Coronary Angiography and Angioplasty

It has been estimated that around 17 people die from cardiovascular diseases every day in Singapore. Statistics also show that 1 in 3 deaths in the country is caused by heart disease or stroke. Thankfully, there are ways one can reduce his or her risk of cardiovascular disease, and this includes checking the heart’s condition through angiography.

Angiography is the process of taking X-ray images of arteries and blood vessels to check for abnormalities, especially those which affect blood flow. It may be done alongside an angioplasty, which refers to a procedure that restores and regulates the flow of blood.

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Coronary Angiogram

A coronary angiogram is a specialized X-ray imaging test that checks for narrowing or blockages in the coronary arteries which supply blood to the heart. It is primarily used to determine the location and extent of the damage in the arteries, as well as which treatment is most suitable to address such issues.

This procedure is done through a technique called cardiac catheterization, in which a thin, hollow tube (catheter) is inserted into an artery or vein in the groin or wrist, and further directed to the heart using an X-ray machine.

A special dye visible in an X-ray will be injected into the heart’s blood vessels to allow for a clearer view of the heart’s chambers, valves and coronary arteries, and how well blood flows through them. The patient is sedated during a coronary angiogram.

Why is Coronary Angiography done?

In mild cases, artery blockage may be treated with prescribed medications, as well as diet and lifestyle adjustments. However, a coronary angiogram may be recommended if the patient has:

  • signs of coronary artery disease such as chest pain and shortness of breath
  • unstable angina
  • a congenital heart disease or defect
  • abnormal electrocardiogram, echocardiogram or stress test results
  • heart valve or blood vessel problems

As a diagnostic tool, a coronary angiogram is done to:

  • determine the location and severity of the narrowing or blockage of the artery
  • treat a diseased or damaged artery
  • locate and treat a bleeding or tumor site
  • take blood samples
  • map out arteries and blood vessels before surgical procedures
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Coronary Angioplasty and Stenting

Coronary angioplasty with stenting is a procedure used to open or widen narrowed or blocked coronary arteries. It can be done in two ways, namely: temporarily inserting then inflating a balloon inside the artery to widen it, or permanently placing a wire mesh tube (stent) inside the artery to keep it open and prevent blockage or narrowing.

Similar to an angiogram, an angioplasty involves inserting a catheter holding the balloon or stent in place through an incision on the groin or wrist.

Why is Coronary Angioplasty done?

Coronary angioplasty is mainly performed to address a heart ailment called atherosclerosis, especially if medications, and diet and lifestyle modifications prove to be insufficient. Atherosclerosis refers to the buildup of fatty plaque that causes arteries to narrow and harden, resulting in chest pains (angina) or a heart attack.

However, angioplasty treatment is not a suitable treatment if the patient has diabetes, a weak cardiac muscle (myocardium), or multiple diseased or blocked blood vessels. In such cases, coronary artery bypass surgery is more suitable.

Coronary angioplasties may also be conducted as an emergency treatment following a heart attack.

What are its risks?

Despite being a less invasive treatment for narrowed or blocked arteries, coronary angioplasty still carries risks such as:

  • Restenosis – The re-narrowing of an artery after angioplasty
  • Blood clots – Stent placement may result in blood clots, which can lead to a heart attack or stroke
  • Bleeding – Though rare, excessive bleeding may develop at the catheter puncture site
What to expect after an angioplasty?

The Doppler echocardiogram is done to measure and evaluate the amount, speed and direction of blood flow to the heart’s chambers and vessels. Performed alongside transthoracic or transesophageal echocardiograms, this method is used to detect abnormal blood flow and pressure indicative of issues in the heart’s valves or walls.

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Headed by Dr Eric Hong, EH Heart Specialist offers a wide range of diagnostic and treatment options for the safe and effective management of cardiovascular conditions. For more information, contact us at 6736-1068 today.

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