Angiogram and Angioplasty.

Thursday, the 4th of December, 2014; will always be in mind. It was the first time, in my 53 years of living, that I was hospitalized. Everything happens for good reason(s). I would like to share my story, as to assist others to go through the pace and experience of angiogram and angioplasty.

From Google translate,
Angiogram is:
An X-ray photograph of blood or lymph vessels, made by angiography.
“Dye is injected through the catheter, and the X-ray machine takes angiograms of your heart and blood vessels.”

Angioplasty is:

Surgical repair or unblocking of a blood vessel, especially a coronary artery.
“Further cases may be detected by searching for coded coronary artery operations such as bypass surgery or angioplasty .”

Beginning of my story.

At The Clinic.

On Thursday about 8 pm, I went to a clinic in Kota Damansara. Felt some uneasiness in my left chest. They did the basic checks using stethoscope and ECG (Electrocardiogram : a record or display of a person’s heartbeat produced by electrocardiography). All was normal. However, when they checked my BP (Blood Pressure : the pressure of the blood in the circulatory system, often measured for diagnosis since it is closely related to the force and rate of the heartbeat and the diameter and elasticity of the arterial walls.) it was 180/100. A normal BP should be about 125/70, for those above 50 like me, ideally about 135/80.
So the doctor requested that I went to the emergency ward of the nearest hospital. As I was feeling fine, I requested the doctor to check again my BP. The doctor asked me to rest for 30 minutes, before checking again. My BP was still 180/100 after half an hour of rest. I was instructed immediately to go to the nearest hospital. Took a medicine to lower my BP which was given by the doctor, and I was on my way to the nearest hospital.

At The Hospital.

At about 9 pm, I was at the hospital. I was feeling fine. Walked into the emergency ward, with my referral letter. The emergency doctor attended me. Again checked my BP. It went down to 157/90. The doctor says I can go home after doing another ECG. I obliged and did the ECG. The nurse apologized after doing the first ECG, and requested to do a second one. After the nurse did the second ECG, the doctor came to see me. I was perplexed on the aghast look of the doctor. The doctor said, “I am very sorry, but I have no choice to admit you to the hospital”. He explained, in the first ECG, my heartbeat was irregular. Only for that moment it was captured during the ECG. The second ECG, done one minute later, it was normal. For that split moment, at that exact time, the ECG managed to capture the irregularity. If not I was already on my way back home.

Friday, 5 th December 2014.

The Cardiologist came to see me at the ward. Explained to me the options that I can explore. The basic thing to do is an echo test for the heart, and stress test (a test of cardiovascular fitness made by monitoring the heart rate during a period of increasingly strenuous exercise.) to determined the condition of my heart. From these two test, then only can the Cardiologist give a better opinion on my condition.

Obliging, I did the two test. The echo test (similar to the baby scan for pregnant women) was done. Seems to be normal. From the outside outlook, the heart is normal.

Then I did the stress test. Walking on the treadmill. Supposedly to go up to the 4th level. I gave up on the 3rd level. No chest pain, but was tired.

After discussing with the Cardiologist, I was advised to go for an angiogram. I was assured that the risk factor for the procedure is about 1 percent. If two or less, major arteries are blocked  more than 50 percent, the advise given was to go for an angioplasty. If all three major arteries are blocked, than a heart bypass surgery (Heart bypass surgery creates a new route, called a bypass, for blood and oxygen to reach your heart) is highly recommended.

The angiogram was scheduled for the next day. My BP was monitored closely. It went, yo-yo, high in the early mornings, normal nearing the afternoon and up again in the evening. At one time it shot up to 190/100. I have no idea why is my BP so high. I am resting in bed! The wonderful part is that I am feeling fine.

In the late evening, the nurses, shaved the little hairs I have on my wrist. Was embarrassed when the two nurses, shaved my groin. I actually apologized to both of them.

Saturday, 6th December, 2014

The angiogram was scheduled at 11 30 am. So I had to have my breakfast before 6 am. Fasting for a minimum of four hours is needed. I was sleeping most of the morning, as I do not want my BP to spike.

At about 12 noon, they wheeled me to the operating theater. Soon I was in the operating theater, with the technicians busy preparing for the angiogram procedure. I was focused on wanting to know the condition of my heart and its arteries. Like all believers, I prayed to Allah S.W.T. so that there will be no major issues during the procedure. God willing.

Meticulously and diligently the technicians setup the machine and gadgets. Cleaned my wrist and groins. ( They gave me disposable underwear). It was there I found out why? The technician, cut the underwear on the right side of my groin. All sorts of wires, cables and clips are attached to all parts of my body. If during the procedure, any issues arises while using the wrist, then the procedure have to be carried out through the groin. Because of the veins through the wrist is smaller or twisted, it maybe not viable to proceed.

The difference, going through the wrist or groin is that, through the wrist, you will heal and be mobile earlier and  faster. If the procedure is through the groin, you cannot move for a minimum of six hours, while if through the wrist, you cannot move the wrist for at least four hours, but you can walk around if you want to.

