How do doctors check coronary arteries to see if plaque is buidling up or to see if they're blocked?

Question

Do they use a needle?

Answer 1

you run a cather up the femoral artery and into the coronary arteries and inject radiolabeled dye and then take Xray images if the heart, in which the coronary arteries will be visible and any plaques will result in a narrowing of the lumen.

Answer 2

All of the procedures related to x-raying the heart go
under the heading of cardiac catheterization.

An angiogram simply takes x-ray pictures of the vessels and arteries in order to investigate evidence of narrowing or onbstruction due to plaque. An intervenous tube is usually placed in the patient's arm and radioactive die is released into the vein in order to provide the medium for producing the x-ray.

A coronary angiogram or cardiac catheterization is a bit more complex in that they actually feed the wire through the vein into the heart, usually from the groin, and as well as having the ability to take pictures, the doctors are also able to measure the pressures within the heart chambers to determine how the blockage is affecting the flow of blood into and out of the heart.

The catheterization procedure is usually the last diagnostic
step before surgery.

Recently the surgery itself is done at this stage as many
procedures to clear the plaque can be done with a catheter rather than with open heart surgery. This makes the surgery
minimally invasive. There are increased risks to the patient with open heart surgery.

more details here:
http://en.wikipedia.org/wiki/Coronary_angiography

Answer 3

The gold standard test is coronary angiography, and in that case a rather large needle is inserted in a large vessel in the groin, so a catheter can be snaked up into the coronary arteries and dye injected. It isn't the sort of thing you do just for jollies, so less invasive methods are normally used as screening tests.

Answer 4

Only in some cases do they use a needle an send something to the heart, most doctors perfer noninvasive procedures.

An angiography is the most recent method, but ultrasound is gaining popularity. The dye injection and x-ray or CT scan is the oldest method.

For an angiogrpahy the doctors stick a fiber optic up your femoral artery (main leg artery) and send it right up to the heart to scan the hear arteries from the inside.

According to Wikipeida: http://en.wikipedia.org/wiki/Atherosclerosis#Treatment
"Atherosclerosis is a disease affecting arterial blood vessels. It is a chronic inflammatory response in the walls of arteries, in large part due to the deposition of lipoproteins (plasma proteins that carry cholesterol and triglycerides). It is commonly referred to as a "hardening" or "furring" of the arteries. It is caused by the formation of multiple plaques within the arteries."

First a stress test is used to see if a problem might exist (that's running on a treadmill with a oxygen supply hooked to your face and your nose pinned shut to measure your resperation and performance that ratio determines how you heart is performing).

Ultrasound has been used most recently as well as coronary calcium scoring by CT (this is when the dye is injected via a cather). The other methods are medabolic studies to not perform an invasive or surgical procedure where anatomic (abdominal girth) and physiologic (blood pressure, elevated blood glucose are checked.

Picture of a plaque filled artery: http://en.wikipedia.org/wiki/Image:Atherosclerosis%2C_aorta%2C_gross_pathology_PHIL_846_lores.jpg

According to Wikipedia: http://en.wikipedia.org/wiki/Atherosclerosis#Diagnosis_of_plaque-related_disease
"Areas of severe narrowing, stenosis, detectable by angiography, and to a lesser extent "stress testing" have long been the focus of human diagnostic techniques for cardiovascular disease, in general. However, these methods focus on detecting only severe narrowing, not the underlying atherosclerosis disease. As demonstrated by human clinical studies, most severe events occur in locations with heavy plaque, yet little or no lumen narrowing present before debilitating events suddenly occur. Plaque rupture can lead to artery lumen occlusion within seconds to minutes, and potential permanent debility and sometimes sudden death.

Greater than 75% lumen stenosis used to be considered by cardiologists as the hallmark of clinically significant disease because it is typically only at this severity of narrowing of the larger heart arteries that recurring episodes of angina and detectable abnormalities by stress testing methods are seen. However, clinical trials have shown that only about 14% of clinically-debilitating events occur at locations with this, or greater severity of narrowing. The majority of events occur due to atheroma plaque rupture at areas without narrowing sufficient enough to produce any angina or stress test abnormalities. Thus, since the later-1990s, greater attention is being focused on the "vulnerable plaque."

Though any artery in the body can be involved, usually only severe narrowing or obstruction of some arteries, those that supply more critically-important organs are recognized. Obstruction of arteries supplying the heart muscle result in a heart attack. Obstruction of arteries supplying the brain result in a stroke. These events are life-changing, and often result in irreversible loss of function because lost heart muscle and brain cells do not grow back to any significant extent, typically less than 2%.

Over the last couple of decades, methods other than angiography and stress-testing have been increasingly developed as ways to better detect atherosclerotic disease before it becomes symptomatic. These have included both (a) anatomic detection methods and (b) physiologic measurement methods.

Examples of anatomic methods include: (1) coronary calcium scoring by CT, (2) carotid IMT (intimal media thickness) measurement by ultrasound, and (3) IVUS.

Examples of physiologic methods include: (1) lipoprotein subclass analysis, (2) HbA1c, (3) hs-CRP, and (4) homocysteine.

The example of the metabolic syndrome combines both anatomic (abdominal girth) and physiologic (blood pressure, elevated blood glucose) methods.

Advantages of these two approaches: The anatomic methods directly measure some aspect of the actual atherosclerotic disease process itself, thus offer potential for earlier detection, including before symptoms start, disease staging and tracking of disease progression. The physiologic methods are often less expensive and safer and changing them for the better may slow disease progression, in some cases with marked improvement.

Disadvantages of these two approaches: The anatomic methods are generally more expensive and several are invasive, such as IVUS. The physiologic methods do not quantify the current state of the disease or directly track progression. For both, clinicians and third party payers have been slow to accept the usefulness of these newer approaches."

Answer 5

anagrams. not called a needle