Posted on September 3rd, 2007 under Patient Stories & Updates.
Yesterday, I received an interesting email from Karen, who has been diagnosed with severe aortic stenosis. Her cardiologist told her that an angiogram will be needed prior to surgery. Karen’s questions to me were about the exam and angiogram risks.
More specifically her questions were, “Does an angiogram hurt? Is it painful? Is there any potential danger or angiogram risks during the test?”
Unfortunately, I have no personal experience that enables me to respond to the questions about the pain of an angiogram. Although I did have a double heart valve replacement (aortic and pulmonary valves), I did not have an angiogram prior to surgery. Because, I was relatively young and in good, physical condition, my surgeon (Dr. Vaughn Starnes), did not feel it was necessary.
That said, many patients will have an angiogram during the diagnosis period and/or the day before surgery.
“Angiogram?” you may be wondering, “What the heck is an angiogram? What are the potential angiogram risks or dangers?”
I know. I know. There are lots of questions about the process leading up to heart valve surgery. That’s one of the reasons I wrote my book, The Patient’s Guide To Heart Valve Surgery – to help patients and caregivers better understand each step of the cardiac surgery experience.
Anyways, back to the topic of angiograms and potential angiogram risks. Coronary angiography is the process of creating an angiogram of your heart using dye, a thin, flexible, hollow tube called a catheter and a rapid succession of x-rays resulting in a motion picture.
According to the Mayo Clinic, patients are awake during the procedure so that you can follow instructions. Throughout the procedure you may be asked to take deep breaths, hold your breath, cough or place your arms in various positions. Your table may be tilted at times.
Most cardiologists consider cardiac catheterization safe and low-risk. Depending on your personal pain threshold, getting an angiogram is relatively painless because local anesthesia is used. The whole process can usually take between 30 – 45 minutes.
A coronary angiogram is different than an ordinary, non-invasive x-ray because the dye is injected into the heart arteries with the catheter. This enables the x-ray to contrast the arteries with the surrounding body tissue. The cardiologist can then see which arteries are narrowed or blocked, even the very smallest ones, and recommend the best method to solve problem via balloon angioplasty, a coronary artery bypass graft (bypass surgery), stent placement, or treatment with drugs prior to / during heart valve surgery. Ultimately, the angiogram will also help determine how well the heart is functioning by looking carefully at it’s main chamber, the left ventricle.
Potential Angiogram Risks
According to the Mayo Clinic, there are some risks associated with angiograms. “As with most procedures done on your heart and blood vessels, coronary angiography does pose some risk. Major complications are rare, though. Among the potential risks and complications are:
- Heart attack
- Trauma to the catheterized artery
- Irregular heart rhythms (arrhythmias)
- Allergic reactions to the dye or medication
- Perforation of your heart or artery
- Kidney damage
- Excessive bleeding
- Blood clots
- Radiation exposure from the X-rays
Considering the above, you truly want to make sure that you find a trusted and reputable cardiologist to perform the angiogram. Recently, I read a horrible book called Coronary. The book details a massive lawsuit brought against several cardiologists, cardiothoracic surgeons, and Tenet Healthcare because several physicans (e.g. Dr. Moon in Redding, California) were performing fraudulent angiograms and bypass surgeries on patients.
- Finally, you should know that not all patients require angiograms prior to heart surgery – heart valve replacement and heart valve repair included. Please read “Do All Patients Have An Angiogram Before Heart Valve Surgery?” for several patient inputs and discussions.
If you would like to learn more about angiogram procedure from the patient perspective, please click on this link – Ken’s Cardiac Catheterization.
I hope that explains this diagnostic test and the angiogram risks.
Keep on tickin!