Angiogram

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An angiogram has a stated risk (NHS website) of 1/500 patients having a stroke or heart attack during the procedure. That does not seem very safe to me, especially as these figures do not take account of perforated blood vessels, reactions to contrast dye or heavy bleeding at wound site.

I was told by my baffoon of a cardiologist that 'I had JUST ABOUT convinced him that I was a candidate for an angiogram. When I asked why he replied that he was putting me forward as I am a smoker. I have not smoked for 23 years. I do not drink, my weight and cholesterol is within normal range, I exercise and have a healthy diet. I also have hyper alderesterone and a GP who refused to treat my high BP for several years as he said I was 'Doing it to myself.'

The result?

Eye sight and possible heart damage and now being bullied into having a risky procedure on the whim of a consultant who thinks I am a smoker when I am not. Hardly inspires confidence.

Have asked for a ct angiogram or just for the opportunity to discuss why this is not an option in my case but am met with 'It was the consultants decision and he must have had a good reason for making that decision''

Now the Endocrinologist is insisting I have the angiogram before he will proceed with further treatment for the hyper alderesteronism.

I suppose they have to  their develop their skills for their private patients by practicing on someone.

Source(s):

Anonymous Eve · just now

 

1 like, 11 replies

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11 Replies

  • Posted

    Hi niamh,

    Angiograms just like everything in this world have associated risks, referring back to your ex smoking status I have found that doctors "think" that we could slip back into smoking, I did but that was my personal choice and ,yes albeit an exscuse, I was shunned back into smoking by the way I was treated by medical staff on one ocassion and I am now trying to quit again, Researchers believe that being a smoker you can reduce the damage by giving up, that maybe so but I had an old school GP tell me years and years ago that smoking does not do the damage doctors/ researchers of today lay claim to (Naturally this is very debatable) this old school doctor told me that if you was an active person like I was it does no harm, how ever if I was to be a sedentary type of person well then for sure I'd be asking for trouble with smoking like clogged up lungs,empysema and the obvious becoming obese... As an example back in my days a majority of sportsmen/sports women smoked  after their weekend rounds of football,tennis even athletes, I was an athlete..The body cleared the "toxins" out of the system, the lungs were functioning as they should because they were getting exercised every single day at training and a bigger work out on competition days.I remember about 15 years ago researchers released a paper about nicotine and how they found out it was good for the heart and in preventing coronary artery blockages, how ever they did issue a big statement at the end of their findings "don't go rushing out and start up smoking" I have neverbeen able to find that paper again not even online, I believe it is drummed into them at medical school that smoking kills. I know lots of non smokers that have succumbed to lung cancer and many other cancers and passed, I know several people that have empysema either from hereditary causes or the trade they worked in, it's usually the concrete .well any type of dusty work enviroment.. anyrate enough about smoking smile

    Back to the Angiogram, Yes it depends on the doctor of the day, they usually have specialised cardiologists to perform this procedure and it's not very often that they stuff up, I had one very qualified cardiologist do 2 of my Angio's the first onwe went off with out a hitch but unfortunately the second time he wasn't quick enough to put immediated pressure on the main aretery entry point and squirted a bit of blood but it was quickly seen to and the bleeding stopped in less than a minute, back then the only  discomfort was having to lay on your back for 5-8 hours with a bag of sand on the entry point, you can feel the dye go through your system but they warn you before they inject it, you will find you will get a very quick rush of warmth, a hot flush feeling go through your whole body and only last 10-20 seconds at the most.

    Today Cardiologist now prefer to go through via the wrist, they say it's a shorter route to the heart, they have a new technique of putting pressure on the entry point, it's a wrist band placed over the entry point and blown up with air to a certain pressure and then you are placed in recovery if you are an out patient (well it's the same if you're an in patient as well) the nursing staff check on you every 1/2- 1 hour and from memory they release a small amout of air with a syringe after the first 2 hours and then again hourly after that ..now obviously if you are on blood thinners I dare say a different time frame maybe used in releasing the pressure, when I had my third Angio I had it go up through the right wrist from memory and at times I felt itchy where the band was but I think that may of just been me because I've never liked anything on my wrists . There obviously would be more risks in the elderly with angiograms but all in all it is a relatively safe procedure, it is usually used as a last resort, a systemibi (spelling) is usually ordered, that is bot a resting and stress test, they can do it either way,with me they did the resting part first, they inject you with the dye and get you to sit for aprox 40-45 mins sometimes it can be less and then they get you to lay down and an xray type machine will rotate slowly around your chest (takes around 20 minutes) depending on the doctor they get you to go back the next day and do the stress test,You are injected again with a dye and have to sit for around 15 -30 min then they get you on a treadmill at a set speed(to get your heart rate up to a certain amount of beats - I can't remember how many, don't quote me on this but I think around 120-140 bpm) for around 4 minutes then sometimes they may slightly incline the treadmill for a minute. If you think you can't walk  for that long they can inject a drug to increase your heart beat and is completely reversable if you run into trouble which I was informed, very rare...As I couldn't walk that's how I was tested as explained above, If you can walk on a treadmill I think the testing time is the same...The other testing procedure which is non evasive is the heart echo, it's just like an ultra sound and they look for faults with your heart like valves, chambers, etc etc

