An angiogram is a diagnostic procedure used to examine blood vessels, particularly the coronary arteries that supply the heart. It helps identify blockages, narrowing, or other abnormalities that may restrict blood flow and cause chest pain, heart attacks, or other cardiovascular issues. The procedure is typically performed in a catheterization lab (cath lab).
A local anesthetic is administered to numb the insertion site, usually in the groin or wrist. A thin, flexible tube called a catheter is inserted into an artery and carefully guided to the heart’s blood vessels. Once in place, a contrast dye is injected through the catheter. This dye makes the arteries visible on a series of X-ray images, allowing the doctor to observe blood flow and detect any blockages or irregularities.
The entire procedure generally takes between 30 minutes to an hour. Patients are usually awake but sedated for comfort. After the angiogram, the catheter is removed, and pressure is applied to prevent bleeding. Most patients can return home the same day, although some may require observation.
An angiogram is considered safe, though it carries minor risks such as bleeding, infection, or allergic reactions to the dye. It is a vital tool for diagnosing and guiding the treatment of heart disease.
Angioplasty & Stent Placement
Angioplasty with stent placement is a minimally invasive procedure used to open narrowed or blocked arteries, most commonly in the heart. It is typically performed to restore blood flow in patients with coronary artery disease, which can cause chest pain (angina), shortness of breath, or heart attacks.
The procedure begins with the insertion of a thin catheter into an artery, usually in the groin or wrist, and guiding it to the blocked coronary artery. A tiny balloon at the tip of the catheter is inflated at the site of the blockage, pushing the plaque against the artery walls and widening the artery. This process is known as angioplasty.
To keep the artery open and reduce the risk of future blockages, a stent—a small, mesh-like metal tube—is placed in the artery. The stent remains in the artery permanently, acting as a scaffold to maintain proper blood flow. Some stents are coated with medication (drug-eluting stents) to help prevent re-narrowing.
The procedure usually takes 30 to 90 minutes and is done under local anesthesia with sedation. Recovery is quick, and most patients are discharged within a day. Angioplasty with stent placement is a safe and effective treatment for managing coronary artery disease and preventing heart attacks.
CABG
Coronary Artery Bypass Grafting (CABG) is a surgical procedure used to improve blood flow to the heart in people with severe coronary artery disease. It is recommended when one or more coronary arteries become narrowed or blocked, reducing oxygen-rich blood supply to the heart muscle and increasing the risk of chest pain (angina) or heart attack.
During the procedure, a healthy blood vessel is taken from another part of the body—usually the leg (saphenous vein), chest (internal mammary artery), or arm (radial artery)—and grafted to bypass the blocked artery. This new route allows blood to flow freely to the heart muscle. Depending on the number of blocked arteries, a patient may undergo single, double, triple, or quadruple bypass surgery.
CABG is performed under general anesthesia and usually takes 3 to 6 hours. The heart may be stopped temporarily while a heart-lung machine maintains blood flow during the surgery, or it may be done on a beating heart (off-pump CABG). Most patients spend a few days in the ICU and a week in the hospital, followed by several weeks of recovery.
CABG significantly reduces symptoms, improves quality of life, and lowers the risk of future heart attacks in patients with complex coronary artery disease.
Heart Failure Diagnosis & Treatment
Heart failure is a chronic condition in which the heart is unable to pump blood effectively to meet the body’s needs. Diagnosis typically begins with a physical examination and review of symptoms such as shortness of breath, fatigue, swelling in the legs, and rapid heartbeat. Doctors use diagnostic tests to confirm heart failure, including an electrocardiogram (ECG), echocardiogram (ultrasound of the heart), chest X-ray, blood tests (like BNP), and sometimes stress tests or cardiac MRI.
Treatment focuses on improving heart function, managing symptoms, and preventing disease progression. Lifestyle changes are essential and include reducing salt intake, maintaining a healthy weight, regular physical activity, limiting alcohol, and quitting smoking. Medications play a key role, such as ACE inhibitors, beta-blockers, diuretics, ARNI, and aldosterone antagonists, which help lower blood pressure, remove excess fluid, and reduce strain on the heart.
In more severe cases, advanced therapies may be needed, including implantable devices like pacemakers or defibrillators, or surgical options such as valve repair or even heart transplantation. Regular monitoring and follow-up are crucial to adjust treatment plans as needed.
With proper management, many people with heart failure can live longer, more active lives and reduce their risk of hospitalization or complications.
ECG & TMT
ECG (Electrocardiogram) and TMT (Treadmill Test) are common non-invasive diagnostic tests used to assess heart function and detect cardiovascular conditions.
An ECG records the electrical activity of the heart using small electrodes placed on the chest, arms, and legs. It provides a visual representation of the heart’s rhythm, rate, and electrical conduction. An ECG helps detect abnormalities like arrhythmias, heart attacks, enlarged heart chambers, and electrolyte imbalances. The test is quick, painless, and typically completed within 5 to 10 minutes in a clinic or hospital.
A TMT, or stress test, evaluates the heart’s response to physical exertion. The patient walks or runs on a treadmill while connected to an ECG machine. The speed and incline of the treadmill gradually increase to raise the heart rate. Throughout the test, doctors monitor the ECG, blood pressure, and symptoms like chest pain or breathlessness. TMT helps identify ischemia (reduced blood flow to the heart), exercise-induced arrhythmias, and overall cardiac fitness.
Both tests are often used together to diagnose coronary artery disease, assess exercise tolerance, or determine the effectiveness of cardiac treatment. They are safe when supervised and provide valuable insights for early detection and management of heart conditions.
2D and 3D Echocardiography
2D and 3D Echocardiography are non-invasive imaging techniques that use ultrasound waves to visualize the heart’s structure and function. They are essential tools for diagnosing and monitoring various heart conditions.
2D Echocardiography (two-dimensional) is the most commonly used type. It provides real-time, flat, cross-sectional images of the heart. This allows doctors to see the size and shape of the heart chambers, the movement of heart walls, and the function of the heart valves. It is widely used to detect conditions like valve disorders, cardiomyopathy, pericardial effusion, and congenital heart defects.
3D Echocardiography offers more advanced imaging by capturing detailed, three-dimensional views of the heart. It provides a more accurate assessment of heart structures and function, particularly useful in complex valve repairs, congenital heart disease, and surgical planning. 3D echo allows for better visualization of valve anatomy and improves the evaluation of left ventricular volume and ejection fraction.
Both procedures are safe, painless, and usually performed using a transducer placed on the chest (transthoracic echo). In some cases, a probe may be passed into the esophagus (transesophageal echo) for clearer images.
Together, 2D and 3D echocardiography offer comprehensive insights into cardiac health, aiding in accurate diagnosis and effective treatment planning.
