Angiogram - to have or not?
Discussion
Not sure if I'm looking for advice, or if I just think writing this down will put it in perspective for me.....anyway.
4 weeks ago I ended up in A&E with chest/back etc pains. Paramedic on the way in was fairly sure it was nothing serious (ECGs were all normal) but in A&E I returned a positive Troponin reading so they decided Heart Attack and admitted me.
Got transferred to a specialist Cardiac Unit and 6 hours later they took more blood - no Troponin.
Much confusion because ECGs still normal, no risk factors etc etc.
So Cardiologist gave me 3 options:
1) go home
2) have a CT Angiogram
3) have an Angiogram.....but there are "some pretty horrible things that can go wrong".
So, I went for 2.
Went to see a different Cardiologist for the results - nothing, no blockages etc, blood flow looks good etc. His view is it wasn't a heart attack at all.
Except, on the scan there is something that doesn't look right on the Left Coronary Artery - it looks like the inner edge is kinked slightly. It could be:
1) just how it looks on the scan
2) a tear in the inner lining of the artery, which could heal itself, or could let blood in behind it causing the lining to swell and block the artery - then I die.
Number 2) and it killing me are a lot less likely than 1) - he thinks.
"How do you tell what it is?" I ask
"Do an angiogram" he says "except there are some pretty horrible things that can go wrong, including causing one of these tears."
If it is a tear he reckons they could stent it and fix it.
He is going to get a couple of other Cardiologists to have a look, but to be honest I think I've already decided to have an angiogram.......
If I was 70 I'd probably just get on with things, but I'm 40 and have a wife and 5 year old to think about. Wouldn't want to drop dead and have her find out that what killed me was something we knew about but I decided not to do anything about.
So, angiograms - are they really worth the risk? It is either that or I suspect I won't sleep properly ever again.
Or am I being daft?
4 weeks ago I ended up in A&E with chest/back etc pains. Paramedic on the way in was fairly sure it was nothing serious (ECGs were all normal) but in A&E I returned a positive Troponin reading so they decided Heart Attack and admitted me.
Got transferred to a specialist Cardiac Unit and 6 hours later they took more blood - no Troponin.
Much confusion because ECGs still normal, no risk factors etc etc.
So Cardiologist gave me 3 options:
1) go home
2) have a CT Angiogram
3) have an Angiogram.....but there are "some pretty horrible things that can go wrong".
So, I went for 2.
Went to see a different Cardiologist for the results - nothing, no blockages etc, blood flow looks good etc. His view is it wasn't a heart attack at all.
Except, on the scan there is something that doesn't look right on the Left Coronary Artery - it looks like the inner edge is kinked slightly. It could be:
1) just how it looks on the scan
2) a tear in the inner lining of the artery, which could heal itself, or could let blood in behind it causing the lining to swell and block the artery - then I die.
Number 2) and it killing me are a lot less likely than 1) - he thinks.
"How do you tell what it is?" I ask
"Do an angiogram" he says "except there are some pretty horrible things that can go wrong, including causing one of these tears."
If it is a tear he reckons they could stent it and fix it.
He is going to get a couple of other Cardiologists to have a look, but to be honest I think I've already decided to have an angiogram.......
If I was 70 I'd probably just get on with things, but I'm 40 and have a wife and 5 year old to think about. Wouldn't want to drop dead and have her find out that what killed me was something we knew about but I decided not to do anything about.
So, angiograms - are they really worth the risk? It is either that or I suspect I won't sleep properly ever again.
Or am I being daft?
http://www.bhf.org.uk/heart-health/how-we-help/sup...
You can speak to a cardiac nurse and I have found them to be extremely helpful. Good luck.
You can speak to a cardiac nurse and I have found them to be extremely helpful. Good luck.
I had an angiogram (wrist entry) at 22. I don't recall them explaining any particular risks but decided it was better to be safe and check I was OK.
Felt a prod somewhere in my chest while they were at it and could feel it being pulled out around the shoulder area which was weird, but everything was fine otherwise.
