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HelenaKervinen

Diagnostic Coronary Angiography

Essentials

  • Coronary angiography is used to investigate the anatomy of the coronary arteries and to assess the number, location and severity of possible coronary stenoses.
  • In the case that a significant stenosis is found it is possible at the same time to perform a therapeutic intervention, i.e. balloon angioplasty (also using a drug-eluting balloon) and, if needed, insertion of a metal mesh (bare-metal or drug-eluting stent) to secure the patency of the vessel.

Indications

Angina pectoris or other symptom triggered by exertion

  • The way to proceed can be agreed upon in a regional care pathway, but a cardiologist's assessment is often needed concerning the indication http://www.dynamed.com/evaluation/diagnostic-cardiac-catheterization-and-coronary-angiography#GUID-C5E4163D-5255-4E07-B4BA-CEA0E0FBA0AF of the procedure. The suitability of the patient for potential invasive treatment interventions (PCI or CABG) and for the necessary pharmacotherapy should be assessed beforehand.
  • Exercise-related angina pectoris symptoms (chest pain, dyspnoea, fatigue) during medication and a very high pretest probability of CHD (> 85%): consider either coronary angiography or other type of diagnostic imaging.
  • Exercise-related symptoms that repeatedly disturb the life of the patient despite optimal medication, when the pretest probability of CHD is 15-85% and the patient has findings suggestive of ischaemia either in an exercise stress test or in another diagnostic imaging study.
  • Exercise-related angina pectoris symptoms (chest pain, dyspnoea, fatigue) during medication, when the pretest probability of CHD is 15% and the patient has some other finding suggestive of ischaemia (reduced left ventricular function or a local wall motion disturbance, arrhythmias).

Acute chest pain

Other indications

  • Heart failure of unknown aetiology or wall motion disturbance: search for the cause
  • As further investigation in a patient surviving resuscitation after ventricular fibrillation
  • Assessment of invasive management of a valvular heart disease
  • Assessment prior to heart transplantation

Contraindications

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