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Angiography Health Feed

I was admitted to hospital a week ago with symptom of ghabrahat from last 2 days. On several check up in hospital, I am diagnosed non diabetic, non hypertensive, non smoker. My coronary angiography was done which shows single vessel disease for which stress thallium was done and advised medical therapy. Discharge summary says final diagnosis - cad- actuate coronary syndrome, nsr- no ccf, b12 deficiency. cholesterol total - 207, triglycerides - 151, hdl - 45, ldl - 136, vldl - 26, hdl ratio - 4.60.coronary angiography report says - left main, lad,lcx are normal and rca - dominant, 80% distal stenosis, jerky movement at lesion site. Stress myocardial perfusion imaging shows global resting lvef - 56 +- 5 % with impression adequate stress and good effort tolerance, no scan evidence of stress induced reversible ischemia noted jn lv myocardium, normal resting systolic lv function with no rwma as estimated by quantitative gated spect. Stress total severity score - 23, rest total severity score - 52, reversibility total severity score - 0.tab ceruvin a 75 mg, tab rosuvas 20 mg, tab me 12 was advised. I want to know what medical procedure should we continue? Should we go for angioplasty/stent or should continue with medicine to clear the blockages? If you want I can send the report to you.

Cardiologist, Gurgaon
I was admitted to hospital a week ago with symptom of ghabrahat from last 2 days. On several check up in hospital, I ...
Hello Mr. lybrate-user, your stress thallium report says "no scan evidence of stress-induced reversible ischemia" -,it means even under stress there was no compromise in the blood supply in the area supplied by the blocked artery (rca 80%) so no angioplasty is needed now. You should just continue with the medication advice and follow good lifestyle -- regular exercise/ daily 2-3 km walking- restricted -low-fat diet - and follow up with your doctor if any new symptoms arise. Cholesterol levels are very high so a low-fat diet should be followed with rosuvas which is advised.
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On 11/11/19 my 2d echo showed grade 2 diastolic dysfunction, mild pulmonary hypertension, concentric lvh, la is mildly dilated, aortic sclerosis and stress test positive and suggested angiography which I have not perform till now. Yesterday 09/06/20 again went for ecg and 2d echo which showed normal ecg and grade 1 diastolic dysfunction only. Rest all are normal. Taking this medicines cilacar 20 mrng telday 40 night atorva gold 10 what change in medicine should I do now? Should I go for angiography? What should I do now?

Dr.Rajiv Bajaj 93% (2902ratings)
MBBS, MD - Internal Medicine, DM - Cardiology, Fellowship in EP
Cardiologist, Delhi
On 11/11/19 my 2d echo showed grade 2 diastolic dysfunction, mild pulmonary hypertension, concentric lvh, la is mildl...
Better to avoid angiography in such cases. Tmt is mostly giving wrong report in ladies with hypertension. Explain this to your dr, he may be forgetting and then ordering excessive invasive tests unnecessarily.
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सर मैंने मार्च 2019 मै एंजियोग्राफी करवाई थी जो की नार्मल रिपोर्ट आयी है और ct angiogram bhi karwaya normal hai 2017 मै tmt test 2 bar करवाया तथा 2d echo 4बार करवा लिया कई बार ecg trop t test xray करवा लिया सब की रिपोर्ट्स नार्मल डोक्टोर्स मुझे pentoc or clonazepam देते है फिर भी मेरी चेस्ट मै हल्का दर्द बना रहता है कभी ठीक होता फिर होने लगता है और आजकल तेज चलने मै भी छाती के बीच मै दर्द हो रहा है सर एंजियोग्राफी के एक साल बाद ब्लॉक बन सकता है blockage बनने मै कितना समय लगता है or sir ये दर्द कैसे ठीक होगा क्या सर्वाइकल से ये दर्द होता है मुझे सर्वाइकल की प्रॉब्लम है

Dr.Sambhaji Kshirsagar 89% (14ratings)
BHMS, Bachelor In Pharmacy
Homeopathy Doctor, Jalgaon
सर मैंने मार्च 2019 मै एंजियोग्राफी करवाई थी जो की नार्मल रिपोर्ट आयी है और ct angiogram bhi karwaya normal hai 2017 ...
First of all your weight its 81 kg. आपला जॉब १ जगह पर बैठकर काम करने का होगा ऐसा मुझे लगता है digestion or acidity ki समस्या भि रहति होंगी कट्टे प्रारंभी पाटील भुंगे जाती में जलन के साथ दर्द होता होगा तो यह पचनकि समस्या है।
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Know How Angioplasty Can Help Combating Heart Disease!

Dr.Siddhartha Mani 92% (46ratings)
MBBS, MD - General Medicine, DM - Cardiology
Cardiologist, Kolkata
Know How Angioplasty Can Help Combating Heart Disease!

When a person suffers from the typical symptoms of heart weakness that includes breathlessness, weakness, sudden sweating, discomfort while doing minor exertions, chest pain, pain radiating along the arms, back, neck and shoulders and other symptoms, the doctor will ask for investigations to study the heart.