ETA info of circumstances...chest pains over the weekend and again Monday morning so went to A&E. Blood tests showed levels of Troponin suggesting a fairly major heart attack. They couldn't find any problems with scans, angiogram or daily blood samples over the week I was in hospital. Got discharged officially a few months later as a one off with no additional risk over anybody else my age of having further heart problems.
Felt a prod somewhere in my chest while they were at it and could feel it being pulled out around the shoulder area which was weird, but everything was fine otherwise.
ETA info of circumstances...chest pains over the weekend and again Monday morning so went to A&E. Blood tests showed levels of Troponin suggesting a fairly major heart attack. They couldn't find any problems with scans, angiogram or daily blood samples over the week I was in hospital. Got discharged officially a few months later as a one off with no additional risk over anybody else my age of having further heart problems.
Edited by iacabu on Wednesday 27th November 12:55
Jader1973 said:
4 weeks ago I ended up in A&E with chest/back etc pains. Paramedic on the way in was fairly sure it was nothing serious (ECGs were all normal) but in A&E I returned a positive Troponin reading so they decided Heart Attack and admitted me.
Firstly, the Para needs (needed) to be careful as to what he/she said. A 12 lead ECG is used to rule things IN and not rule them OUT. It is only about 75% accurate. You could be having a massive MI (heart attack) and still have a normal ECG.I've watched dozens of Angios on lots of different people, some old and very poorly. All of whom survived to tell the tale.
The Left Coronary Artery is a VERY important bit of piping. It feeds the left side of your heart which is the most important part. It is not known as the widowmaker for nothing.
If it tears and bleeds, you will/could suffer a Cardiac Tamponade. This would lead to anything from discomfort to death!
Based on what you are saying here, I would have the Angio. The alternative is to leave it, and then you might have to face angioplasty in 10 or 20 years time when you are older/less fit.
Jader1973 said:
Or am I being daft?
Yes. MTFU 
I perform CT cardiac angiograms as part of my job. Unless your heart rate was above 65bpm or highly unpredictable when the scan was done it's unlikely that it is just an odd appearance (though not impossible, there are other variables involved as well).
Regardless I would personally go for the angio as it will tell whether or not something is wrong, and if it is it can be treated at the same time. If there's nothing there then you have peace of mind.
Yes they aren't without risks but the staff in cath labs are well trained and they perform angiograms on weaker patients on a daily basis. You'll be in good hands.
Regardless I would personally go for the angio as it will tell whether or not something is wrong, and if it is it can be treated at the same time. If there's nothing there then you have peace of mind.
Yes they aren't without risks but the staff in cath labs are well trained and they perform angiograms on weaker patients on a daily basis. You'll be in good hands.
I have no medical knowledge but my experience is that any risks, no matter how small, are pointed out. Even with minor surgery I have had had various risks pointed out. Not sure why they do this but it seems the norm these days.
My wife had an angiogram in her mid 40s following an attack of miocarditis. She had your concerns but breezed through it as thousands do every day.
Again, from a layman's point of view, if you think the logical thing is to do it, then do it and try not to worry. You'll be fine.
My wife had an angiogram in her mid 40s following an attack of miocarditis. She had your concerns but breezed through it as thousands do every day.
Again, from a layman's point of view, if you think the logical thing is to do it, then do it and try not to worry. You'll be fine.
Thanks for all the replies.
Jumbobeef - he was careful. He wasn't going purely off the EKG when he said he doubted it was anything serious. Badly worded post from me.
Zeduffman - funny you mentiond heart rate - it was 74. Guy doing the scan was happy with the images though - apart from the issue with the LCA!
I'll see what they say when I go back, but unless they are 100% sure it is nothing I'll be having an angiogram, especially given how important the bit of plumbing with a possible issue is!
Thanks again.
Jumbobeef - he was careful. He wasn't going purely off the EKG when he said he doubted it was anything serious. Badly worded post from me.
Zeduffman - funny you mentiond heart rate - it was 74. Guy doing the scan was happy with the images though - apart from the issue with the LCA!
I'll see what they say when I go back, but unless they are 100% sure it is nothing I'll be having an angiogram, especially given how important the bit of plumbing with a possible issue is!
Thanks again.
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