Tag Archives: coronary angiography

Introduction For many years coronary angiography (CA) has been used as the gold standard in the assessment of coronary artery disease (CAD), and even a normal result is considered a worthwhile outcome.1 However, concern has been raised about the use and overuse of what is an invasive and expensive procedure.2-4 We examined our cardiac catheter database to assess our diagnostic yield in terms of detecting CAD, and also in terms of subsequent referral for coronary revascularisation, whether this be by percutaneous coronary intervention (PCI) or coronary artery bypass surgery (CABG), in a population of patients being assessed for possible CAD.

Introduction Multi-detector computed tomography coronary angiography (CTCA) is becoming increasingly available in UK Hospitals. The National Institute for Health and Clinical Excellence (NICE) clinical guideline 95, released in 2010, recommended the use of calcium score ± CTCA in patients with low likelihood chest pain of recent onset.1 American College of Cardiology (ACC)/American Heart Association (AHA) appropriateness criteria for CTCA recommend its use in patients with low or intermediate likelihood chest pain.2 The rationale for the recommendations of CTCA is its excellent negative-predictive value.3 A further important point is that fu

When the dentist said: “Be still your beating heart!” Dear Sirs, We all often encounter a patient history and apparent presenting complaint that we can not precisely and cleverly explain. Our patient, Mr BW, a fit and active 53-year-old man, attended a routine appointment as an outpatient. He had done this many times previously as he was experiencing difficuties with heart rate control and troubling symptoms secondary to atrial fibrillation (AF). Coincidentally, he had also had amalgam dental fillings drilled some 18 months previously. Since then, his cardiac problems had escalated. There appeared no clear causality between the fillings a

MDCT coronary angiography (CTCA) has been shown to be highly accurate at detecting coronary artery disease (CAD) with more than 30 studies and several meta-analyses confirming excellent sensitivity and negative predictive value (NPV), when compared with invasive X-ray coronary angiography.1 This was confirmed in three multi-centre trials: Assessment by Coronary Computed Tomographic Angiography of Individuals Undergoing Invasive Coronary Angiography (ACCURACY) (n=230), Coronary Artery Evaluation Using 64-Row Multi-detector Computed Tomography Angiography (CORE-64) (n=291), and Meijboom et al. (n=360)2-4 (table 1). The positive predictive value

Figure 1. Dissection of the common femoral artery, characterised by contrast holdup post-injection, due to contrast staying in one of the layers between arterial tunica intima and tunica adventitia Very rarely, the needle can displace following successful intraluminal cannulation. If the wire does not easily pass, it is important never to force it. Such an event occurred on this occasion. Following an unsuccessful attempt to pass the wire, contrast was injected through the needle. This demonstrated dissection of the common femoral artery, characterised by contrast holdup post-injection, due to contrast staying in one of the layers between art

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