Thursday, May 17, 2012

25.0 Risiko Angiogram




Courtesy of Intermountain Medical Imaging, Boise, Idaho. All rights reserved.

An angiogram is an X-ray test done to take pictures of the blood flow in an artery or vein. During the test, you lie on a table and a dye is injected into a blood vessel in the groin or elbow. A special camera takes pictures of the dye as it moves through the blood vessels.

In this picture, the radiologist uses monitors and table controls to position the person before an angiogram. The large C-arm can turn to take X-ray pictures from many different angles.

Medical Review: Kathleen Romito, MD - Family Medicine & Andrew Swan, MD, CCFP, FCFP - Family Medicine & Howard Schaff, MD - Diagnostic Radiology
(Last Revised: February 7, 2011.  Author: Healthwise Staff)

Setiap procedure perubatan mengandungi risiko yang perlu diambil oleh setiap pesakit. Malah mengambil atau memakan ubat juga ada kesan sampingan dan risiko. Oleh itu, ikutlah nasihat doktor pakar.

Mengapa Angiogram diperlukan?

Your doctor may recommend that you have a coronary angiogram if you have:
  • Symptoms of coronary artery disease, such as chest pain (angina) 
  • Pain in your chest, jaw, neck or arm that can't be explained by other tests
  • New or increasing chest pain (unstable angina)
  • A heart defect you were born with (congenital heart disease)
  • Heart failure
  • Other blood vessel problems or a chest injury
  • A heart valve problem that requires surgery
You may also need an angiogram if you're going to have surgery unrelated to your heart, but you're at high risk of having a heart problem during that surgery.

Because there's a small risk of complications, angiograms are usually done after noninvasive heart tests have been performed, such as an electrocardiogram, an echocardiogram or a stress test.

(Rujukan: http://www.mayoclinic.com/health/coronary-angiogram/MY00541/DSECTION=why-its-done)

Risiko dan komplikasi dari Kaedah Angiogram

As with most procedures done on your heart and blood vessels, coronary angiogram has some risks. Major complications are rare, though. Potential risks and complications include:
  • Heart attack
  • Stroke
  • Injury to the catheterized artery
  • Irregular heart rhythms (arrhythmias)
  • Allergic reactions to the dye or medications used during the procedure
  • A tear in your heart or artery
  • Kidney damage
  • Excessive bleeding
  • Infection
  • Blood clots
  • Radiation exposure from the X-rays

(Terjemahan dari artikel asal)  Kemungkinan ujudnya masalah utama dari Angiogram adalah terlalu kecil tetapi beberapa masalah akan ujud. Dalam keadaan kes biasa, masalah timbul dalam masa 2 jam selepas menjalani Angiogram ketika kita berada di bilik pemulihan. Jika ujud masalah ketika Angiogram, ujikaji tidak akan dilengkapkan. Kita mungkin memerlukan rawatan segera (kecemasan) termasuklah pembedahan.

Terdapat kebarangkalian/kemungkinan tindakbalas allergik (allergic reaction) terhadap dye iodine. Tindakbalasnya boleh jadi sederhana (rasa gatas dan bebintik ruam) atau lebih terok (masalah penafasan atau sudden shock).  Kebanyakan tindakbalas-tindakbalas boleh dirawat dengan ubat. Pastikan anda memaklumkan doktor jika anda mengalami "hay fever" (Allergic rhinitis, often called hay fever, is an overreaction of the immune system to particles in the air that a person breathes. This overreaction causes inflammation and symptoms such as sneezing; a runny, stuffy, or itchy nose; and itchy, watery eyes. Other symptoms of allergic rhinitis may include a temporary loss of the sense of smell, headache and fatigue, dark circles under the eyes, and mucus draining from the nose down the back of the throat (post-nasal drip)) atau asthma atau allergi iodine atau allergi makanan.

There is a small chance that the catheter may damage a blood vessel or dislodge a piece of clotted blood or fat from the vessel wall. The clot or fat can block blood flow to the brain, arm, leg, or intestine (bowel).
Bleeding from the needle site may occur. Also, a blood clot can form where the catheter was inserted. This may cause some blockage of the blood flow in the arm or leg.

The iodine dye used for the test can cause water loss or direct damage to the kidneys. This is a special concern for people who have kidney problems, diabetes, or who are dehydrated. Special measures are used during the test to prevent problems for people who need an angiogram and have these conditions.
There is always a small chance of damage to cells or tissue from being exposed to any radiation, even the low level used for this test.

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