The Heart is a muscular organ in the chest and like any other muscle in the body, it has its own unique blood vessel network that does the function of supplying nutrition to the heart muscles. Like any network, the Cardiac blood supply also begins with major vessels that branch off into minor and then very small blood vessels. It is these very small blood vessels that actually reach the muscle fiber to give nutrition.

When this is a problem with the free-flowing blood to reach the muscle cells, the strength of the heart muscles reduces and the overall heart functioning is in trouble. Until now, it was commonly believed that cholesterol deposits make blockages in the blood vessels that cut off nutrition supply causing the heart to go into disease stage. Today, extensive research has proved that there are many reasons for hampered blood supply to heart muscles, and plaque formation (blockages caused by cholesterol deposits) need not be the reason for heart attacks entirely. Blood vessel disease called Atherosclerosis is the root cause.

In modern times, if the patient consults a cardiologist, the first line of investigation prescribed is the Angiography. This procedure requires the patient to be admitted to the hospital. Under anesthesia, the Doctor will make a cut/incision in a major blood vessel of the thigh joint or the arm. He will then insert a tube called catheter into the blood vessel and guide it through the major arteries till it reaches the important position from where the blood vessels that supply nutritious blood to the heart muscles is reached. At this position, a dye is pushed into the blood flow and a series of specialized X-rays are taken that will show the blood vessels.

In these images, it is the Doctor’s expertise that will identify positions where the blood flow is reduced, or disturbed. The dye has a short life span and is able to show flow dynamics only up to the secondary blood vessel network. The Doctor will determine which part of the heart blood vessels are affected based on these images, the length of the plaque, position and kind of blockage and derive the damage to heart, based on these anatomical visuals. The catheter is then removed; the blood vessel opening stemmed and the patient has to remain immobile in the hospital till the blood vessel improves. The Doctor will prescribe a list of medication that includes beta-blockers, aspirins, statin and antibiotics.

Very often, if the Doctor decides, he will suggest the next procedure of Angioplasty immediately. This procedure involves pushing a mini wireframe tube called ‘stent’ or an inflatable balloon through the same catheter to the area of blockage. This balloon or stent is guided to the area of the blockage and mechanically expanded to push aside the plaque to help the blood flow resume. There are different kinds of balloon and stent procedures.

None of these procedures “removes” the blockage plaque. The procedure helps to resume blood flow in the major arteries only. 

No invasive therapy is safe and there is a lot of reports backed by Research Data from very reputed global authoritative organizations that highlight the unnecessary number of angio procedures being done as well as the side effects of these procedures within few months. (Many Stent Procedures Unnecessary” Heart Drugs Just as Good at Preventing Heart Attacks, Death in Some People, Study Shows By Charlene Laino: March 26, 2007 (New Orleans).

Can blockage affect a person after having angiography?

It is important for the patient and patient’s family to understand that the blockage formation process in the body does not reverse with angioplasty or even a Bypass procedure. The patient suffers from the same kind of symptoms as earlier when new blockages form in different sections of the coronary network or very often when a deposit/scar forms within the stent itself leading to hampered blood flow. This ‘reformation of blockages’ is referred to as restenosis. This is the greatest problem registered in current studies of patients after angio and bypass and this is seen within a few weeks to after 10 to 14 months of the procedure.

The reformation of blockages or further formation of new sites with blockages depends on the individual patient's health condition. Patients who are Diabetic, High BP, on certain kind of long term medication, obese, with bad lifestyle; all have the additional threat of secondary attacks.

Restenosis cannot be prevented with another stent or bypass procedure. The procedure only once again’ mechanically opens the blockage or in CABG, creates a bypass around the blocked blood vessel.

How can restenosis be prevented?

The only and best way to avoid restenosis is to make major changes in diet, exercise, weight management, stress management. It is also very important to be under the right kind of medication that will support the natural process done by the Liver and blood to reduce and wash out inflammation (that causes maximum problems in natural blood flow), repair blood vessels, reduce and remove existing blockages and scar tissue within blood vessels, add strength to the heart muscles.

These new studies and treatment options should be searched out by the patient and his/her family to understand the reason of blockages, the possible need and safety of invasive procedures, the option to medicine based treatments before undertaking any invasive procedure. Remember, it is scientific research that has clearly proclaimed that less than 30 -20% of all the angio’s performed are necessary or have a lasting effect on their own.

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CT Angiography Of Brain - Know Merits Of It!

Dr.Nitin Jagdhane (Jain) 91% (33ratings)
MCh Neurosurgery, Fellowship in Spine surgery, MS - General Surgery
Neurosurgeon, Mumbai
CT Angiography Of Brain - Know Merits Of It!

A brain computed tomography angiography (CTA) is a specialized neurologic CT scan, and it involves fast CT imaging while simultaneously injecting IV contrast into a vein in the arm. This procedure allows visualization of the specific vascular anatomy of the organs in the body. It can also be used to evaluate vessels or plan a surgery. Mostly it is used to identify a small aneurysm or arteriovenous malformation (abnormal communications between blood vessels) inside the brain.

