HOW TO DEFINE AVASOIC OCCLUSION?
IS ANGIO CONDITIONAL?
- One of the stories we hear frequently comes from patients whose coronary artery occlusion or stenosis was found as a result of Coronary Angiography.
- “I recently had a check-up. All my results have been good. The doctor said my veins were all open. Where did this come from?
- Unfortunately, this situation, which causes confusion, cannot be explained well, so it can turn into an inextricable situation.
- Now I’m going to tell you briefly and simply what’s going on.
- Three types of examinations are classically performed after the examination or in the check-up programs. EKG, Chest X-ray and Blood Tests.
- ECG is the cheapest and most convenient examination, but it can only detect chest pain (which is not always), arrhythmia (palpitations), the effects of previous attacks, and enlargement or enlargement of the heart chambers. A normal ECG does not mean that there is no cardiovascular disease. Its sensitivity is considered to be around 50%.
- On the other hand, the chest X-ray only shows the previous damage to the heart, the size of the heart and rarely the calcifications in the great vessels.
- Blood tests also show tissue damage to the heart muscle in newly developing conditions characterized by chest pain.
- The fact that all these tests are normal does not mean that there is no cardiovascular disease.
- Sometimes Echocardiography is included in these packages. Echocardiography gives information about the general functions of the heart and the size of the valves and chambers of the heart. The defect in the contraction of some regions suggests that there may be a stenosis in the coronary vessels. In this case, the patient is directed to angiography.
- So what else can we do?
- In the next step, we see the Exercise Test: Exercise ECG.
- This test is called ECG and blood pressure recording as a result of exercise performed with an increasing tempo and incline, usually every three minutes, on the treadmill. However, as you can guess, this test may not be able to do this test for every person due to low physical performance, or factors such as excess weight, discomfort in the knees and age cause it to not be preferred. The sensitivity and specificity of the exercise test is at the level of 60-76%. There is a fairly significant percentage remaining in the gray zone. In other words, the fact that the Exercise Test is normal does not mean that you are not a cardiovascular disease again.
- In the next stage, we come across a method that is used especially in those who cannot do the Effort Test. Scintigraphy. Scintigraphy is a Nuclear Medicine method. Radioactive materials are given intravenously and circulation in the heart is monitored. This display is displayed regionally. If there is left bundle branch block, it may give false positive results. Differences in interpretation in scintigraphy also make diagnosis difficult. So, what are the rates in this examination? It is 69-84%.
- With the developing technology, MRI and Computed Tomography started to be used for the diagnosis of Cardiovascular Occlusions. First we have to say that these are expensive. While the diagnosis rate is 89-87% in MRI, this rate is 91-30% in Computed Angiography. Here, the reason for the decrease in the specificity of Computed Tomographic Angiography is whether the detected strictures really disrupt tissue nutrition. Classical Angiography and FFR method still maintain their value in this regard.
- As a result, as you can see, despite all the developments, there is no method that can diagnose 100% like Classical Angiography.
- It is not possible to say that your veins are completely open without angiography. It does not mean that “all of your veins have been opened” when the stenoses detected in the previous angiography are normal and the tests mentioned above are normal.
- An example for you; A patient who used a drug that was recently advertised on the market for his stenosis detected in angiography for his stenosis detected in angiography, which was advertised on the market recently, insisted that his examinations were normal without even having an Effort Test, and went home, saying, “All of my veins were opened,” and he had a heart attack and relapsed a short time later. angiography and surgery.
- In summary, it is not possible to obtain an acquittal without an angio. Angiography is performed comfortably and safely, especially on the arm. With a 20-minute process, you can get rid of the questions in your mind without wasting time.
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