Hello everyone! I am Dr. Xu of Cardiovascular Medicine, spreading the correct scientific knowledge and escorting your cardiovascular health!
In the outpatient or inpatient department, patients often ask, doctor, I want to know if I have coronary heart disease , is it better to have coronary CTA or coronary angiography?
To answer this question, we need to understand what coronary heart disease is.
The full name of coronary heart disease is coronary atherosclerotic heart disease.
It is mainly caused by coronary stenosis or spasm, inducing myocardial ischemia .
90% of coronary heart disease are caused by coronary artery stenosis. In order to determine whether there is stenosis in the blood vessel, some imaging examinations are needed. Coronary CTA and coronary angiography are both tests that are useful for diagnosis.
Most of the time, the doctor will give you direct advice, but sometimes the doctor will ask the patient to participate in the choice, should he do coronary artery CTA or coronary angiography?
So for patients, it is still necessary to understand the differences and pros and cons of the two.
First of all, let’s look at coronary CTA. The advantage is that it can be completed in the outpatient clinic. In essence, it is an enhanced CT. Before the examination, an intravenous trocar is given on the arm. During the examination, contrast agent can be injected from the trocar. It is a non-invasive examination and does not require hospitalization. It is short, low cost, and a relatively high diagnosis rate.
and its disadvantages are also present. First of all, coronary CT has certain false positive and false negative problems.
In other words, patients with negative coronary CT results may still be coronary heart disease, which causes false negatives, including limitations of CT itself, imaging quality, and examiner experience, etc. Similarly, those with positive CT cannot be fully diagnosed as coronary heart disease, and further coronary angiography is needed to confirm the diagnosis.
Another point is that the contrast dose required for coronary CTA is relatively large. For patients with mild and moderate renal function, be careful to choose to avoid the risk of contrast agent nephropathy .
The amount of contrast agent during coronary angiography is much smaller than the contrast agent of coronary CTA.
In addition, coronary CTA is just a test, not a treatment method.
CTA found that the patient had coronary heart disease, so he needed coronary angiography to see if intervention and treatment were needed to intervene.
Then some patients will ask, since coronary angiography is more accurate than CTA, wouldn’t I just choose angiography?
, let’s talk about the pros and cons of coronary angiography.
The advantage of coronary angiography is:
1. It is the gold standard for diagnosing coronary heart disease,
2. The dosage of contrast agent is small during coronary angiography. For patients with mild and moderate renal abnormalities, the risk of contrast agent kidney disease can be reduced, which is relatively safe.
3. Coronary angiography can solve the problem by discovering problems, implanting a stent or dilating a drug balloon.
But at the same time it still has some limitations:
First, coronary angiography requires radial artery or arterial vascular puncture, the guidewire will enter the blood vessel and reach the heart and the blood vessels for injection of contrast agent, which is a minimally invasive surgery. After the operation, local compression is required for 6 hours, which is a certain risk.
Second, coronary angiography requires hospitalization, which is time-consuming and expensive than CTA.
In general, both choices have their pros and cons. Which one should be chosen depends on the specific situation of the patient.
Everyone has different situations. There is no best choice, only the most suitable choice.
is OK. That’s all for the content I’ve shared with you today. I hope it will be helpful to everyone. Pay attention to health and Dr. Xu, and we will see you next time!
I am Dr. Xu Hongxin, Chief Physician of the Department of Cardiovascular Internal Medicine, Wuhan University People's Hospital!
The location and time of the clinic: Every Monday morning and Friday afternoon, the Shouyi Campus of Wuhan University People's Hospital!
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