How This Simple Test Could Save Your Heart—and Your Life!

By: Geraldus Sigap

Heart disease is one of the leading causes of death worldwide, but early detection and intervention can make all the difference. One of the most powerful tools doctors have to assess the health of your heart is a coronary angiogram, a procedure that can detect blockages or narrowing in the arteries that supply blood to the heart. If left undiagnosed, these blockages could lead to a heart attack or other serious heart conditions. By undergoing a coronary angiogram, you can take control of your heart health and potentially save your life.

A coronary angiogram is a diagnostic procedure that allows doctors to get a detailed look at the blood vessels in and around your heart. These blood vessels, called coronary arteries, are crucial because they supply oxygen-rich blood to the heart muscle. Over time, these arteries can become narrowed or blocked due to a buildup of fatty deposits, known as plaque. This condition is called coronary artery disease, and it can significantly reduce blood flow to the heart, increasing the risk of a heart attack.

Figure 1. Coronary angiogram procedure

During the procedure, a special dye is injected into the coronary arteries through a thin, flexible tube called a catheter. The catheter is typically inserted through an artery in your wrist or groin and guided to the heart. Once the dye is injected, X-ray images are taken, allowing doctors to see any areas of narrowing or blockage in the arteries. The images created during the angiogram give a clear picture of how blood is flowing to the heart and whether there are any areas that need treatment.

A coronary angiogram is typically recommended for individuals who are experiencing symptoms of heart disease or are at high risk of developing it. Some common symptoms that might prompt your doctor to suggest a coronary angiogram include:

Chest Pain (Angina): This is one of the most common signs of coronary artery disease. If you experience chest discomfort, pressure, or pain, especially during physical activity or stress, it could indicate that your heart is not getting enough oxygenated blood.
Shortness of Breath: If your heart is not pumping effectively due to narrowed arteries, you may feel breathless, especially during exertion or even while resting.
Dizziness or Fainting: Reduced blood flow to the heart can affect the rest of your body, leading to lightheadedness or fainting spells.
Abnormal Stress Test Results: If you have already undergone a stress test, and the results show that your heart is not responding well to physical activity, your doctor may suggest a coronary angiogram for further evaluation.

Additionally, individuals with a family history of heart disease, those with high blood pressure, diabetes, high cholesterol, or a history of smoking are at a higher risk of developing coronary artery disease. In such cases, even if symptoms are mild or absent, a coronary angiogram can provide critical insights into the state of your heart health. The procedure itself is relatively simple and is usually done in a hospital’s catheterization laboratory, often referred to as a cath lab. Before the procedure begins, the patient is typically given a mild sedative to help them relax, but they remain awake during the procedure. The doctor first numbs the area where the catheter will be inserted, which is usually in the wrist or groin. A small incision is made, and the catheter is gently guided through the blood vessels toward the heart. This part of the procedure is usually painless, and patients may only feel a slight pressure as the catheter is moved into place. Once the catheter reaches the coronary arteries, the doctor injects the contrast dye through the catheter. As the dye flows through the arteries, X-ray images are taken, showing the blood flow and highlighting any blockages or narrowed areas. The entire procedure typically takes less than an hour.

Figure 2. Normal CAG (A) and pathological CAG (B)

After the angiogram, the catheter is removed, and the incision site is bandaged. Most patients can go home the same day, although they will need to rest and avoid strenuous activity for a short period of time to allow the incision to heal. The results of your coronary angiogram will help your doctor determine the best course of action for managing your heart health. If the angiogram reveals that your coronary arteries are clear and blood flow is normal, your doctor may recommend lifestyle changes to maintain your heart health, such as eating a heart-healthy diet, exercising regularly, and avoiding smoking.

If blockages or narrowed arteries are detected, your doctor may suggest additional treatments to restore normal blood flow to your heart. These treatments may include:

Medications: If the blockage is not severe, medications to manage cholesterol, blood pressure, and blood thinning can help prevent further narrowing of the arteries.
Angioplasty and Stent Placement: For more significant blockages, your doctor may recommend an angioplasty, a procedure in which a tiny balloon is inserted into the blocked artery and inflated to widen it. A stent, or small mesh tube, may also be placed in the artery to keep it open and ensure blood flow remains unobstructed.
Coronary Artery Bypass Surgery: In cases where multiple arteries are blocked, coronary artery bypass surgery may be necessary. This involves creating a new route for blood to flow around the blocked artery using a healthy blood vessel taken from another part of the body.

The primary benefit of a coronary angiogram is its ability to provide detailed, accurate information about the health of your coronary arteries. This information is essential for diagnosing coronary artery disease and deciding on the most appropriate treatment. By detecting blockages early, a coronary angiogram can help prevent heart attacks and other serious heart complications, making it a life-saving tool for many patients. In many cases, patients undergo a CT Coronary Angiography (CT-Cor) before a Coronary Angiogram (CAG). CT-Cor is a non-invasive test that uses X-rays and contrast dye to create detailed images of the coronary arteries. It is often the first step because it is quick, comfortable, and effective at ruling out significant blockages. This test is ideal for early detection, especially in low to moderate-risk patients, as it can detect soft plaques that may lead to coronary artery disease. However, if CT-Cor shows narrowing or blockages, CAG may follow. CAG is a minimally invasive procedure that uses a catheter to provide a more detailed look at the coronary arteries. Unlike CT-Cor, it not only diagnoses blockages but also allows immediate treatment, such as angioplasty or stent placement, if needed. This makes CAG the gold standard for diagnosing and treating coronary artery disease, as it offers a clear view of severe blockages and the ability to intervene on the spot. When comparing the two, CT-Cor is non-invasive, diagnostic only, and ideal for ruling out disease in patients with mild symptoms. In contrast, CAG is minimally invasive, highly accurate, and both diagnostic and therapeutic, making it more suitable for patients with significant symptoms or confirmed blockages.

At RS Abdi Waluyo, our cardiologists is committed to providing world-class care to ensure your heart remains healthy. With extensive experience in diagnosing and treating heart conditions, our specialists are well-versed in performing coronary angiograms with precision and care. Our state-of-the-art facilities are equipped with the latest technology, ensuring that you receive the most accurate diagnosis and the best possible treatment.

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