  • A patient can expect the following things during the brain CTA examination:
  • The patient is asked to lie on the examination table.
  • If contrast is used, an automatic injection pump connected intravenously will release the contrast material at a controlled rate.
  • Although the movement of the table occurs slowly at first, it gains rapid momentum when the actual CTA is performed.
  • The patient may be asked to hold his/her breath during the scanning.
  • Any motion in the form of breathing or body movements can lead to artifacts on the images.

The entire CTA exam may be completed within a few seconds. However, the patient’s actual time in the room may be long. This delay can occur as the technologist takes his/her time to position the patient on the table, check or place an IV line, do preliminary imaging to verify the beginning and end points of the exam, and set up the scan and contrast injection settings based on the part of the body being imaged.

Benefits of brain CTA include the following:

  • The need for surgery may be eliminated by angiography; however if surgery remains necessary, it can be performed with much accuracy because of brain CTA findings. As the CTA is able to detect the obstruction of blood vessels, it allows for potentially corrective therapy.
  • The CTA may give precise anatomic detail than a magnetic resonance imaging (MRI), particularly in cases of small blood vessels.
  • The CTA is faster, noninvasive, and has lesser complications than catheter angiography, which involves placing a catheter (plastic tube), (usually at the groin) into the patients’ major blood vessels and injecting a contrast material along with probable sedation or general anesthesia.
  • The CTA examination costs lesser than catheter angiography.No radiation remains in a patient's body after a CTA examination.

Risk factors for brain CTA

A small chance of cancer from excessive exposure to radiation History of allergy to X-ray contrast material Risk for kidney failure, as the contrast material could potentially further damage the kidney function in patients with pre-existing kidney disease

2537 people found this helpful

Age Related Macular Degeneration - How To Diagnose It?

Dr.Vrij Bhushan 86% (26ratings)
MD - Ophthalmology, MBBS
Ophthalmologist, Dehradun
Age Related Macular Degeneration - How To Diagnose It?

Age-related macular degeneration, also known in brief as AMD or ARMD is one of the most common age-related causes for vision loss. It causes “blind spots” in vision, causing difficulty in activities requiring central vision like reading, sewing, driving, watching TV, computer usage, etc.

How it happens?

The centre portion of the eye is known as retina which has a screen in the posterior portion. For proper vision, light falls on this screen and is then processed to enable ‘vision.’ When this screen is not clear, blurred vision results. It may not cause total blindness but impairs vision including double vision and loss of central vision.

Types: There are two types of AMD, wet and dry.

  1. Dry: There are yellow deposits known as drusen which form in the macula, and as they grow in size, they impair vision, specifically the central vision. This is the common variant and can lead to the wet form.
  2. Wet: There are abnormal blood vessels which are formed in the retina. There is leaking of blood and fluid which makes it ‘wet.’ There could be scarring of these leaked substances, which again leads to loss of central vision. Further studies have shown that retina produces a protein knows as vascular endothelial growth factor (VEGF) which promotes the generation of new blood vessels, normally required for the production of new blood vessels. However, increased VEGF causes excessive proliferation of blood vessels, leading to macular degeneration.

Risk factors: Though age related, there are definitely some factors which put one at a higher risk for AMD

  1. Genetics: AMD is hereditary and runs in families
  2. Gender: Females are more prone to develop AMD than males
  3. Ageing: People above 60 are at greater risk
  4. Smoking: Direct and passive smoking contributes to AMD.
  5. Obesity: Accelerates the pace of AMD and the severity of complications.
  6. Hypertension: Increases the chances of developing AMD
  7. Ethnicity: Caucasians are more prone to develop AMD as their lighter skin and eye color is more prone to sun damage
  8. Sun exposure: Increased sun exposure accelerates the onset of AMD

Symptoms:

  1. No symptoms in the initial stages
  2. Gradually, there is impaired central vision, affecting activities like reading, driving, and computer usage
  3. Color perception is impaired

Diagnosis:

  1. A routine eye exam will reveal the yellow deposits which actually cause the condition.
  2. An angiography may be done after injecting a dye to detect blood vessel growth.

Treatment:

There is no cure, but progress can be delayed

  1. Anti-angiotensin agents reduce pressure in the eyes and stop the development of newer blood vessels
  2. Vitamins help slow down loss of vision
  3. Vision aids to correct vision
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I am a heart patient having two blocks one with 80%and another with 40% as per the angiography was done and as per the reports given. I would like to have an expert advise whether I required to do an angioplasty along with starting immediately for both or else what is the doctor's suggestion?

Dr.Sajeev Kumar 91% (39583ratings)
C.S.C, D.C.H, M.B.B.S
General Physician, Alappuzha
I am a heart patient having two blocks one with 80%and another with 40% as per the angiography was done and as per th...
If your site of block is not a fatal portion and if you have no serious symptoms; oke angina or attacks you can wait with medicines and review after 6 months. But if the block is in a dangerous area you need immediate angioplasty.
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