Coronary angiography: the "key" to open the heart's blood supply channel, you can understand it in one minute!

The coronary artery is an important blood vessel that supplies blood to the heart's myocardial cells. When the coronary artery is narrowed or blocked, it may cause heart diseases such as coronary heart disease, affect the normal function of the heart, and even endanger life. Coronary angiography is a method of examination that can clearly show the internal conditions of the coronary artery, and is considered the "gold standard" for the diagnosis of cardiovascular diseases.

1. What is coronary angiography?

Coronary angiography is a minimally invasive interventional examination. The doctor will insert a thin and soft catheter, usually through the radial artery at the wrist or the femoral artery at the base of the thigh, along the blood vessels to the opening of the coronary artery, and then inject contrast agent. The contrast agent will flow with the blood, making the coronary artery clearly visible under X-rays. The doctor can accurately judge the health of the heart's blood supply vessels by observing the shape and course of the coronary arteries and whether there are stenosis, blockage and other lesions.

2. Why do we need coronary angiography?

If the patient has typical symptoms of angina pectoris, such as squeezing, dull pain or tightness in the chest after physical activity or when emotionally excited, and the pain may radiate to the precordial area, shoulders, back and other parts, and the symptoms are not significantly relieved after resting or taking nitroglycerin; or other examinations such as electrocardiogram, treadmill test, cardiac ultrasound, etc. show signs of myocardial ischemia, but the extent and range of coronary artery lesions cannot be determined, then coronary angiography can play a key role in providing an accurate basis for the formulation of subsequent treatment plans and determining whether the patient needs coronary artery intervention (such as stent placement) or coronary artery bypass surgery.

3. The process of coronary angiography:

Before the operation, the doctor will conduct a comprehensive assessment of the patient, including asking about the medical history and completing relevant examinations (such as blood routine, coagulation function, liver and kidney function, etc.) to ensure the safety of the operation. During the operation, the patient will lie on the operating table and remain awake, but the local puncture site will be anesthetized, so there will be little pain.

After the doctor successfully punctures the artery, he will carefully insert the catheter along the blood vessel pathway and send the catheter to the coronary artery opening under the guidance of X-ray fluoroscopy. He will quickly take X-rays while injecting contrast agent. The whole process usually takes about 15 to 30 minutes, and the specific time varies from person to person.

After the operation, the doctor will apply pressure to the puncture site to stop bleeding and ask the patient to rest in bed for a period of time to promote the healing of the puncture site. At the same time, the doctor will closely observe the patient's vital signs and any discomfort.

4. Risks and precautions of coronary angiography

Although coronary angiography is a relatively safe examination, it also involves certain risks, such as bleeding at the puncture site, hematoma, vascular damage, contrast agent allergy, arrhythmia, etc. However, the incidence of these complications is low, and the doctor will make adequate preparations and countermeasures before the operation to minimize the risks as much as possible.

Patients need to fast and abstain from water for a certain period of time before the operation as required by the doctor. They should drink plenty of water after the operation to promote the excretion of contrast agent and reduce the impact of contrast agent on the kidneys. The puncture site should be kept clean and dry, and strenuous activities and hard pressure should be avoided to prevent the occurrence of complications such as bleeding.

Coronary angiography provides strong support for cardiologists to accurately diagnose coronary artery disease, helping many patients to identify the cause of the disease and receive effective treatment in a timely manner, thereby improving heart function and quality of life. If you have other questions about coronary angiography, you can consult a professional cardiologist.

The Department of Cardiovascular Medicine of the Second People's Hospital of Hunan Province (Provincial Brain Hospital) started coronary intervention, pacemaker implantation, intracardiac electrophysiological examination and radiofrequency ablation as early as 2005. It is one of the earliest hospitals in Hunan Province to carry out interventional diagnosis and treatment. Through continuous efforts, it has gradually carried out complex, chronic occlusive lesions and other difficult coronary intervention treatment technologies, as well as IABP, ICD implantation, and patent foramen ovale closure treatment.

With the establishment of the hospital's chest pain center in 2022, the number of coronary angiography and interventional diagnosis and treatment techniques performed by the Department of Cardiovascular Medicine has increased significantly. In 2024, Hunan Provincial People's Hospital No. 2 (Provincial Brain Hospital) performed more than 1,600 coronary angiography and intervention-related treatments. The overall strength of the department has been significantly enhanced, and its specialty characteristics have been highlighted.

If you need diagnosis and treatment of cardiovascular diseases or need further information about coronary angiography, you can go to the Department of Cardiovascular Medicine of Hunan Provincial Second People's Hospital (Provincial Brain Hospital) for registration and consultation.

Hunan Medical Chat Special Author: Liu Ling, Department of Cardiology, Hunan Second People's Hospital (Provincial Brain Hospital)

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(Edited by Wx)