Doctor, Do I Need Angiography Now?
![- MEDiscuss Honest Conversations 15](https://www.mediscuss.org/wp-content/uploads/2024/06/Honest-Conversations-15.png)
Patient: “Doctor, I have been told I need a coronary angiography. Do I really need this procedure?”
Doctor: “I understand your worry. Coronary angiography is a diagnostic procedure that helps us see how well the blood vessels of your heart are functioning.”
Patient: “But is it absolutely necessary?”
Doctor: “Not always. We recommend it when we suspect significant coronary artery disease, especially if other tests like an ECG, stress test, or echocardiogram suggest a problem.”
Patient: “What exactly happens during the procedure?”
Doctor: “A small catheter (thin tube) is inserted into a blood vessel in your arm or leg and gradually guided to your heart. A special dye, commonly called ‘contrast’ is injected to make your coronary arteries visible on X-ray images.”
Patient: “What are coronary arteries?”
Doctor: “Coronary arteries are the blood vessels that provide oxygen-rich blood to your heart muscles. They are essential for keeping your heart healthy and functioning properly.”
Patient: “Is angiography safe?”
Doctor: “Generally, it’s a very safe procedure, but like any medical procedure, it has some risks, such as bleeding, infection, or an allergic reaction to the contrast dye. These are rare, and cardiologists take precautions to minimize them.”
Patient: “What if I don’t want the angiography?”
Doctor: “Without it, we might miss important information about the condition of your heart. This could compromise our ability to give the best treatment for you.”
Patient: “Are there alternatives to this test?”
Doctor: “Yes, there are non-invasive tests like CT angiography or stress tests, but they might not provide as detailed information as a coronary angiography.”
Patient: “What is the difference between angiography and angioplasty?”
Doctor: “Angiography is a diagnostic test to view your coronary arteries. Angioplasty, on the other hand, is a treatment procedure. If we find a blockage in your coronary arteries during angiography, we might perform an angioplasty to open up the blocked artery using a tiny balloon and place a stent to keep it open.”
Patient: “What is a stent?”
Doctor: “A stent is a small metal tube with mesh-like wall. It is inserted into the blocked artery to keep it open and ensure proper blood flow to the heart muscles. It helps prevent the artery from becoming narrow again.”
Patient: “Thank you. I have clarity about the procedure now. But I thought angiography is needed only when there is chest pain. Isn’t that correct?”
Doctor: “Chest pain is the commonest reason for angiography, but it is not the only one. We may also recommend it if you have symptoms like shortness of breath or if other tests indicate possible heart problems.”
Patient: “One of my friends was advised angiography as a part of a general check-up. What about that?”
Doctor: “Routine use of angiography as a general check-up is not necessary. However, in some high-risk individuals or those with significant risk factors, a cardiologist might recommend it to rule out serious conditions.”
Patient: “I heard that the dye used in angiography can cause kidney failure in some people. Is that correct?”
Doctor: “Yes, the dye can sometimes affect kidney function, especially in people who already have kidney problems. We assess kidney function before the procedure and use many methods to minimize this risk, such as ensuring good hydration and using the smallest necessary amount of contrast dye.”
Patient: “Okay. That means there should be at least some symptom for angiography to be considered, right?”
Doctor: “Generally, yes. Angiography is usually recommended when there are symptoms like chest pain, shortness of breath, or when other tests suggest a potential problem with your coronary arteries. It is not generally done without some indication of a problem.”
Patient: “How do I decide if I should go through with it?”
Doctor: “Discuss your concerns with your cardiologist. Consider the benefits and risks. Remember, our goal is to ensure you receive the best care based on current evidence and your specific situation.”
Patient: “Thank you, Doctor. Your explanation has helped me understand this better.”
Doctor: “You are welcome.”
This article is part of the Honest Conversations series: Explore the articles from this series:
- Doctor, Do I Need Angiography Now?
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- Honest Conversations in Healthcare – A Series
![Shashikiran Umakanth](https://www.mediscuss.org/wp-content/uploads/2024/01/shashikiran-sm.png)
Dr Shashikiran Umakanth (MBBS, MD, FRCP Edin.) is Professor & Head of Internal Medicine at Dr TMA Pai Hospital, Udupi, Manipal Academy of Higher Education, India. He shares his insights on Medicine, Health and Life here.