Diseases of the cardiovascular nature today, unfortunately, are typical not only for the elderly, but also for middle-aged, and even young people. Everyone knows about their danger. We also know that any disease is easier to prevent than to cure. As for the pathologies of this spectrum, they are quite effectively detected at the earliest stage by the modern diagnostic method - CT coronary angiography. What are its features, what are the indications and contraindications for holding, how the event goes - these are all the topics of our today's article.
What is coronary angiography?
CT coronary angiography will be one of the offshoots of a fairly common research in modern medicine. CT stands for computed tomography.
Coronary angiography in general terms is an X-ray examination of large blood vessels leading to the heart. They are filled with a special contrast agent, after which the necessary pictures are taken on medical equipment.
Injection of contrast is often scary for patients. However, it is this substance that helps the specialist in the picture to examine the lumen of the vessels,the condition of their walls. Without it, it is impossible to achieve clear frames that will make it possible to make the correct diagnosis. In most cases, the contrast agent is a solution of urografin.
Coronary angiography is a fairly easy procedure to implement. First, the mentioned contrast is introduced to the patient, then the X-ray machine takes pictures of the vessels on a special film. However, some modern devices already do without it.
After the contrast agent fills the vessels, effective shots are taken, which will be the basis for the diagnosis. They clearly show not only the narrowing of the gaps, but also the formed blood clots.
Types of coronary angiography
So far, we have only talked about computed tomography - CT coronary angiography (its types depend on the accuracy of the device - 32 or 64-slice). The types of the main procedure are as follows:
- General.
- Selective.
- Carried out using a CT scanner - CT coronary angiography.
Let's talk briefly about each.
Coronary angiography general
The simplest examination of all presented. A specialist injects a contrast drug directly into the coronary vessels. After that, the necessary pictures are taken on the x-ray machine. But even such a traditional method helps to identify a large number of cardiac and vascular pathologies.
Selective coronary angiography
What is special about this method? In fact, this is a modernized version of the above. During the examination, the doctor does not examine all the vessels, butconcentrates on several or even on one. Such a selective (selective) approach is reflected in the title.
The procedure requires the installation of a special catheter for the patient - it is through it that the contrast agent is delivered. A special wish for the event is a good film for the X-ray machine. Its poor quality may affect the resulting image. If it is fuzzy, vague, then the doctor will not be able to make an accurate diagnosis based on it.
A significant advantage of the selective method - it does not require the introduction of large volumes of contrast agent. Another feature is the rapid completion of the procedure. Moreover, in a short time, a specialist can receive images of vessels of various locations.
However, selective coronary angiography has a significant disadvantage - the procedure cannot be performed on the same probes. They need to be replaced, and this event can lead to atrial fibrillation. The disadvantage of the method is the fact that the selective type of coronary angiography is carried out only with the help of complex equipment - such that it is capable of making a large number of frames per minute. It is important to pay attention to the quality of probes for examination.
Coronary angiography MSCT
The full name of CT coronary angiography is multislice computed tomography aimed at examining the coronary vessels. However, this procedure also helps to examine other important elements of the cardiovascular system, such as the valves of the main muscle of the body.
The downside of CT-Coronary angiography of the vessels of the heart can be called the fact that not every medical clinic performs the procedure. It is connected with the fact that a high-speed multislice computed tomography scanner is needed for the examination. Another condition is that the apparatus must be at least 32-slice in order for coronary angiography to be performed. Such a specific technique has a corresponding cost.
How is CT coronary angiography of the heart vessels performed? The beginning of the event is standard - the specialist fills the examined vessels of the patient with a contrast agent. In the vast majority of cases, they are various iodine solutions. Then the patient lies down on the couch under the tomograph, and the doctor takes the necessary pictures with the help of the apparatus.
As you can see, the examination is extremely simple and fast, requiring no specific preparation or hospitalization. If the pictures show relatively good results, then after the procedure the patient can go home and return to normal life. Because of this, many prefer CT scans to the methods listed above.
Main benefits of the procedure
Now we know what it is - CT coronary angiography. Let's highlight its important advantages that patients note in their reviews:
- Almost complete absence of invasiveness - procedures associated with any medical penetration through the protective barriers of the body - mucous membranes, skin.
- The ability to conduct a comprehensive detailed examination of the coronary vessels without hospitalization.
- Relatively fast in timeprocedure.
- The ability to detect hidden pathologies. Such as vascular stenosis.
- The ability to determine the type of atherosclerotic plaques at an early stage of pathology development - soft or calcified formations.
- Assessment of the correctness of the imposition of shunts, walls, control over them after some time after the operation.
It is noted that CT coronary angiography of the heart is periodically prescribed to specialists whose work is associated with constant nervous strain, stress on the heart, without consequences for their he alth. In addition, this event is not prohibited even with an acute form of myocardial infarction.
Indications for the procedure
What is CT coronary angiography? Diagnosis, which is indicated for many diseases of the cardiovascular sphere. We will present a list of those pathologies, the study of which is recommended mainly in this way:
- An attack of angina that manifested itself in the treatment of myocardial infarction.
