Coronary Angiography IN INDIA

Computed Tomography Angiography (CTA): Current Technology & Clinical Use for Heart Test

CT angiography, short for computed tomography angiography(CTA), is a non-invasive diagnostic tool that combines the power of CT scanning with the visibility of blood vessels. CT angiography has made revolutionary changes in detecting and diagnosing cardiovascular diseases through its high-resolution, three-dimensional images of blood flow.

CT angiography is a technical imaging technique that allows physicians to view the blood vessels in various body parts. It uses the principles of computed tomography (CT) scanning, which involves taking multiple X-ray images from different angles and reconstructing them into cross-sectional images.

Unlike traditional angiography, which requires the insertion of a catheter into the blood vessels, CT angiography is non-invasive and requires no invasive procedures. Instead, it uses a contrast dye injected into the bloodstream to enhance the visibility of the blood vessels during the CT scan.

The CT scanner rotates around the patient’s body, capturing images of the blood vessels from different angles. A computer then processes these images to create detailed, three-dimensional images of the blood vessels. It allows physicians to evaluate the structure and function of the blood vessels, identify any abnormalities or blockages, and make an accurate diagnosis.

CT angiography can be performable on various body parts, including the brain, neck, chest, abdomen, and extremities. It is helpful to diagnose the conditions like coronary artery disease, pulmonary embolism, aortic aneurysm, peripheral artery disease, and stroke.

CT Angiography: Symptoms

Chest Pain

Chest pain is one of the most common symptoms that could indicate the need for a CT angiography scan. Various reasons, including coronary artery disease, pulmonary embolism, or aortic aneurysm, can cause chest pain. CT angiography scan can help detect the cause of chest pain and enable doctors to provide timely treatment.

Shortness of Breath

Shortness of breath or wheezing could indicate pulmonary embolism, which occurs when a blood clot blocks the pulmonary artery. CT angiography scan can help detect the location and size of the blood clot, thereby enabling doctors to provide the appropriate treatment.

Leg Pain

Leg pain can be a reason for peripheral artery disease (PAD), which occurs when the arteries in your legs become narrow or blocked. CT angiography scan can help detect blockages and enable doctors to provide timely treatment to prevent complications like amputation.

Abdominal Pain

Abdominal pain can arise from an aortic aneurysm, a bulge in the wall of the aorta. An aortic aneurysm can be life-threatening, and a CT angiography scan can help detect its location and size, enabling doctors to provide timely treatment.

Headache

Various reasons, including an aneurysm, a bulge in the wall of a blood vessel in the brain, can cause headaches. CT angiography scan can help detect aneurysms and enable doctors to provide timely treatment before it ruptures.

CT Angiography: Pre-Procedure

Before undergoing CT angiography, patients need to follow specific pre-procedure instructions to guarantee precise and dependable results. The instructions could differ based on which part of the body is under scan and the purpose of the examination. Pregnancy and breastfeeding should not necessarily prevent an individual from undergoing CT angiography; however, before scheduling any tests, they should discuss it with their healthcare provider, as the contrast dye used may pose risks to an unborn baby.

Patient Counseling and Informed Consent

Given the potential risks and complications associated with CT angiography, healthcare providers must conduct thorough patient counselling and obtain informed consent before proceeding. It involves discussing the nature of the procedure, its potential benefits and risks, alternative imaging options, and any specific considerations based on the patient’s circumstances.

Patient counselling are clearly explained the risks if any of the procedure, and steps taken to control them. Patients should disclose any relevant medical history or concerns.

Obtaining informed consent means ensuring that patients fully understand the procedure, its risks, and the available alternatives. Patients must be able to ask questions, express concerns, and make informed decisions based on their needs and preferences.

Preparation and Patient Information

An angiogram is typically performed in a hospital or imaging centre. It is a fast, non-invasive procedure without needing sedation or general anaesthesia for assessment.

