Q. My doctor advised angiography after seeing my echo reports. Why?

Answered by
Dr. Sagar Ramesh Makode
and medically reviewed by Dr. Nithila A
Published on Aug 01, 2019

Hello doctor,

As I am feeling tired of walking, my company doctor suggested for ECG, and it showed no abnormality, after which he suggested going for ECHO. The ECHO report shows as follows, ECHO diagnosis RWMA, trivial MR, grade I LV diastolic dysfunction, no pericardial effusion or clot. Now doctor had advised me to for angiography to see the exact one. Please advice.

Dr. Sagar Ramesh Makode

Cardiology General Medicine Internal Medicine
#

Hello,

Welcome to icliniq.com.

I have gone through your reports (attachment removed to protect patient identity). In ECG, there is RBBB (right bundle branch block), and ECHO shows RWMA (regional wall motion abnormality) and mild LV systolic dysfunction. There is a mild cardiac dysfunction, so you should undergo coronary angiography rather than CT as there is evidence of blockages on echo. We must address those blockages to prevent further decline in heart function.

Your medicines are fine, but it would be better if you can request your doctor to add beta-blockers like Metoprolol to improve the heart function. Also, your sugars are entirely uncontrolled, which has played an important role in causing these blockages. So, sugars should be well controlled. Continue to have daily walking or brisk walking. Low calorie and a low oily fatty diet. Also, you should start regular medicines like Aspirin and Statins and have it without default. So overall, it is better to go for coronary angiography. If you do not want to undergo any significant angiography then alternatively you may have CT coronary angiography which if shows abnormalities then finally will need coronary angiography. I hope this helps you and get back if you have any doubts.

Thank you doctor,

What is the difference between coronary and CT angiography? Is there any risk in coronary angiography. If your opinion confirms about blockage in heart vessels, then what will be the treatment whether surgical or taking medicines?

Dr. Sagar Ramesh Makode

Cardiology General Medicine Internal Medicine
#

Hello,

Welcome back to icliniq.com.

Usually, both are safe, but coronary angiography is a more invasive procedure and carries relatively more risk than CT coronary angiography. However, it is more accurate than CT coronary angiography. The method of choice in you is coronary angiography. If blockages are severe and more than 80 percent, then it needs angioplasty or bypass according to the number of blockages, if less than that, then treatment can be done through medicines.

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