this at 34? Both stress test results showed low risk. • Why is my Dr. pushing for angio? Recently had
nuclear stress test and was told lower half of my hart is not getting
enough oxygen. Diagnosed as Angina and given nitro but as of yet have have
not
needed to take. Scheduled for Angio in July but requests for non-invasive
procedures seen to be ignored. I am also a large breasted women, so that
is a concern. I am 63 years old, slightly over weight but otherwise strong
as a bull and healthy. How can I get them to perform
ct. first. • CHG -- not sure why you were given 3 separate
CT scans -- one should have done the trick. Depending on whether low-dose
protocols were used, the radiation from a CT Angiogram is the same as
a nuclear stress test on the high side, and a tenth of that on the low
side.
MRI does not use ionizing radiationat all, and X-rays are pretty low
as well. The CT Angiogram should have shown any blockages, but your cardiologist
may be looking for something else. Does he offer transradial catheterization
(through the wrist)? That can reduce the complications. • CHG- I had a heart attack Nov/07 and had the
usual treatment incl. cardiac catheterization with a stint [stent] put
in place. I was fine until last December when I developed a pain and
pressure in my heart area. Since then I have had 3ct scans, 4 x-rays and
2 MRI's
an echo-cardiogram along with other emergent medications. This all without
any diagnosis of the cause of the pressure or pain. This all happened
over a period Dec/09-the present. Now my cardiologist wants to do another
cardiac
catheterization. Our concern is #1 how is all the radiation I have had
throughout this period going to affect me and 2. i really don't want
to go through the risks that another cardiac catheterization presents.
We
would appreciate
any advice or input you could offer. • Dean -- have you discussed a CT angiogram (non-invasive)
with your cardiologists? Read our special section, "Patient
Guide to Heart Tests". • I have had a echo cardiogram (normal),24 hour
monitor (normal) and a walking stress test lasting approximately 12 minutes.
During the walking test I had no
pain at any time but the odd palpitation & I told was not unusual under these
conditions. The heart trace during the test was fine. However, during the recovery
stage they noted a small change in the trace which was considered to be either
a potential blockage or reduction in flow or possibly blood pressure. My history
is one where I get palpitations (quite noticeable to me), blood pressure was
139/90 but has come down to 126/76 (exercise and dietary changes)my cholesterol
went from 6.6 to 7.1 hence put on statins 40mg. I have been recommended angiography.
My question is, is there an alternative method which could establish whether
there is a blockage/reduced flow rather than the invasive angiography? P.S. A
sibling has a similar problem with palpitations and has not had to resort to
an angiography, they have advised me of the potential problems using this method
and that I should give careful consideration to having the angio. I am 52 & exercise
5 times a week 45mins on a bike with no problems. • Radiation is similar IF low-dose protocols are
used in the CT angiogram -- if not the CT radiation is higher -- about
the same as a nuclear stress test. • My Stress Test showed a spot in an artery that
the Thallium did not reach. I am due to have an Angiogram in two days
and am very nervous about the risks. What is the difference between the
amount
of radiation given in an Angiogram compared to a CT heart scan? Please
advise as soon as possible. Thank you. • There are techniques to lessen reactions, special
contrast dyes that use less or no iodine and hydration protocols -- tests
may need to be performed to judge exactly what in the dye causes the hypersensitivity
reaction. • I need an angiogram but i'm allergic to contrast
dye so what does one do,
any help please. • Sam -- You might want to discuss a simple Calcium
score test, which is a CT scan without contrast. It shows calcium
buildup --
but that's all. Zero Calcium (or a very low score) would indicate
low risk of coronary
artery disease (CAD). But if the presence of CAD
is already evident, as indicated possibly by the angina and CHF,
then such a test would not be telling you very much that
you don't
already
know. This
is a difficult call, but it's one that needs to be made by specialists
in this field, weighing the pros and cons of your uncle's specific
clinical status and whether or not the angina can be controlled in
other ways
(medications, etc.). • My uncle is 73, CHF and CAD patient. Everything
is well controlled until some recent increase in angina. His own cardiologist
is reluctant to order an
angiogram because of the Kidney risk. Some other hospital cardiologists brought
up doing an angiogram, but the kidney risk seems like a major issue to all of
them. My uncle's creatinine is slightly elevated (around 1.45), plus because
of his CHF he is very volume restricted and, as I understand, effective hydration
will not be possible in his case (as he could easily go into edema). What are
the alternatives, while keeping the kidneys safe? I have seen an earlier answer
with reference to less dye used for the CT - how much (volume) of dye is USED
in CT? How much does the kidney risk go down? Any help would mean so much. Thanks. • I am 58 male. Had a DES placed last October.
