Coronary heart disease is a heart disease in which the lumen of the coronary arteries is narrowed or blocked by "hardening" lesions, causing myocardial hypoxia, ischemia and necrosis.
The arteries of the body are like a busy "ring road", as long as there is a traffic jam or a slowdown in traffic, it will slowly affect the whole body. If there is a problem with the coronary arteries, the impact is not trivial. The root cause of stasis and blockage is blood clots or plaques.
Under normal circumstances, X-rays do not see blood clots and plaques, but if a contrast agent is used to assist in "development", it is clear where it is blocked and where it is narrow. Very simply, where the blood cannot pass and narrows, the contrast agent has the same reaction, which is the principle of coronary angiography and the "gold standard" for diagnosing coronary heart disease.
Coronary angiography is to send a hose with a diameter of 1-2mm from a puncture port to the coronary opening, inject an appropriate amount of contrast agent, make the coronary artery "show the real body", confirm whether there is coronary heart disease, can intuitively detect the location of the disease, the degree of lesion, and provide treatment solutions, such as the application of bypass surgery, stent implantation or drug treatment, etc.
As for the puncture site, the first choice is usually the right radial artery, followed by the left radial artery, or ulnar, brachial, or femoral artery. However, coronary angiography is not required in patients with coronary artery stenosis within 70%.
Why should you not do a "coronary angiography" test lightly? There are 6 points to consider:
1. It is essentially a minimally invasive examination carried out in the human heart, although the trauma is minimal and the risk is controllable, but the essence is a kind of "tightrope" surgical process, which has high requirements for doctors, and must choose a regular and professional hospital.
2. There may be contrast agent allergy, the most common contrast agent is iopromide, about 100 ml per injection, some patients may be allergic, mild rash, vomiting, heavy may appear blood pressure, heartbeat and other abnormalities, and even need rescue.
3. The choice of puncture site should be cautious, if it is selected in the femoral artery, the incision is easy to infect, and the bed rest time increases, which has a greater impact on patients with heart failure. In fact, a significant proportion of patients are at the opening of the femoral artery.
4. Embolic complications may occur, such as plaque embolic complications, thromboembolic complications, air embolism, etc., which have high requirements for the doctor's operation level and the safety of the instrument. To prevent thromboembolism, some patients are given heparin before surgery.
5. Some patients may suffer from contrast nephropathy, which should be discharged through the kidneys, and there are still some risks for patients with reduced kidney function, elderly patients or patients with diabetes.
6. The cost is not low, the average cost is about 5000-8000 yuan each time, and the charging standards in each region are different, and generally speaking, it is not cheap.
However, as the gold standard for the diagnosis of coronary heart disease, the technology has been relatively mature, and the overall risk is controllable.
Acute myocardial infarction – Determine which blood vessel is blocked and open it as soon as possible.
Angina that can't be relieved by medication — doctors can't tell which blood vessel is narrowed and to what extent.
Angina after stent surgery – find out if the stent is narrowing or if there is a problem with other blood vessels.
Sudden ventricular arrhythmias with unknown cause – find out if there is a problem with coronary heart disease.
Sudden syncope and convulsions - prevent and rule out sudden cardiac death.
Unexplained cardiac insufficiency – especially heart failure at the first episode.
In general, coronary heart disease should not be careless, it should be taken seriously, and professional judgment and operation should be handed over to professional doctors to do.