- Comprehensive diagnostics before surgery on coronary vessels, heart.
- Suspicion of infectious endocarditis.
- Kawasaki disease.
- Examination before any type of surgery performed on a patient who has had a heart attack.
- Congestive heart failure.
- Failure of therapy for malignant arrhythmia.
- The absence of the effect of highly effective drugs prescribed forangina.
- Comprehensive examination of the heart, coronary vessels before transplantation of any tissues or organs to the patient.
- History of cardiac arrest for reasons unknown to doctors.
- Blunt chest trauma in recent medical history.
- Hypertrophic cardiomyopathy.
- Pathological processes affecting the aorta, coronary vessels.
- Deviations in the work of the heart in coronary disease, etc.
Preventive examination
We discussed above the cases in which computed tomography of the coronary vessels of the heart is mandatory. For example, to make an accurate diagnosis, assess the patient's condition, exclude the fact of pathogenic changes, plan a specific treatment.
However, there are a number of cases when this procedure is not required, but is advised in the form of effective prevention of serious diseases. After all, the fact is that this examination is able to determine the pathology at an early stage, when it can be completely cured without harm to the body.
CT coronary angiography in this case is indicated for patients who belong to the so-called risk groups:
- According to age. Men over 40, women over 45.
- According to the way of life. Obesity, weight problems, improper diet, Constant emotional stress, nervous strain, hard (physically, emotionally, mentally) work, smoking, addiction to alcohol.
- For diseases in the medical history. Post-stroke, stablehigh blood pressure, diabetes, high levels of "bad" cholesterol, vascular disease, hereditary predisposition to heart disease.
Absolute contraindications to the procedure
Although CT coronary angiography of the heart (in Izhevsk and other cities is performed in a number of diagnostic centers) is the safest procedure among its kind, it also has a number of contraindications.
Here is a list of those in which the examination is strictly prohibited:
- Pregnancy at any stage - both waves and contrast are harmful for the baby.
- Calcinosis affecting the coronary vessels.
- Individual intolerance to iodine, the main component of the contrast medium.
- Liver, kidney failure.
- Severe stage of diabetes.
- Arrhythmia.
- Tachycardia.
- Series of thyroid diseases.
Relative contraindications to the procedure
Now let's talk about the relative contraindications to CT coronary angiography (we discussed the indications above). The following are situations in which the procedure is undesirable, but possible after the normalization of the patient's condition, with the permission of his attending doctor:
- Ventricular arrhythmia of uncontrolled type. The specialist allows CT only if the disease is transferred to the category of controllable.
- History of intoxication through cardiac glycosides.
- Hypokalemia of uncontrolled form.
- Highbody temperature.
- Uncontrolled hypertension.
- Infectious endocarditis.
- Pathological processes associated with poor blood clotting.
- Some diseases of the internal organs.
- Decompensated heart failure.
Preparation for examination
Quality equipment and a contrast agent are the main conditions for successful CT coronography of blood vessels. However, special preparation of the patient for the procedure is no less important.
Judging by the reviews of CT coronary angiography, these are completely simple activities:
- A blood test taken no earlier than two weeks before the date of the CT examination. The doctor is important indicators for creatinine and urea to determine the possibility of using a contrast agent.
- The CT procedure itself takes place on an empty stomach.
- Before the examination, the patient must remove all metal objects - jewelry, clothing items, piercings, etc.
- If he is taking any medication, be sure to tell the specialist before the procedure.
- If the heart rate exceeds 60 ular/min, then medication will be required to slow it down. Otherwise, this fact will be a serious obstacle to qualitative research.
- Although CT coronary angiography is a fairly complete procedure in most cases, other examination results may be required. For example, ultrasound, magnetic resonance imagingbody.
How is the procedure performed?
Thus, non-invasive computed tomography of the coronary arteries can be performed in any medical clinic with a 32-slice (for more accurate results, of course, better with a 64-slice) equipment.
An approximate sequence is as follows:
- One hour before the event, the patient takes a drug that will slightly slow his heart rate. This is necessary to get more accurate shots.
- The patient is fitted with an intravenous catheter through which a contrast agent is injected.
- A person on a couch is placed under the examination area of a CT scanner.
- At a moment called diastole (a relaxed state of the heart muscles), the equipment takes the necessary pictures. The period required for this is monitored using an electrocardiogram.
- During the examination, the patient must strictly follow the recommendations of a specialist, because this method is extremely sensitive to the heart rate.
- At the end of the procedure, the patient is given a disk with the images recorded on it. The specialist gives advice on the pathologies identified during the diagnosis.
- With a conclusion on the procedure, a disk with recorded information, you should contact your doctor.
Thus, CT coronary angiography today is the most comprehensive, safe and fastest method among similar diagnostic methods. Another plus is the ability to identifycardiac, vascular pathologies at an early stage. The downside of the procedure will be the lack of distribution of the necessary equipment in clinics, the price is from 8,000 to 25,000 rubles.
