Cardiac catheterization is a vital medical procedure that serves as the foundation for coronary angiograms and angioplasty surgery. While these terms are often used interchangeably, they refer to different aspects of heart care. In Hong Kong, approximately 10,000 angioplasty procedures are performed each year, with a success rate of over 90% . Most patients can leave the hospital on the same day, making it a common and effective treatment for coronary artery disease.

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What is Cardiac Catheterization?

Cardiac catheterization is a low-risk diagnostic procedure that allows doctors to assess the heart’s function and blood flow. During this procedure, a thin, flexible tube called a catheter is inserted into a blood vessel, usually in the arm or groin, and guided to the heart. Through this catheter, medical professionals can measure heart pressure, evaluate oxygen levels, and check for blockages or abnormalities in the coronary arteries.

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Cardiac catheterization is not considered a surgery because no large incisions are made. It involves a small puncture site that heals quickly, allowing for a short recovery time. This procedure is often performed on an outpatient basis, meaning patients can go home on the same day. If necessary, additional tests such as a coronary angiogram can be conducted during the same session to provide further insight into the condition of the arteries.

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What is a Coronary Angiogram?

A coronary angiogram is a type of cardiac catheterization used to diagnose blockages in the coronary arteries. This test involves injecting a contrast dye through the catheter, making the arteries visible on X-ray images. Cardiologists can determine if any narrowings or obstructions could restrict blood flow to the heart by observing how the dye moves through the blood vessels.

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The coronary arteries are crucial in supplying oxygen-rich blood to the heart muscle. If one of these arteries becomes blocked, it can lead to a heart attack. Coronary angiograms are typically recommended for patients who have had abnormal stress tests, unexplained chest pain, or a history of heart attack or heart failure. If blockages are identified early, doctors can decide on the most appropriate treatment, which may include lifestyle modifications, medication, or a coronary angioplasty procedure.

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How to Prepare for a Coronary Angiogram

Preparation for a coronary angiogram is straightforward. Patients are usually advised to fast for at least eight hours before the procedure, during which water is generally allowed. Certain medications, such as anticoagulants, diabetes drugs, and diuretics may need to be adjusted to reduce the risk of complications. Your healthcare provider will provide specific instructions based on your medical history and current medications.

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What Is a Coronary Angioplasty?

Coronary angioplasty is a procedure designed to open clogged blood vessels and restore proper blood flow to the heart muscle. This minimally invasive treatment is often performed as an emergency intervention for heart attacks or as a planned procedure to address severe blockages found during an angiogram.

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During angioplasty, a catheter with a deflated balloon at its tip is guided to the site of the blockage. Once in position, the balloon is inflated, pushing the plaque against the artery walls and widening the blood vessel. In most cases, a small, expandable metal mesh tube called a “stent” is inserted to keep the artery open. The stent acts as a scaffold, preventing the artery from narrowing again.

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Stents used in angioplasty are typically between 2 to 5 millimeters in diameter and 8 to 38 millimeters in length. Some stents are coated with medication to reduce the risk of restenosis, a re-narrowing of the artery. This procedure significantly improves blood flow and reduces the likelihood of future heart complications.

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Why Might Someone Need Coronary Angioplasty?

Coronary angioplasty is recommended for patients with significant artery blockages that restrict blood flow to the heart. These blockages are often caused by atherosclerosis, where fatty deposits, cholesterol, and other substances build up on the artery walls.

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Patients who have tried medication and lifestyle changes but continue to experience symptoms such as chest pain (angina) or shortness of breath may also be candidates for angioplasty. In emergency situations, such as a heart attack, angioplasty can be a life-saving procedure that quickly restores blood supply to the heart. The treatment will improve blood circulation, which will help reduce the risk of further cardiac events and enhance overall heart health.

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The Path to a Healthier Heart

Cardiac catheterization, coronary angiograms, and angioplasty are essential processes in diagnosing and treating heart disease. While catheterization provides access to the heart’s blood vessels, angiograms help identify blockages, and angioplasty serves as a treatment to restore proper blood flow. With Hong Kong’s high success rate in performing angioplasty procedures, these interventions offer an effective solution for managing heart health.

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Sources:

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https://my.clevelandclinic.org/health/diagnostics/16832-cardiac-catheterization

3. Coronary angiogram. (2023). Mayo Clinic. Available from: https://www.mayoclinic.org/tests-procedures/coronary-angiogram/about/pac-20384904

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