Guard Your Heart

Doctors advise thorough testing and a complete diagnosis before opting for angiograms and angioplasty

Been advised to get an angiogram or angioplasty done for coronary heart disease (CHD)? First make sure it's what you really need. Cardiologists in the city say there is a growing trend of tests such as the conventional coronary angiography test, which comprises inserting a hollow tube into the body and evaluating the heart's blood supply, being advised without basic tests being done first. Encouraging people to make an informed choice about any procedure, doctors warn that hasty decisions might be putting you at more risk.

Dr A B Chandorkar, consultant interventional cardiologist, explains that CHD is a narrowing of the blood vessels that supply blood and oxygen to the heart, with symptoms that include chest pain, shortness of breath and fatigue, which can be diagnosed and treated in several ways. "But these days angiography seems to be advised and performed without preliminary tests being done first. This can be risky for young men and women with very low probability of coronary artery disease who are being made to undergo the tests," says Dr Chandorkar. Dr Manoj Durairaj, Director of Cardiac Surgery at Ruby Hall Clinic, agrees. He says a step-wise diagnostic approach is always recommended."We advise the patient to get an ECG or 2D Echo, few blood tests and a stress test. These basic tests need to be followed before a CT coronary angiogram is advised," he adds.

Doctors say that an angioplasty to "remove the severe blocks" is also now being offered soon after the angiography. They say this practice is justifiable as a life-saving resort when the patient is critically ill typically in the Critical Care Unit, but in all other cases the patient should have an opportunity to obtain a second opinion before opting for an angioplasty. Often, everyone may not necessarily be in agreement about the presence of severe diseases or of the necessity of the procedure.

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