Patients must be adequately prepared and informed before undergoing a CT angiography procedure. The preparation process typically involves providing patient-specific instructions beforehand. It may also include fasting for a certain period, especially if contrast dye will be used, and avoiding certain medications that could interfere with the results.

Additionally, patients will be asked to provide detailed medical information and any relevant medical history. It helps the healthcare team better understand the patient’s overall health and any potential risks or complications that may arise during the procedure. Patients must disclose any allergies, particularly to contrast dye, as this can impact the approach taken during the CT angiography. It is also necessary to consult with your physician about the presence of pacemaker implants.

A nurse or technologist will assist in getting the patient dressed into a hospital gown and remove any jewellery or metal objects that might interfere with the study. Any metal objects or jewellery should be removed before taking part. It may also be advised for removal of hearing aids or removable dental work and wearing loose clothing for comfort. Sticky patches known as electrodes will then be placed on your chest so that the doctor can monitor heart rhythm throughout.

Administration of Contrast Dye

During a CT angiography, contrast dye is often used to enhance the visibility of blood vessels and provide clear images. The contrast dye is usually administered through an intravenous (IV) line, inserted into a vein in the arm. It allows the contrast dye to be delivered directly into the bloodstream, ensuring it reaches the blood vessels of interest.

Once the patient is ready, the contrast dye will be injected. Patients may experience a warm sensation or a metallic taste in their mouth as the dye circulates through their bodies. It is a normal reaction and typically subsides quickly. The healthcare team will closely monitor the patient during the administration of the contrast dye to ensure their safety and well-being.

IV is given with an analgesic if required. As it passes through your veins, the contrast dye will light up on images helping your doctor identify blockages or abnormalities within your heart quickly and accurately. CT angiogram results should be ready within a short period.

CT Angiography: During Procedure

After all the pre-procedure precautions, the patient is taken for further proceedings:

Positioning and Scanning

After administering the contrast dye, the patient is positioned on a specific CT scanner table. The positioning may vary depending on the area of the body to be examined. The healthcare team will ensure the patient is comfortable and properly aligned to obtain the best images.

Once the patient is in position, the CT scanner will move through the gantry, a large circular opening in the machine. The gantry contains the X-ray tube and the detectors that capture the images. The patient must lie still during scanning to avoid blurring or distortion of the images.

The CT scanner will capture a series of images, often in multiple phases, to visualise the blood vessels and any potential abnormalities or blockages. Scanning is usually quick and painless, with the CT scanner emitting minimal radiation. The healthcare team will closely monitor the patient from a separate control room, ensuring that the images are high quality and that the procedure progresses smoothly.

One of the essential aspects of a successful CT angiography procedure is for the patient to remain still and relaxed throughout the process. It is necessary to obtain clear and accurate images of the blood vessels. The healthcare team will instruct the patient on achieving a state of stillness and relaxation.

During the scanning process, patients may exercise a breathing technique to follow. It involves taking slow, deep breaths and holding them briefly at specific intervals. This technique helps to minimise any motion artefacts that could potentially affect the quality of the images.

Sometimes, patients may be given a mild sedative to help them relax if they have difficulty staying still. Medication to reduce your heart rate may also be advised in some cases. These can be particularly beneficial for individuals who experience anxiety or claustrophobia in enclosed spaces. The healthcare team will assess each patient’s needs and determine if sedation is necessary to ensure a successful CT angiography procedure.

The duration of a CT angiography procedure can vary depending on several factors, including the scan’s complexity and the body’s area being examined. The entire process, including preparation, administration of contrast dye, positioning, scanning, and recovery, can take anywhere from 30 minutes to an hour.

CT Angiography Post-Procedure

After the procedure, patients may be required to remain under observation for a short time to ensure no immediate complications or adverse reactions occur. The healthcare team will provide specific instructions on any post-procedure care that may be necessary.