The Angiogram.

At about 1 pm, the technicians is ready with all the preparation, and the Cardiologist arrived shortly. As was briefed earlier, the procedure will use Local Anesthetic (LA). What it means is that the procedure will be done, while you are awake. Exciting! And it reduces the risk factor. It started with the Cardiologist administering the LA on the wrist. A very small cut is made. Feels like being bitten by the red ant. Then a small tube is inserted into the cut vein in your wrist. Yes, it was all done while the Cardiologist is talking and chatting with you.

Through that tube, a catheter is introduced into the vein. I cannot feel it moving in my veins, but I can hear it as it passes by my right side. Then a dye is used to mark the the veins. With this special dye, photos or X-ray like pictures can be taken on all the major arteries to the heart. Normally, we have a major, right and left artery. Normally the right artery is dominant than the left artery.

The cardiologist informed me, that my left artery is dominant than the right artery. My right artery is so small and it is 100 percent blocked. My main artery is 80 to 90 percent blocked. I am so lucky, that my left artery is huge and not blocked! Very Lucky!

The diagram below is an example of a normal heart and arteries for you to visualize what I am writing about. In my case, my main artery is number 5 in the diagram below. My right artery is number 2, and my left artery is number 4 (if I am not mistaken).

Heart

More bad news, my main artery is blocked for about 70 mm (7 cm) long. Nothing can be done for my right artery as it was too small and 100 percent blocked. Thus the recommendation given is to put in two stents for the 90 percent blocked main artery. There in the operating theater, I felt, I just want to get it over with. I am thankful, I do not need to do a by-pass. I gave permission to proceed with the angioplasty, putting in two stents.

The Angioplasty. 

It was about 1 20 pm when the procedure started. I can hear again the catheter moving in my vein. This time around, I can feel uneasiness in my chest. I immediately informed the Cardiologist, as the feeling is very new to me. The Cardiologist instructed to one of the technician to administer oxygen to me. The uneasiness disappear immediately and the Cardiologist gets back to his work. If I am not mistaken it was at this point that the balloon was inserted into the blocked artery to widen the path so that the stent can be placed accordingly.

The below diagram might assist you to understand what I am writing about.

Balloon

After a short while, I can feel a bearable pain (like being cut with a knife) in my chest. Apparently the first stent was put into place. And soon after the second stent was put overlapping the first stent. The pain inserting the second stent was slightly less. I can feel the “uneasiness” when the stent is being expanded by the inflated balloons.

The below diagram is how the stenting process done.

Stenting

By about 2 10 pm all was done. I managed to thanked the Cardiologist and all the technicians for their superb job.

I did not feel any pain or discomfort in my chest after the procedure. But I felt tired after “The harrowing ordeal”. Throughout the whole procedure, I was keeping my mind focus on getting through the procedures, only after it was all done, that I realized how harrowing it can be. That was when I decided to write about this invaluable experience. To share with others that the whole procedure is like brisk walking in the park. Some uneasiness and a little bit of pain.  Just keep on taking the strides.

The Recuperation Period.

I was wheeled back into the ward at about 2 20 pm. Relieved and tired.

At about 2 30 pm, some of my blood brothers came for a visit.

Hospital

I thanked Allah S.W.T. for the smoothness of the procedures. Thank you to the doctors, cardiologist, technicians, nurses, food caterer, cleaners and all staff of the clinic and hospital for your dedication. Thanks a lot to my family, relatives, blood brothers, friends, teachers, and all of you; for your never ending prayers for my well being and presence in my time of need. Alhamdulillah.

I was discharged on Sunday 7th of December, 2014.

Today I am recuperating at home and writing this invaluable experience of mine. I always share with anyone that is willing to share with me, mine and their experience. I always said, only those that has tasted the honey, will be able to share and convey how the honey tasted. I hope by sharing this experience going through angiogram and angioplasty will ease “the harrowing experience” one might think or feel what they will go through.

What I have learned?

1) Eat right.

2) No smoking.

3) Do your best now.

4) Live your life.

5) Be prepared.

6) Be grateful.

7) Focus on what you want.

8) We can get what we want!

The Cost.

About RM 32, 700.00 (Approximately USD 10,000.00) borne by insurance. Thank you and Alhamdulillah.

NOTE: This sharing of experience is only for your understanding and guide. NEVER use it as a diagnose of your condition. Get a specialist to advice you accordingly.

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8 comments on “Angiogram and Angioplasty.

  1. Very informative Rostam. I had experienced the same thing up until the stage Angiogram, where they found out that there is no blockages. I am not allowed to move the right leg up to 6 hours after the procedures to allow the cut in the main artery to heal.

  2. This is one honey that I hope I don’t need to taste.
    sorry that I could not visit you as I hv been unwell for the last few days myself

  3. Well written Bro Rostam. Thank you for sharing; May Allah continue to shower His blessing upon you & your loved ones

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