Prior to the placement, the cardiologist was able to due a non-invasive
SCAN of my heart and found the blockage. I understand that now that the
stent is placed, the test can not be done. Is anyone aware of any post
Stent placement tests, scans that can be done short of going to the Cath
Lab? thanks. • Adams in Georgia -- nuclear stress tests have
a relatively high false positive rate and many imaging specialists are
now feeling that Cardiac CT, a.k.a. multislice CT angiograms, a.k.a.
CCTA, are more accurate for diagnosing and/or excluding coronary blockages
--
negative
predictability of CT is in the 99% range -- meaning if the CCTA shows
no blockage, you can be 99% sure it's correct. Without CCTA, you would
probably
have gone on to an invasive angiogram in the cath lab, with a 3% risk
of complications. • I had a stress test and that showed a shady area
- did the 64 slice CT
showed 0 nothing -- said I had golden pipes. • JC -- To answer your question, read the various
interviews and news articles we have posted in our "Imaging
and Diagnosis Center". These are decisions
to be made between you and your cardiologist. The risks of a standard
angiogram are small, but a CT angiogram (CTA) is a very accurate test
for ruling
out coronary artery disease and it carries virtually no risk. However,
if your cardiologist believes you have a high likelihood of having a
flow-limiting blockage,
a catheterization with possible angioplasty is probably going to be required
at some point, so a CTA won't add any information. • Lead up to flu caused heart like symptoms. EKG showed left branch blockage
similar to 14 years ago but otherwise healthy heart. Did Nuclear stress this
time. Stress portion went very well with no appreciable change in EKG at 174/?
and 135 pulse after 7 1/2 minutes with no symptoms, 66% ejection rate. Pictures
showed moderate blockage of artery leading to right chamber. Dr. want to follow
up with cath. I am 61 and in good health but very anxious about risks associated
with cath and am questioning whether to do it at all. Any thoughts on this? • Lorraine -- has your dad's cardiologist discussed
the possibility of a non-invasive CT Angiogram (no catheter, done in a
few minutes) to determine if he has a treatable blockage? He's on medical
therapy, which works, but if he is still having symptoms which limit his
activity, he, you and his cardiologist should talk. • Hi my dad had a triple bypass operation in 1989
(aged 50) and he made a good recovery within a couple of years, in 1998
he was advised to have an angiogram as some of his previous symptoms
had reoccurred, under the angiogram he unfortunately suffered a stroke,
from
which he did make a good recovery, although it did leave some not so
visible damage, the angiogram taken at that time did show that one of his
arteries
had a 90% blockage but because of the stroke the consultant choose to
treat my dad with good medication, rather than do invasive surgery or angioplasty!
He recently has had some of the reoccurring symptoms and is now 69 years
old! Can you advise or give me any information to what are the alternatives
to angioplasty,
taken into consideration my dad's previous experiences? • Milda -- there are techniques that radiologists
use to do studies (such as an MRA) where there is no or very diluted
contrast used -- and also hydration techniques to lessen kidney damage.
