Can you get a heart attack during an angiography?

Angiography is a common test done to visualise blood vessels in the heart, looking for blockages or narrowing that could result in heart disease.

Recently, an acquaintance complained of mild chest pain and discomfort after dinner. The 33-year-old male was rushed to a hospital in Chennai where an Echocardiogram and ECG were done. While both results came out normal, he was kept under overnight observation, which was followed by a treadmill ECG in the morning. Since this test result showed a variation, he was advised an angiography (a procedure that uses X-rays to produce an angiogram to reveal the health of blood vessels) during which he had a major heart attack and collapsed.

With only 10 per cent of his heart functioning, the doctor suggested a transplant. Now his left leg, until mid-thigh, has been amputated which has improved heart functioning by one per cent and if the patient remains stable, a heart transplant may not be required.

Taking a cue from this case, let’s understand the odds of getting a heart attack during angiography, a common test done to visualise blood vessels in the heart, looking for blockages or narrowing that could result in heart disease.

According to Dr Brajesh Kumar Mishra, interventional cardiologist and cardiac electrophysiologist, Manipal Hospital, Gurugram, it is often performed when one has symptoms of chest pain or shortness of breath or if there’s suspicion of a heart condition. “While generally considered a safe procedure, patients sometimes report a little anxiety regarding the risk involved,” said Dr Mishra.

What happens during the test?

It is a relatively non-invasive test. A thin tube, also called a catheter, is inserted via a vein — usually in the groin or wrist — and is advanced towards the heart. “A specialised dye is injected which allows for blockages or narrow arteries to be visualised under X-ray guidance by the doctor,” said Dr Mishra.

Can a heart attack occur?

Dr Mishra told indianxpress.com, “Although very rare, it may result in the complication of a heart attack”. “The occurrence of a heart attack during an angiogram is usually less than 0.001 per cent, especially for those patients who are being diagnosed through the procedure. Most of the patients do not experience any severe problems while undergoing the procedure,” said Dr Mishra.

In most instances of a heart attack occurring, Dr Mishra explained that it is usually based on the prevailing condition of the heart, such as severely clogged arteries, that the angiogram tests for. “A probable dislodgment of the plaque or rupture of plaque in the arteries by either the catheter or dye may cause the blockage that may bring about a heart attack. The doctors are, nonetheless, fully trained to take swift and appropriate action in case such a possibility may arise,” said Dr Mishra.

How to avoid complications?

Physicians take many precautions to avoid complications, even heart attacks, asserted Dr Mishra. “You will be thoroughly screened for the procedure by blood tests and imaging to make sure your heart is in stable condition. The procedure itself is controlled by very experienced cardiologists,” said Dr Mishra.

What to keep in mind?

However, Dr Vidya Suratkal, cardiologist, Lilavati Hospital Mumbai emphasised that it is important to note that the risk of choosing not to undergo an angiogram is even greater if you have symptoms of a heart attack such as chest pain or discomfort, tightness in the chest, difficulty in breathing, or weakness, especially on the one side of the body. “If you are concerned or curious about the risks associated with the angiography process then consider consulting a doctor for detailed discussion,” said Dr Suratkal.

https://indianexpress.com/article/lifestyle/health/possible-to-get-heart-attack-during-angiography-procedure-angiogram-experts-9551581/