ANGIOGRAM

• Cardiac Angiogram


  Imaging technique to visualize the coronary arteries
• Cardiac Intervention


  Procedure to treat blockages in the coronary arteries
• Indications for Coronary Angiography

  • Coagulopathy
  • Decompensated congestive heart failure
  • Uncontrolled hypertension
  • CVA
  • Refractory arrhythmia
  • GI hemorrhage
  • Pregnancy
  • Active infection
  • Renal failure
  • Uncooperative patient
  • CM allergy
• Complications of Coronary Angiography


  • Catheter
  • Diagnostic catheter
  • Guiding catheter
• Catheter size


  4F-14F for diagnostic, 6F-16F for interventional
• Catheter type


  Radial artery route: optitorque

  Femoral route: Judkins Lt/Rt, tiger

  Ventriculogram: pigtail
• Angiographic views of Left Coronary Artery


  • AP

  LAO cranial

  LAO caudal

  RAO caudal

  RAO cranial

  Lateral
• Angiographic views of Right Coronary Artery


  • LAO

  RAO

  RAO cranial

  LAO cranial

  Lateral
• Grading stenosis


  Comparing the area of narrowing to an adjacent normal segment, and calculating the percentage reduction
• Ejection Fraction


  Measure of how much blood the heart pumps out with each contraction
• Causes of decreased Ejection Fraction


  • Weakness of heart muscle

  Heart attack damage

  Problems with heart valves

  Long-standing/uncontrolled high blood pressure
• Causes of poor angiograms


  • Patient factors: size, movement

  Hardware/devices: pacemaker, multiple surgery clips