Keep asking
questions until you find a radiologist who is familiar with these techniques. • My husband is currently on the inactive kidney
transplant list. The doctors are requiring an angiogram prior to putting
him on the active list. His nephrologist is telling him the dye will
kill the kidney function he currently has (15%-18%). Would an MRA, or any
other
alternative procedure give the transplant doctors the information on
his heart they require and get him on the active list. • Renuka -- in a patient such as your father, one
who has a history of coronary artery disease, the standard invasive angiogram
is usually the test of choice, since there is a high likelihood of finding
a problem -- and a catheterization can be turned into an angioplasty
if something obvious is found. Did the angiograms show any disease?? Iodinated
contrast dyes, used both in catheterizations AND non-invasive CT scans,
have been associated with kidney problems, and patients with low kidney
function
must be managed
carefully
for these
types
of tests,
but we haven't seen any studies regarding an effect from dye on Potassium
levels. • My dad has had a temp. pacemaker put due to low
heart beat 29 . He is 71 and has already had a triple bypass 10 years
ago. A heart attack a month back, an angiography 15 days ago and then this
last
week. All happening too fast. Potassium levels too rising. Could this
be a result of the dye at the time of the angio or due to very strong medication.
Had a kidney complete test done 3 months ago with all within range. Please
clarify. • Cenia -- the tests you have had fall into two
categories: the stress tests, whether nuclear or echo, are "functional
tests" -- among other things, they measure whether or not the various parts
of your heart muscle are receiving sufficient oxygen from the blood --
or how well your heart is "functioning", but they don't really
visualize a blockage. The standard angiogram (or cath) actually images the
arteries and
any blockages can clearly be seen. A newer type of angiogram, done with
multislice CT (called a CT Angiogram, or CTA), can also be done. Like the
standard angiogram, it visually shows any blockages. But it is non-invasive
(no
cath lab) and
takes about
15 minutes. It can carry a higher radiation dose than a cath, but the dose
is equal to or less than a nuclear stress test. However, your cardiologist
may want to do the stress test for specific reasons. Whether or not
a CT angiogram would be useful for you is something you should discuss
with
your
cardiologist. • Question about dense breast tissue and false
positive/false negative nuclear scan. In 2006 I had an inpatient chemical
stress test and a nuclear scan at a major heart hospital; the findings
of which were various inconsequential blockages in the RCA and a major
life-threatening blockage at the top of the LAD artery, so much so that
I was not allowed out of bed until an angiogram could be done the next
morning. The angiogram showed absolutely no blockage anywhere at all
in the LAD and an 80% blockage at the top of the RCA which was stented.
The
false negative/false positive was blamed on dense breast tissue. Now
I am due to have another stress test next week at my local cardiologist's
office. He wants to do the nuclear scan and says he can take the previous
issue into consideration, but I am doubtful and do not know what to do.
How can my doctor know whether the results of the new scan--whatever
it
shows--will be trustworthy? I don't want a problem to go undiagnosed,
and yet I wouldn't want to be sent for an angiogram unnecessarily. Would
you
please help me sort this out? • F/u to earlier post - My mother's aneurysm is
in the heart (near the aorta I believe). Does this make a difference?
Thanks for the info. • TD -- allergies to contrast dye are relatively
specific but your concerns should be communicated clearly to the physician.
You didn't mention where the aneurysm is located, but the answer is that
an MRA may be an option -- there is a contrast agent sometimes used in
MRAs, containing
gadolinium, which has been implicated in a specific reaction in patients
with impaired kidney function. But there are also techniques for performing
MRAs without contrast. See our article on methods
for doing contrast-free MRAs. • My mother was recently diagnosed with an aneurysm
(via ultrasound). Now the Dr. wants to follow up with an angiogram to
determine the nature/severity of the aneurysm. My mother is in relatively
good health
(for a 72-year-old) but she's extremely sensitive to meds and I'm concerned
about the contrast dye. Would an MRA (mentioned above) be an appropriate
alternative? If so, what are the risks with an MRA? Thanks in advance
for your advice. • Jokhan -- read these posts. You could go for an
angiogram, or get a multislice CTA which has been shown to be 99% accurate
for negative results -- that is, if the CTA shows no coronary artery disease,
you can be confident that there is none. And it's only 15 minutes, non-invasive
and avoids the risks (although they are small) of the more invasive procedure. • Hi I am 30 yrs old male, having a healthy life.
but Last week I felt little discomfort in my chest, somehow I got concern
to meet a cardiologist. I met cardiologist, Dr suggested me for TMT. And
TMT found +ve for inducible ischaemia, other things are negative. Dr's
advise is, I can ignore it or I can go for angiogram for confirmation.