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  • Posted

    I forgot to mention that once the stress part is done they get you to sit again for around 15 minutes and then you are taken back into the xray room where they rotate that xray type machine around your chest again, this can also tell them if you have a blockage ...Angiograms are used as a last resort or if you have had a heart attack . But then again it does come down to the specialist in which way he/she wants to go
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  • Posted

    Thank you for all the valuable information Samuels. It is interesting that you say angiograms are used as a last resort. The Idiot Baffoon consultant put me forward for one before I had had any other tests, the form of angiogram he is insisting on which is a right and left side catherization is now largly considered obsolete as echocardiogrms are considered a much safer option which give the same information.

    The echo cardiogram that was performed AFTER he ordered the angiogram against my express wishes showed only slight thickening of left ventricle.

    I feel so angry about the way he has acted. I have asked for a second opinion and even wrote to him asking for information but of course, he did not reply, though his web page aimed at his private patients states that he prides himself on his clear communication with patients.

    Nhs patients are expected to submit to doctors decisions without explanation. It appears I am not now to get a second opinion.

    What a mess.

    Thanks again.

     

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    • Posted

      Hi,

      Wow...Not entitled to a second opinion ?  Pardon my ignorance but what is NHS ? Yes  I've had 3 Angiograms over the years, and my cardiologist was telling me that they prefer to use it as a last resort as there are other testing procedures in place . I think it has a lot to do with our government  because of the costs of individual tests (I live in Australia) and we have a system where medicare take care of all our medical costs including testing for low-mid range wage income earners.

      I had my first angiogram at the age of 32  from memory as I have what I was told a rare cholestrol problem and it "apparently" warranted an immediate angiogram to make sure I had no blocked arteries, luckily everything was all good in there, I continued to have problems (unexplained chest pains) I then had  other tests to evaluate things but nothing showed up, hesitatingly he ordered another angiogram and still found nothing so a diagnosis of the small blood vessels in the heart were going into spasms causing my chest pains, now it was explained to me that these blood vessels are naked to the eye and also can't be seen via angiogram or other testing procedures.In the end the diagnosis was changed to Prinzmetal angina where the coroanary arteries also go into spasm but unfortunately here they do not do the recommended test to determine Prinzmetal angina, they say the drug used to see if they can get the coronary arteries to spasm under angiogram conditions is rather dangerous, that's what my new cardiologist had told me as my original Cardio said he was going into retirement sad ...however I have since learnt that he is still practising privately and I can go see him anytime I choose to.

      Back in October 2013 I was 46 and I had my normal cluster of chest pains and wasn't feeling right, I left it for nearly a whole day before seeking help as it only felt like indigestion, because I'm a regular in or ER they just shoved me out in the waiting room but after an hour a nurse came and got me and put me into an ER cubicle and a doctor had informed me that I had suffered a heart attack, I was stabilised pain wise and admitted into the cardiology ward and the next morning I was in the cath lab , apparently that is the "Norm" after a heart attack, what they had found was the start of atherosclerosis in the right coronary artery, some doctors called it a signifacant blockage and was the cause of my chest pains, others say to me that it is only a baby blockage. The term used was 50-60% occlussion in the RCA so In my thinking that even at 50 %  that's half the artery blocked and would naturally limit the blood flow from that artery to the heart but cardiologists are saying that it's nothing to worry about and that it's not blood flow restricting..( I still can't work that one out) to me the laws of science, if something is half blocked it's going to cause problems ?.