In the days following the CT angiography, patients may experience some mild side effects, such as bruising or tenderness at the site of the IV line insertion. Typically, such symptoms are transient in nature and will resolve on their own. However, if any unusual or severe symptoms occur, it is essential to contact the healthcare provider immediately.

After your test, you should usually be able to return home shortly or be asked to remain in the hospital overnight while being monitored by a nurse. Ensure that someone provides transport home from the hospital in case of any complications. Fatigue the day after surgery is common, as your wound site could remain tender for several days afterwards.

Fluid Intake

Patients must drink plenty of fluids following the procedure to help flush out the contrast dye from their system. It can help minimise any potential side effects and ensure a smooth recovery. Patients should also follow their healthcare provider’s instructions regarding medications they may need to take or avoid after the procedure.

Diet recommendations

Your Doctor may ask you to refrain from eating for four to eight hours before the procedure; however, no restrictions on water consumption are present before and after the test. Also, easily digestible food is recommended after the procedure.

CT Angiography: Risks and Complications

Here are the following risks and complications of CT Angiography:

Radiation Exposure Risks

One of the primary concerns regarding CT angiography is the potential risk of radiation exposure. CT scans use X-rays to generate detailed images of the body’s internal structures. While the amount of radiation used in a single CT angiography scan is relatively low, repeated or excessive exposure to radiation can increase the risk of developing cancer in the long term. This risk is especially significant for young children, pregnant women, and individuals’ undergoing multiple CT scans.

To mitigate the risks associated with radiation exposure, radiologists and technicians follow strict protocols to ensure that the amount of radiation used during a CT angiography scan is kept as low as reasonably achievable (ALARA). It includes using the lowest possible dose of radiation necessary to obtain clear images and employing advanced imaging techniques and technologies that minimise radiation exposure without compromising the diagnostic accuracy of the scan. Patients need to let their healthcare providers know if they’ve had any past radiation exposure or worries before undergoing a CT angiography procedure. It will help ensure a more tailored approach to their care.

Allergic Reactions

Another risk associated with CT angiography is the possibility of allergic reactions to the contrast dye used during the procedure. Contrast dye is often administered intravenously to enhance the visibility of blood vessels on the CT images. Most commonly, a type of contrast dye called iodine-based contrast is used, which has been used for decades and is generally well-tolerated by most patients.

However, in some cases, individuals may have an allergic reaction to the contrast dye. Symptoms of an allergic reaction can vary from mild to severe and may include hives, itching, nausea, vomiting, difficulty breathing, or anaphylaxis, a life-threatening allergic reaction. Patients must inform their healthcare providers about known allergies, particularly to iodine, shellfish, or previous reactions to contrast dyes. It will allow the medical team to take appropriate precautions, such as administering antihistamines or using alternative contrast agents if necessary.

While allergic reactions to contrast dye are relatively rare, it is essential for patients to be aware of this potential complication and to communicate any concerns or previous responses to their healthcare providers before undergoing CT angiography.

Contrast-Induced Nephropathy (CIN)

Contrast-induced nephropathy (CIN) is a potential complication following the administration of contrast dye during CT angiography. CIN is characterized by a sudden decline in kidney function after administering contrast dye, increasing serum creatinine levels. It is evident in patients with pre-existing kidney disease or those with risk factors such as diabetes, dehydration, or certain medications.

To minimize the risk of CIN, healthcare providers will evaluate a patient’s kidney function before the CT angiography procedure. Patients with impaired kidney function may be given intravenous fluids before and after the process to help flush out the contrast dye from their system and reduce the risk of CIN. Additionally, alternative imaging options that do not require contrast dye may be considerable for individuals with significant kidney disease or other risk factors.

Renal Impairment Complications

In rare cases, CT angiography can potentially lead to the development or worsening of renal impairment in patients with pre-existing kidney disease. It can occur due to various factors, including the contrast dye’s impact on the kidneys, dehydration during the procedure, or using certain medications that can further compromise renal function.