Kindly suggest me what should I do, shall i go for angiogram? • Tom -- CT Multislice and CTA are two names for
the same procedure (see the Editor's Blog entry from yesterday about this
-- "The
Super X-Ray". Your question about whether or not CTA is equivalent
to a standard invasive angiogram is most timely. The largest study yet
on this subject was presented on Monday at the American Heart Association
meeting (read
our article about the CorE 64 Trial). CTA is pretty much an imaging
mode to see structural data and blockages, not so much to measure flow,
although some research on CT perfusion imaging is being done at Johns Hopkins.
However, if your mother's cardiologist is concerned about blocked arteries,
then CTA is an excellent test for ruling out blockages -- highly accurate
(99%). We
just
conducted
an
interview
with
Dr. Michael
Poon, president
of the Society for Cardiovascular CT, and he stated that for patients where
there
is a question about blockages, but where the likelihood is low to intermediate,
that's who CTA is for. Certainly I would ask the cardiologist more about
CTA, especially for an elderly patient. The test takes 10 minutes and,
outside of possible allergies to the contrast dye, there are no complications. But
your mom's cardio may have good reasons why he wants the angiogram. Just
make sure you understand what those reasons are. • How does a CT Multislice differ from a Coronary CTA? What are the pros
and cons? Will either, or both, provide the cardiologist the same kind of diagnostic
information as an angiogram? Why would my mother's cardiologist want to do the
more invasive angiogram rather one of the less invasive procedures? She is almost
85 and is taking Betapace to control her atrial fibrillation. His concern seems
to be centered on arterial flow from one part of the heart to another. • I live near portland, oregon. My cardiologist
who initiated the tests which led to my double bypass open heart surgery
in june, 2006, says he wants to do another angiogram now. I don't want
it, i want an alternative non-invasive procedure. What is available to
me here? Who is the best known cardiologist in the Portland Or and greater
Portland area who also uses non-invasive testing for 'blockage' due to
sudden shortness of breath before they resort to invasive measures. I
will be 68 this month. Type 2 diabetes, SLE patient but never have taken
steroids,
I refuse. At time of my stress test, the only part of testing which showing
premature heartbeats, I had 6.8 potassium levels, a rarity for me who
is usually low in potassium. My cardiologist is angry with me, but I need
a 2nd opinion, where do I go please? Thank you for taking time. • Nancy -- an alternative to a cath, as you can
see in this topic, is modern CT Angiography which, when done by experienced
cardiologists or radiologists, can rule out the presence of coronary artery
disease. The current state-of-the-art CT scanner would be a 64-slice unit.
The test
is fast (15 minutes), does not involve an arterial puncture and healing
(just an IV for contrast injection) and is very accurate for ruling out
narrowings. The downside is that contrast IS used (some people are allergic
to contrast
dye, some with compromised kidney function need to limit their exposure)
although contrast is also used in a standard invasive angiogram. Also there
is a degree of radiation exposure -- in modern systems, it's about the
same or slightly more than an invasive angiogram. You can read more about
the various tests used to diagnose CAD in our Imaging
and Diagnosis Center.
