Coronary Angiography (Mr DD)

CT, a 64 year old male, presented with atypical chest pain. He had a medical background of type 2 diabetes mellitus and high cholesterol. His previous echocardiogram a few years ago showed good biventricular systolic function (good pumping action of the parts of the heart that pump blood to the rest of the body). A more recent ECG (electrocardiogram) showed left ventricular hypertrophy (thickening). He was offered a diagnostic coronary angiogram with the access point being through the right radial artery (in the wrist) using a 6F Impulse catheter. The test revealed mild disease within the left anterior descending artery.

SA, a 59 year old male, underwent a coronary angiogram as part of the work up for a coronary artery bypass graft (CABG). He had a background of high blood pressure, obesity, ischaemic heart disease (with previous coronary angiogram) and smoking. He underwent a further coronary angiogram through the right radial artery (in the wrist) with a 6F TIG catheter. The test showed severe disease in the left circumflex and right coronary arteries, as well as a patent (opened) stent in the left anterior descending artery. Lesions were found to be suitable for angioplasty. The patient was referred back to the cardiothoracic surgeons for further discussion regarding his treatment.

PD, a male aged 64, presented with exertional shortness of breath, absent of chest pain. His medical background included high blood pressure, high cholesterol and a family history of coronary artery disease. He was offered to have a coronary angiogram through the right radial artery (in the wrist) using a TIG 5F Diagnostic catheter. The test revealed moderate ostial posterior descending artery stenosis which was crossed with a Verrata wire and no change in the pressures across the lesions were shown.

WS, a 43 year old male, presented with chest pain. His medical background included high blood pressure and smoking. He underwent a coronary angiogram through the right radial artery (in the wrist) using a TIG 5F Diagnostic catheter. The test revealed mild disease within the left anterior descending artery alongside some mild vessel spasm seen in the right coronary artery.

Mr GD started experiencing severe chest pain. When the ambulance service arrived they noted abnormalities on his ECG suggestive of a heart attack (ST segment elevation myocardial infarction). Therefore he was brought as an emergency to the cardiac catheterisatiojn lab. On arrival he was reviewed by the interventional cardiology team who though he was having a ongoing heart attack. He had coronary angiogram that revealed a blocked blood vessel supplying the heart that was causing his symptoms. It demonstrated blockage of the left circumflex coronary artery- one of the arteries supplying heart. This was treated with percutaneous (through the blood vessel in the right arm) coronary angioplasty as an emergency. This was performed by relieving the blockage with the use of a coronary angioplasty guide-wire into the blood vessel and then deployment of a drug eluting stent (3mm diameter) to his left circumflex coronary artery. It was also noted in addition to the block blood vessel (treated as an emergency) the patient had severe narrowing in other blood vessels, these were treated at a later date without complication.

AS, a 71 year old woman, came in with recurrent chest pain and shortness of breath. Her risk factors included high cholesterol, high blood pressure and family history of coronary artery disease. She was offered coronary angiogram which was accessed through the right radial artery (in the wrist) with a 5F TIG diagnostic catheter. The test showed no abnormalities.