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Angiocardiography is examination of the blood vessels or chambers of the heart. It is performed by tracing, via x-ray or nuclear medicine, the course of a contrast dye or radionuclide that has been injected into the bloodstream. These pictures are called angiograms. The left ventricle, heart valves, coronary arteries, aorta, and pulmonary arteries are the structures most often examined with this technique.
In traditional angiocardiography, a contrast material or dye is injected into the heart. The contrast material absorbs x-rays differently than do the surrounding blood vessels and soft tissue, allowing structures of the body to be more clearly visualized on film. Once the contrast material is injected, large x-ray films are exposed in two planes at right angles to each other, which permit the simultaneous recording of two different views (bi-plane angiocardiography). In cineangiocardiography, the x-ray images are brightened several thousand times and photographed on motion picture films. When projected, the passage of the blood may be viewed in slow motion. Cineangiocardiography has mainly been replaced by digital capture of the pictures, which allows real-time display and permits the information to be stored on a CD-ROM and uploaded and transmitted by computer.
Radionuclide angiocardiography uses red blood cells that have been tagged with a low-level radioactive substance so that their path through the circulatory system can be tracked. Several variations of radionuclide angiocardiography are used, including first-pass radionuclide angiocardiography, which examines only one pass of the substance through the heart, and equilibrium radionuclide angiocardiography or gated equilibrium radionuclide angiocardiography, which follows passage of the radionuclide through hundreds of cycles and looks at specific phases of heart function.
Angiocardiography technique is used to evaluate individuals for surgery on the heart and its associated blood vessels. Various techniques measure the volume of blood pumped, the effectiveness of heart contractions, the patency of heart valves, and the condition of the coronary and pulmonary (lung) arteries. During angiocardiography, procedures such as angioplasty, coronary stenting, and valvuloplasty may be performed. Although angiocardiography is a valuable tool in assessing some of the more complicated aspects of heart function, it is also one of the more hazardous diagnostic procedures. Because it is classified as an invasive procedure, angiocardiography must be performed in a hospital setting under strict controls. Recent advances in echocardiography, which is not invasive and does not use radioactive material, are replacing angiocardiographic evaluations for some individuals.
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Source: Medical Disability Advisor
| Angiocardiography can provide both structural (anatomic) and functional (hemodynamic) information about the heart and its vessels. It may reveal anatomical abnormalities such as aneurysms, narrowed or obstructed vessels, or heart chamber enlargement. Angiocardiography can also demonstrate abnormal blood flows or the failure of a valve to close that result in a reflux of blood.
Imaging of the ventricle helps evaluate the heart's performance. Another, more accurate measurement of how the heart is functioning is the ejection fraction. This measurement correlates well with the individual's prognosis and is widely used as an index of ventricular performance.
Ventricular function can also be assessed by radionuclide ventriculography, gated single photon emission tomography (PET), and magnetic resonance imaging (MRI). The latter is the most accurate available noninvasive imaging technique for determination of LVEF, although 3D-echocardiography may provide similar results. The "gold standard" is still angiocardiography. They may reveal localized areas where wall motion is diminished, absent, or opposite in direction from normal motion. Wall motion analysis is especially useful in the evaluation of coronary artery disease. Areas of insufficient blood supply or tissue death (infarction) of the heart can be identified even when overall heart performance appears normal. Ventricular function can also be assessed by echocardiography, but at times angiocardiography provides more accurate information.The arteries and veins of the lungs can be examined by injecting contrast medium into the pulmonary artery. The main purpose of pulmonary angiocardiography is to confirm a diagnosis of a suspected pulmonary plug. This plug is composed of a detached blood clot (thrombus) or other foreign body (embolus). Pulmonary angiocardiography is indicated when noninvasive test results are uncertain or when detailed anatomical information is needed to plan for surgical removal of a pulmonary embolus. Other pulmonary vascular disorders are also diagnosed with this procedure.
Individuals should not have angiocardiography if they have a history of allergic reaction to contrast material, have uncontrolled hypertension, ventricular arrhythmias, severe anemia, active gastrointestinal bleeding, or acute stroke. |
Source: Medical Disability Advisor
| Angiocardiography is an invasive procedure done under anesthesia. Although the actual procedure only takes about 1 hour, preparation and recovery are an all-day process, and some individuals may need to remain in the hospital overnight.
The procedure is performed by inserting a long narrow tube (cardiac catheter) into a blood vessel, usually in the groin or arm, and then advancing it toward the heart. The catheter is placed into a vein to visualize the right side of the heart and into an artery to examine the aorta, coronary arteries, and left side of the heart. After the catheter tip has been guided into the appropriate chamber or vessel, contrast medium is injected through the catheter. The contrast medium mixes with the blood and moves through the circulation, with the movement observed and the image recorded. |
Source: Medical Disability Advisor
| The outcome from the procedure itself is expected to be uneventful. The risk of major complications during the procedure is 1% to 2%, and the death rate from the procedure is about 0.08% (Olade). The test, in general, gives accurate indications of heart and blood vessel structure and function. |
Source: Medical Disability Advisor
| Serious reactions to the contrast material may occur, despite continued efforts to develop less harmful materials. Allergic reactions may include hives (urticaria) and inflammation of eye and eyelid tissues (conjunctivitis). Lung spasms (bronchospasm), swelling of the throat (laryngeal edema), and difficulty breathing (dyspnea) are rare reactions.
Major complications such as cardiac arrest, bleeding, infection, a blood clot in a vessel, muscle contractions and capillary dilation (anaphylactic reactions), shock, convulsions, blue skin (cyanosis), and kidney (renal) toxicity are rare. Should a blood clot become loosened, it could damage other parts of the body and result in very serious disability or, in rare cases, death. In very rare cases, perforation of a coronary artery occurs, necessitating emergency cardiac surgery.
Abnormal ventricular rhythms (arrhythmias) are common if the catheter tip contacts the wall of the ventricle. |
Source: Medical Disability Advisor
| The underlying condition for which the angiocardiography was performed may require adjustments in work requirements. In terms of the procedure itself, nonstrenuous work may resume within a few days to a week following the procedure. Strenuous physical activity or exercise should be temporarily avoided. |
Source: Medical Disability Advisor
| Olade, Roger, and Arshad Safi. "Cardiac Catheterization (Left Heart)." eMedicine. Eds. Gregory J. Dehmer, et al. 21 Mar. 2002. Medscape. 26 Sep. 2004 <http://emedicine.com/med/topic2958.htm>. |
Source: Medical Disability Advisor
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