By all means, discuss this with your cardiologist. But it has been shown
in several studies that If the multislice CT angiogram shows no disease,
you
can
be confident that there is none and you can relax. When he said there was
a "shady area" -- how did he see this -- what test?? • My doctor said I had no symptoms but since I
have anxiety attacks (thinking heart attack) he would go ahead and do a
heart cath. He said one area was shady but he thought it could be where
my heart is laying in my chest or the fact that I have large breasts -
should I do the heart cath? • Tracey -- angiograms, both invasive (done in the cath lab) and multislice CT types require the use of a contrast dye for the imaging. An adverse effect of this dye is that it can cause toxicity if the kidneys are not functioning correctly -- it can even damage the kidneys. So the doctors are right in not wanting to use this until it can be determined that the kidneys are okay. There is a test that doesn't use dye -- called an MRA, or Magnetic Resonance Angiogram. These are less available than the CT or cath lab exams, mainly because not all hospitals have the equipment, or the personnel to interpret the MRA. Once an Acute Myocardial Infarction (a.k.a."heart
attack") is over, the main thing is to stabilize the patient, reduce
any risk for another infarct and ultimately do an angiogram in a timely,
but not emergency, fashion to assess the damage and to determine the course
of treatment. And this treatment decision has recently changed: last year's
OAT trial showed that opening up the totally blocked artery that caused
a heart attack showed no benefit over drug therapy, once 3 or more days
had passed -- which seems counter-intuitive, but the results were pretty
clear. The recommended treatment for a heart attack is to do an angioplasty
within the few couple of hours after the onset of symptoms, but this requires
getting to a hospital that can perform emergency angioplasty quickly, and
the hospital must be able to diagnose and get the patient onto the cath
lab table ASAP (known as "door to balloon time"). By doing angioplasty
quickly, the heart attack is in effect stopped and damage to the heart
muscle is minimized. Let us know how your mother in law fares. • Hello! My mother in law is currently in ICU. She
suffered what they have listed here as "Acute Myocardial Infarction with
Acute Respiratory distress" her kidneys are not fully functional, but are
coming around at a slow pace. Here is my question, the ICU MD wants her
to have a angiogram but state they have to wait for her kidney function
to recover. It has now been 3 days, she lay waiting. Is there any risk
of her waiting for the angiogram? Is there an alternative test you could
recommend in place of the angiogram? ICU MD's say they will not know the
full damage until this angiogram is performed. Do you have any recommendations?
All advice is greatly appreciated. Thank you for your time. • Nita -- your question is a bit off topic -- if
there's interest, we'll start a new thread. Costs for procedures can vary
quite a bit, depending on your hospital or testing center and at what level
you're being tested. Also echocardiograms can vary in terms of how they
are done and the different types -- for example is this a nuclear stress
echo, an echo where adenosine or similar drug is used for patients who
cannot perform the exercise? You also typically have a variety of charges:
the echo itself, the interpretation of it, copies made for your cardiologist,
etc. Our best suggestion is to call a few hospitals or test centers in
your area and ask. For more information on the different tests used to
determine coronary artery disease, go to our Imaging
and Diagnosis Center. • What is the average cost for an Echogram? Thanks. • I have read that the average cost for an angiogram
was $7,000.00 over 10 years ago. I have also read that a sonogram, ultrasound
or echogram cost only a few hundred dollars. Is this information correct?
Secondly, if an ultra sound test is usually step one, when and why is the
angiogram, as a step 2, even needed? It's curious that I have never had
a cardiologist want to do anything on me first but an angiogram and they
never mention the ultrasound when I refuse the angiogram -- as I have always
done. Finally, what percentage of angiograms actually trigger a blockage
so that immediate invasive procedures must be taken to save the patient? • LaRee -- there are alternative tests for coronary
artery disease, such as MSCT scans (read about them in our editor's
Blog) that are less invasive. But if the functioning of the heart chambers
is what's being looked at, then step one is usually an ultrasound, and
then an angiogram. If you have questions as to whether any test is necessary,
a good rule of thumb is always to ask, "How will this test change
her current treatment?" If it won't, or if her ideal treatment can
be found in other ways, then perhaps the test is not necessary. Any invasive
procedure has risks, although percentage-wise, angiography complications
are pretty low. But your cardiologist probably has specific reasons for
ordering such a test. You should discuss the concerns expressed above with
your doctor. And please let us know what you find out. • My mother is 83 years old, diabetic with many
allegies. Her heart specialist would like her to have an angiogram because
she seems to have undue pressure and enlargement in the right chambers
of her heart. She gets along pretty well now and I am afraid that this
procedure may cause more problems than it solves. Any information would
be helpful in order to make an informed decision. |
|||||||||||||