It is also essential for patients to take steps to protect their kidney health before and after the procedure, such as staying hydrated and avoiding medications that may further impair renal function. Regular monitoring of kidney function following the therapy may also be recommendable for individuals with pre-existing renal impairment.

Anaphylaxis

Anaphylaxis is an exceptional but potentially life-threatening allergic reaction that can occur following the administration of contrast dye during CT angiography. Anaphylaxis is a severe systemic allergic reaction that affects multiple organ systems and can lead to a sudden drop in blood pressure, difficulty breathing, and loss of consciousness.

Patients with a history of severe allergies or previous anaphylactic reactions should inform their healthcare providers before undergoing CT angiography to ensure appropriate measures are in place to manage potential allergic reactions.

Contrast Extravasation

Contrast extravasation refers to the leakage of contrast dye from the blood vessels into the surrounding tissues during or after CT angiography.

To prevent contrast extravasation, healthcare providers take precautions such as using appropriate injection techniques, monitoring the injection site during and after the procedure, and being vigilant for any signs of extravasation. Prompt recognition and management of contrast extravasation can help minimize complications and promote optimal patient outcomes.

Pregnancy and Fetal Risks

Pregnant women are prompted to avoid unnecessary radiation exposure, including CT scans, especially during the first trimester when the fetus is most vulnerable to potential harm. While the amount of radiation used in a single CT angiography scan is relatively low and is unlikely to cause significant damage to the fetus, it is still essential for pregnant women to discuss the potential risks and benefits of the procedure with their healthcare providers.

Rare Complications

While the risks and complications discussed so far are relatively common and well-known, it is essential to note that there are also rare but serious complications associated with CT angiography. These include:

Stroke: In rare cases, the injection of contrast dye during CT angiography may dislodge a blood clot, leading to a stroke. It is more likely to occur in individuals with existing blood clots or those at a higher risk of clot formation.
Allergic reactions to medication: Apart from allergic reactions to contrast dye, some individuals may also experience allergic reactions to medicines used with CT angiography, such as sedatives or pain medications.
Adverse reactions to iodine: While iodine-based contrast dye is generally well-tolerated, there have been reports of rare adverse reactions to iodine, such as thyroid dysfunction or iodine-induced hyperthyroidism.

It is essential for patients to be aware of these rare complications and to discuss any concerns or questions with their healthcare providers before undergoing CT angiography. The medical team will assess the individual’s specific risk factors and provide appropriate counselling and guidance to ensure a safe and effective procedure.

Alternative Imaging Options

In some cases, alternative imaging options are considerably safer than CT angiography. These alternatives do not involve ionising radiation or the use of contrast dye and can provide valuable diagnostic information without the associated risks and complications.

Magnetic resonance angiography (MRA): MRA uses magnetic fields and radio waves to create detailed images of the blood vessels. It helps evaluate brain, neck, and extremities vascular conditions. MRA does not involve radiation of ionising type and is generally considered safe for most individuals, including pregnant women and children.
Ultrasound: Ultrasound imaging uses high-frequency sound waves to create images of the body’s internal structures. It is a non-invasive and radiation-free imaging modality commonly used to evaluate blood flow and detect vascular abnormalities. Ultrasound is safe for individuals of all ages, including pregnant women and infants.
Doppler ultrasound: Doppler ultrasound is a specific form that assesses blood flow within the blood vessels. It can provide valuable information about the velocity and direction of blood flow, helping to diagnose conditions such as deep vein thrombosis or peripheral arterial disease.
Digital subtraction angiography (DSA): DSA is an invasive imaging technique involving the injection of contrast dye directly into the blood vessels. It provides highly detailed images of the blood vessels and is considered the gold standard for certain vascular interventions. While DSA carries its risks and complications, it may be necessary when other imaging modalities are inconclusive or insufficient.

CT Angiography Cost in India

A CT coronary angiography can be a valuable diagnostic tool for anyone concerned about heart health. This non-invasive test uses X-rays and a special dye to create a detailed image of your heart’s blood vessels and identify any blockages. But with any medical procedure, cost is always a consideration.

