Naked Science Forum
Life Sciences => Physiology & Medicine => Topic started by: another_someone on 17/02/2008 14:46:11
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There is an elderly lady who has for some time had a probable heart condition (she easily gets short of breath, and has been on some nitrate type heart medicine for some time, which does some good, but things have recently got worse).
She has been advised by the doctors to have an angiogram (with the possibility that if they find something, they could fix it while they are prodding around inside her).
She is not someone who commonly goes into hospital, and even for day treatment, she is nervous of having things messed around inside her. She is asking me for advice (not to make the decision for her - it has to be her decision - but for advice). So I am passing the buck [:)]
What do people here know about the risks, risk factors, and alternatives to, angeograms.
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Hi George. I have had this procedure done. They told me it was relatively safe but there was the chance of death as with other surgeries. He said that anytime they get into your arteries there is a chance of hitting plaque and breaking chips off and it getting into your bloodstream and traveling to the lung or brain...
My procedure went well until after the procedure was over. They have you lie flat for a few hours after the surgery then the incline your bed if you have done well. I made it to this point, but after a few moments in the inclined position my chest become very tight and I begun to have a heart attack.. They gave me another injection into the iv and then put me back flat on my back again... where I stayed till the end of the day... then my bed was raised in increments until They seen that I had passed through that rough spot and...was going to be ok.
He did say that it could happen. They were able to tell me my arteries were clear and there were no blockages but I did have aortic sclerosis but it was not as bad as he thought.. so my tests were real good there which meant I had another problem
When they went in they anaesthesied the area at where they went into the femoral artery.. so as far as comfort during the procedure shots and anaesthetising initially were the biggest painful things.. so really not bad.. Being nervous makes it worse and anything messing with your heart is scary as hell. There are many things that could happen but seldom do. I had complications because I had other unseen problems a blood clot and a good sized aneurysm that we did not know about before this.
They used a clamp to close the artery and there is a risk with that for three months. You must keep your stools soft and avoid constipation if they use the clamp, or "Star closure" as in my case. Constipation could cause too much pressure and can blow it open and you could bleed out quickly!
Like I said I am sure there were other things he talked to me about, but those were the top worries in my head!
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Precise report, thank you Karen,
...now imagine all this done to an old lady without spending BEFORE enough time to explain carefully the whole procedure, the eventual benefits and possible risks!
No surprise she seems to be skeptical about the whole thing.
ikoD
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I had this procedure in November... an angiogram, and then 3 weeks later angioplasty where they put in a stent. I was told about the risks, but in the end, the benefits outweighed them. I had both the angiogram and the angioplasty through my wrist, which they much prefer in the UK if it is at all possible. I would be happy to tell you more about it if you like.
Just as a point of information, I couldn't walk 100m without an angina attack before (I have a congenital lipid disorder} and now I have no pain at all!
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I had the angioram with intent to continue to angioplasty at the same time if more then 1 and 1/2 arteries were blocked by plak.. He said if he found that to be the case full blockage then he would install the stints.. It was not necessary they were open. He said if there were more blockages then that he would stop the procedure and we would discuss the next step which would have been bypass surgery.. but if it was just stints they would do it then.. I am glad I did not have to have that too...
By the way Like you said you had yours through the wrist mine through the groin into the larger femoral artery.. He said in Europe there preference is as you said, its in through the wrist, but he said the preferred practice here was through the femoral as it was a larger artery and less risky as far as plak and exploration of the arteries for the camera to be passed in through the tube to see.
I thought there was one other route but can't remember for sure so.. I won't try to guess.
I am glad your procedure helped you! I am still having a great deal of trouble moving from the computer room to the Loo and back.. The back part takes me out for 20 or thirty minutes at a time.. sometimes much longer and I get so winded and tired I sit down and am falling asleep for periods of time.. but immediate sleep.. like as soon as I sit and lean back... Highly odd for me.. Just get as if I ran a marathon just going to the loo!
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Thanks for the responses. I will pass them on today.
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OK, I have spoken to the lady in question. She was most appreciative of your responses, but is trying to see if there are non-invasive alternatives to angiograms.
One thing she is looking at is EBA (electron beam angiography) - anybody know anything about this?
Another one she has found reference to (although looks less promising) is MSCT (Multi Slice Computer Tomography). Again, any knowledge about this?
Much appreciated.
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I have heard nothing to speak of regarding these procedures and when discussing my options they were never even mentioned.. or I would have jumped on it!
Very interesting though!
From what I was told the method used in the angiogram was the least evasive as it would only require the one time shot and the stints could be done at that time if blockages were there and fixable with angioplasty. Bypass was much more involved..
I hope she finds an even less evasive procedure....Good luck.. Someone like you should go with her and have her request a pre op consultation where you can go and help her ask the proper questions and know what the doctor said so she has a good understanding of what is happening.
I had to go alone and believe me I did not fully understand what the doctor was explaining.. and wish I had had someone to be a second pair of ears it is really helpful when facing this stuff.