      It was determined that I had what they call an NSTEMI (mild heart attack) it wasn't picked up on an ECG in fact the ECG was normal it was only picked up in the Troponin blood test.

      It's interesting that you mention echo cardiograms are the preferred use now, My cardiologist told me that this kind of testing is rarely used unless something mechanical was suspected..I.E heart valves, chamber malfunctions and heart murmors

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    • Posted

      Yes the irritant they use to induce spasm can batter you for days neutral
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  • Posted

    Hi Samuals sorry to hear that you have had so many health problems. I hope they find a solution that you can work with soon.

    I was born with a heart murmer and they found slight left ventricular hyperthropy during the echocardiogram. I find it very strange that the consultant should order an angiogram before the results of the echocardiogram were known, or before doing any other tests.

    Endricologist tells me I need the angiogram urgently but has deferred my appointment to sort out hyperalderesteronism for 4 months so my health problems can't be that urgent.

    Wondering what my options are now as I don't have much faith in either of the consultants.

     

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  • Posted

    I am due to have an angiogram and I am scarred witless, not able to sleep etc., and in a panic. I do not have angina and am suffering no chest pain.(AF) Just out of breath mostly and have had one cardioversion which lasted about 2 weeks at most.[Great while it lasted] I have had a myocardial perfusion and now they want me to have an angiogram. I am an anxiety sufferer and prone to OCD too. Why should I risk a stroke having anangiogram  just to see if I have a problem. Why not an MRI?

    They also want me to take Amiodorone if I have another cardioversion, I refused to take this toxic drug and was prescibed Sotalol instead. I also take Ramipril, Digoxin and of course Warfarin (usually only 2mg ref. my INR yellow book.)

    My main problem other than exhaustion is pain in mostly my right shoulder and down the arm. The cardiologists don't relate this to any of the drugs I take or to my AF but some USA sites think it is the Warfarin.

    Any advice or similar experiences would be greatly appreciated.

    MickE

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    • Posted

      Hi MickE,

      I understand your situation as I use to suffere svere Panic/anxiety attacks, I suppose to a degree I still do. Just let the Cath Lab nurses know and the doctor will write up some medication to relax you. Are they planning on taking you off Warfarin  before the procedure ? I don't know much about Warfarin only that it can be dangerous. I'm pretty sure they have weighed up everything for you to have this procedure done and they have to let all patients know of the risks and unfortunately stoke/heart attack is just 2 of the risks but when I had mine done they informed me that the incident rates are very low, I suppose that could change with age groups and conditions but from the elderly that I have seen come out of the cath lab in good spirits, Although I must admit I don't know their medical history but I hope this can allay some of your fears.

      I to have often wondered why MRI is never used to look at heart /arteries, I won't have an MRI as I'm also clausterphobic, I have never heard of any Cardiologists order MRI's for heart here where I live, but just because I've never heard of it doesn't mean that they don't...perhaps ask you Cardiologist or GP about it ?

      Goodluck.

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    • Posted

      Hi samuels and thanks for your reply. I am working through my anxiety and got a better nights sleep last night. Yes I wiil be off Warfarin for a few days.  I have worked through the copy letter to my GP with my son and looked up the technical words and looked at diagrams. It seems that an Angiogram is the best bet to look at blood flow. Its seems the myocardial perfusion showed up a likely likely restricted flow of the 'left anterior artery descending' which supplies the left ventricle. If they can confirm by injecting the dye as they go  they can then decide what to do. So logically, it is the best course I now think. My brain is still struggling with it but I am sure all will be fine. thanks..
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  • Posted

    I hope your experience with the angiogram is a positive one. And that you get a good result 

    .

    i have been given an 'urgent' appointment at the cardiology dept but am attending with absolutely no information of what it is about so am bringing a friend for moral support.

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  • Posted

    Hi niamh and MickE,

    You both  will be fine with this procedure I'm sure of it,Relativiley quick and painless procedure, The Cath Lab nurses and doctors are there to talk you if you so desire. Depending which way they enter the worst part about it, is laying on your back with a sandbag on your groin area for around 5-6 hours (that's if they enter the artery from that point) If the go via the wrist they use a pressurised wrist band filled with air, at least you can roll around to get comfy in bed that way smile , Nurse comes and checks on it every 15 minutes to start with and then every hour from memory there after and if all is looking good they will start reducing the pressure and let small amounts of air out of the wrist band .

    Goodluck to you both.

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