冠状动脉造影

定义

冠状动脉造影 is a procedure that uses a special dye (contrast material) and x-rays to see how blood flows through the arteries in your heart.

选择的名字

Cardiac angiography; Angiography - heart; Angiogram - coronary; Coronary artery disease - angiography; CAD - angiography; Angina - angiography; Heart disease - angiography

测试是如何执行的

冠状动脉造影术经常伴随着 心导管检查. This is a procedure which measures pressures in the heart chambers.

Before the test starts, you will be given a mild sedative to help you relax.

An area of your body (the arm or groin) is cleaned and numbed with a local numbing medicine (anesthetic). 心脏病专家递过一根空心细管, 称为导管, through an artery and carefully moves it up into the heart. X-ray images help the doctor position the catheter.

Once the catheter is in place, dye (contrast material) is injected into the catheter. X-ray images are taken to see how the dye moves through the artery. The dye helps highlight any blockages in blood flow.

这个过程通常持续30到60分钟.

如何准备考试

You should not eat or drink anything for 8 hours before the test starts. You may need to stay in the hospital the night before the test. Otherwise, you will check in to the hospital the morning of the test.

你要穿病号服. 测试前你必须在同意书上签字. Your health care provider will explain the procedure and its risks.

告诉你的供应商如果你:

• Are allergic to any medicines or if you have had a bad reaction to contrast material in the past
• 正在服用伟哥
• 可能是怀孕

考试感觉如何

在大多数情况下，你会在考试中保持清醒. You may feel some pressure at the site where the catheter is placed.

You may feel a flushing or warm sensation after the dye is injected.

测试结束后，拔出导管. You might feel a firm pressure being applied at the insertion site to prevent bleeding. 如果导管被放置在腹股沟, you will be asked to lie flat on your back for a few hours to several hours after the test to avoid bleeding. 这可能会导致轻微的背部不适.

为什么进行测试

冠状动脉造影可在以下情况下进行:

• 这是你第一次患心绞痛.
• 你的心绞痛越来越严重了, 不会消失, 经常发生, 或发生在静止(称为 不稳定性心绞痛).
• 你有 主动脉瓣狭窄 或者另一个瓣膜问题.
• 你有 atypical chest pain, when other tests are normal.
• 你的心脏压力测试不正常.
• You are going to have surgery on your heart and you are at high risk for coronary artery disease.
• 你有 心脏衰竭.
• 你被诊断为心脏病发作.

正常的结果

There is a normal supply of blood to the heart and no blockages.

异常结果的含义

An abnormal result may mean you have a blocked artery. The test can show how many coronary arteries are blocked, 在他们被封锁的地方, 以及堵塞的严重程度.

风险

Cardiac catheterization carries a slightly increased risk when compared with other heart tests. However, the test is very safe when performed by an experienced team.

Generally, the risk for serious complications ranges from 1 in 1,000 to 1 in 500. 该程序的风险包括:

• 心脏压塞
• 不规则的心跳
• 心脏动脉受伤
• 低血压
• Allergic reaction to contrast dye or a medicine administered during the exam
• 中风
• 心脏病

注意事项 associated with any type of catheterization include the following:

• In general, there is a risk of bleeding, infection, and pain at the IV or catheter site.
• There is always a very small risk that the soft plastic catheters could damage the blood vessels or surrounding structures.
• Blood clots could form on the catheters and later block blood vessels elsewhere in the body.
• The contrast dye could damage the kidneys (particularly in people with diabetes or prior kidney problems).

注意事项

如果发现堵塞, your provider may perform a percutaneous coronary intervention (PCI) to open the blockage. This can be done during the same procedure, but may be delayed for various reasons.

参考文献

等. 2014 ACC/AHA/AATS/PCNA/SCAI/STS focused update of the guideline for the diagnosis and management of patients with stable ischemic heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines, 以及美国胸外科协会, 心血管预防护士协会, Society for Cardiovascular Angiography and Interventions, 和胸外科医师协会. J Am Coll Cardiol. 2014;64(18):1929-1949. PMID: 25077860 www.ncbi.nlm.国家卫生研究院.gov / pubmed / 25077860.

Kern米. 导管插入术和血管造影术. 见:Goldman L, Schafer AI，编辑. Goldman-Cecil医学. 25日,艾德. Philadelphia, PA: Elsevier Saunders; 2016:chap 57.

麦兰·R，丹格斯·GD. 冠状动脉造影和血管内成像. In: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 11日艾德. Philadelphia, PA: Elsevier; 2019:chap 20.

Werns年代. Acute coronary syndromes and acute myocardial infarction. 见:Parrillo JE, Dellinger RP, eds. Critical Care Medicine: Principles of Diagnosis and Management in the Adult. 5日艾德. Philadelphia, PA: Elsevier; 2019:chap 29.