HomeAnswersCardiologyangiographyBased on the attached reports, is angiography the right course of action?

I have attached my mother-in-law's ECG and echo. Is angiography necessary?

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The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.

Medically reviewed by

Dr. Sneha Kannan

Published At August 31, 2020
Reviewed AtDecember 21, 2023

Patient's Query

Hi doctor,

My mother-in-law's pulse had drastically fallen twelve years back, and she was admitted to a hospital. Subsequently, a pacemaker was inserted. It was replaced four years. Today we went for a routine checkup, as she complained of upper back pain and blackouts yesterday. The hospital had done the ECG and echo today and told us that she needs an angiography. Please advise us whether it is the right course of action. We are very anxious about the procedure. I am attaching the prescription, ECG, and echo for your reference.

Thank you.

Hello,

Welcome to icliniq.com.

Please describe her symptoms in detail, including back pain and blackouts. Did she experience interruption while getting up from sleep or while sitting? Is she experiencing back pain recently or for a long time? Any worsening of pain from movements? Now her Echocardiography is subtle, and ECG (electrocardiogram) shows paced rhythm, which is fine with the pacemaker pacing her heart. So I do not see any indication based on reports (attachment removed to protect patient identity). However, she may consider angiography if she has typical symptoms of heart attack or disease like chest pain (or even back pain sometimes) on exertion associated with sweating and uneasiness. Even otherwise, angiography nowadays is not a major test; she may undergo it to clarify things. Alternatively, she may undergo CT (computed tomography) and coronary angiography.

Thank you.

Patient's Query

Hi doctor,

We have checked with our mother-in-law. Regarding the back pain, she says it started only recently, around 15 days back, and she gets it back only when she stands for a long time; otherwise, she does not have back pain. The blackout happened once when she stood in the kitchen for almost half an hour, lasting for ten minutes. She also gets dizziness immediately after lying down but not every day. And she also has diabetes. We have also noticed that her diet is minimal, and maybe she is getting dizziness because of that. Please advise.

Thank you.

Hi,

Welcome back to icliniq.com.

Her symptoms are not very suggestive of a heart attack. Back pain is probably related to musculoskeletal causes like spinal issues. Dizziness is probably related to postural hypotension rather than cardiac. Cardiac pain typically occurs on exertion and relieves with rest (not related to standing). However, some blockages are expected at this age and being diabetic. So your mother-in-law may undergo angiography or CT coronary angiography to look for the status of blockages.

Thank you.

Patient's Query

Hi doctor,

I consulted you about my mother-in-law and shared her ECG and Echo, but I feel it will be better if you can see her personally. Is it possible?

Thank you.

Hi,

Welcome back to icliniq.com.

You may subject her to computed tomography coronary angiography if you are concerned about the conventional angiography. It will clarify our doubts regarding blockages.

Thank you.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Sagar Ramesh Makode
Dr. Sagar Ramesh Makode

Cardiology

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