Heart angiography costs in India can vary based on several factors. Geographical location plays a significant role in determining the price, with major metropolitan cities generally having higher CT angiography costs in India compared to smaller towns or rural areas. The reputation and expertise of the medical facility conducting the test also influence the price, as more renowned hospitals or specific cardiac centres may charge higher fees for their services.

CT coronary angiogram cost in India ranges from Rs 9000 to Rs 15000, depending on various factors and the type of facility used in performing the test. It’s always wise to check specific hospitals, diagnostic centres, or clinics to get up-to-date information on current CT angiography prices in India.

Al-Afiya Medi Tour is a leading medical tourism company based in India and has strong relationships with the best hospitals in the country. We provide exceptional support and advice to both domestic and international clients regarding expenses.

CT Scan Angiography Hospitals India

When performed by a specialized team with access to the best available facilities, a CT scan can aid the doctor in analysing a defect. The top hospitals in India offer outstanding facilities for CT scans and other services all in one location. The patients can benefit from Al-Afiya Medi Tour, which is interlinked with various top hospitals in India and can provide great assistance and guidance for national and international people. CT scan hospitals are present throughout the country, and people are free to choose the place and hospital of their choice. The hospitals in India have state-of-art architecture and eminent facilities in one place for convenience and ease of patients and attendees. Below is a list of a few CT scan centres and hospitals in India-

Apollo Hospitals, Greams Road, Chennai.

Indraprastha Apollo Hospital, New Delhi.

Kokilaben Dhirubhai Ambani Hospital, Mumbai.

Manipal Hospital (Old Airport Road) Bangalore.

Apollo Hospitals, Jubilee Hills Hyderabad.

Fortis Memorial Research Institute, Gurgaon

Medanta The Medicity.

Dr. Lal PathLabs.

3d Diagnostic Centre.

City X-Ray & Scan Clinic Pvt Ltd.

Fortis Escorts Okhla.

Uttrabulls Diagnostics Pvt Ltd.

Thyrocare Aarogyam Centre.

Vrinda Diagnostic Centre Pvt Ltd.

CT Scan Angiography Doctor India

Angiography is necessary, and only for people with heart defects, and requires specialist doctors to perform the scan. The top hospitals in India have skilled and talented faculty of doctors and radiology teams to perform tests and other vital procedures for the patients. Al-Afiya Medi Tour has connections with the best doctors and hospitals in India which is helpful for international and national patients too. With the help of the team, you can reach the doctor of your choice for medical advice and treatment. The best CT scan angiography doctors are excellent in providing services and guidance for the treatment plan suitable as per the health condition, side-effect, and choice of the patient. Below is the list of a few CT scan specialists in India –

Dr. K.K.Talwar

Dr. Col V Hariharan

Dr. Rajiv Bajaj

Dr. Upendra Kaul

Dr. Ashok Khera

Dr. Z. S. Meharwal

Dr. Yugal K Mishra

Dr. Ranjan Kachru

Dr. K. K. Saxena

Dr. Aparna Jaswal

Dr. Ashok Seth

Dr. Atul Mathur

Conclusion

CT angiography has emerged as a groundbreaking and non-invasive imaging technique that provides intricate details of the cardiovascular system, aiding in diagnosing and treating various vascular conditions.

By employing advanced technology and contrast dye, physicians can obtain high-resolution, three-dimensional images of blood vessels without requiring invasive catheterization.

While risks and rare complications are associated with CT angiography, such as radiation exposure and allergic reactions, the benefits of accurate and timely diagnosis far outweigh the potential drawbacks. Healthcare providers must counsel patients thoroughly, address concerns, and obtain informed consent to ensure safe and effective procedures. With CT angiography’s ever-improving precision, it continues to shape the future of cardiovascular healthcare in India and beyond.