On a sunny afternoon, Lao Li was lying on the hospital bed, holding a newly printed coronary angiography report in his hand.
There was a hint of confusion and worry in his eyes.
A few months ago, Lao Li felt a sharp pain in his chest while climbing a mountain, which forced him to interrupt his mountaineering activities for many years.
After an initial examination, the doctor recommended that he have a coronary angiography.
Lao Li checked on the Internet, and all kinds of remarks made him frightened, is coronary angiography really as dangerous as it is said on the Internet? Can he really walk all over the mountains and rivers with vigor and vitality as before?
1. Introduction to coronary angiography
Coronary angiography, which sounds quite lofty, is actually a medical examination method used to observe the condition of the coronary arteries of the heart.
To put it simply, doctors can clearly see every inch of the coronary artery by injecting a special substance called a contrast agent into the patient's body and using an X-ray machine.
This technology is not new, it has been used for 60 years. Don't underestimate this test, it is an important basis for doctors to determine whether there is coronary heart disease and the degree of coronary heart disease.
However, there is always some misunderstanding and fear among the general public about this inspection. Some people say that as soon as this contrast agent enters the heart, it is like a time bomb put in it, which may "explode" a serious illness at any time.
Some people are also worried that once this long catheter is inserted into the body, it will be like an alien in the movie, and it will make a big movement in the body. These statements sound scary, but what is the truth?
2. Safety analysis of coronary angiography
When it comes to the safety of coronary angiography, we must first talk about the frightening contrast agent.
The contrast agent called iodixanol used now has very small molecules, and after entering the body, there are few adverse reactions, and the discharge is fast.
As for the idea that the contrast agent will leave a scourge in the body, it is too much to worry about. After the contrast agent enters the body, it is not absorbed at all, it will circulate with the blood, and finally through the kidneys.
Let's talk about the catheter. Although it may sound scary, in reality, the catheter is much thinner than you might think, and the doctor is familiar with it and accurate.
As for the 0.1 percent mortality rate, it sounds small, but it's daunting. It should be emphasized here that this number is the maximum value of statistics, and in clinical practice, the vast majority of coronary angiography is safe and will not be a major problem.
Lao Li looked at the sunshine outside the window, and the haze in his heart seemed to have dissipated a little. He began to realize that the statements circulating on the Internet were often unfounded. He decided that he should listen to the advice of a professional doctor, after all, doctors are experts in this area.
3. High-risk groups who are not suitable for coronary angiography
Although coronary angiography is widely used to detect heart diseases, it is not suitable for all people.
The first to bear the brunt are patients who are allergic to iodine.
Iodine is the main component of contrast media currently in use, and people who are allergic to it may suffer from allergic reactions and even shock in severe cases if they undergo conventional coronary angiography.
Therefore, for this part of the patient, upfront allergen testing is indispensable.
In addition, patients with hyperthyroidism should be of particular concern.
Iodine contrast may exacerbate symptoms of hyperthyroidism and worsen the patient's condition. These patients should be evaluated with an endocrinologist before deciding whether to undergo coronary angiography.
Patients with renal insufficiency are also at high risk. Because iodinated contrast agents are mainly excreted through the kidneys, renal insufficiency can lead to retention of contrast agents in the body, increasing the risk of kidney damage.
Doctors usually evaluate the person's kidney function markers, such as serum creatinine levels, to decide whether to do tests or use other safer contrast agents.
Finally, patients with severe angina need to be closely monitored by a clinician due to the potential cardiac burden of coronary angiography.
4. Preparation and precautions before coronary angiography
Preparation for coronary angiography is also important, as it is related to the safety and accuracy of the examination.
First, patients undergo a series of basic medical tests, including blood biochemistry analysis, coagulation tests, electrocardiogram and chest X-ray.
These tests can help assess a patient's suitability for coronary angiography and identify possible risk factors early.
In addition, doctors usually ask the patient in detail about the history of drug use, particularly anticoagulant drugs and diabetes medications, as some medications may need to be stopped before surgery.
Mental preparation should not be neglected. Although coronary angiography is a minimally invasive procedure that most patients do under local anesthesia, it is helpful to understand the procedure, possible discomfort, and how to manage it.
Doctors and caregivers counsel the patient to ensure that they remain calm throughout the procedure. In conclusion, thorough preoperative preparation can not only improve the safety of the procedure, but also help to improve the patient experience and the diagnostic value of the examination.
5. Interpret the coronary angiography report
A coronary angiography report sheet is an important map of a patient's heart health for doctors. The report sheet details the flow of contrast in the coronary arteries, revealing narrowing, occlusion, or abnormality of the blood vessels.
Specifically, the major branches of the coronary artery, such as the left anterior descending artery, the right coronary artery, etc., are noted in the report, as well as their degree of stenosis, which is usually expressed as a percentage.
For example, "50% stenosis of the middle left anterior descending artery" means that the diameter of the blood vessel in the middle of the left anterior descending artery is only half of what it would normally be.
This information is crucial for patients. It not only helps doctors decide whether interventional treatments, such as stent implantation, are needed, but also helps doctors develop personalized medication plans.
Of course, interpreting this report is not an easy task and requires a lot of clinical experience and expertise from doctors. When receiving the report, patients should not interpret or make medical decisions on their own, but should fully communicate with professional doctors to jointly formulate a follow-up treatment plan.
epilogue
Coronary angiography, a technique that may be a bit of a mystery in the eyes of some, is actually a routine test in modern medicine, and its safety and accuracy have been widely recognized.
For those who are struggling with heart problems, a coronary angiography is a window into the heart's secrets, allowing doctors to gain insight into the condition of the coronary arteries and identify and treat the problem in a timely manner.