Q. Doctor, what is an angiogram and why have I been asked to have one done?
A. An angiogram is a type of x-ray test that is done to see the blood flow in an artery or vein. It is normally used to examine the blood vessels in the chest, head, back, arms, legs and abdomen.
- A coronary angiogram looks at the arteries near the heart.
- A pulmonary angiogram at those near the lungs.
- A cerebral angiogram is used for the blood vessels near the brain.
- Carotid angiogram examines the blood vessels in the head and neck.
- An aortogram examines the aorta.
- A peripheral angiogram looks at the vessels in the arms and legs.
How it is done
A thin tube known as a catheter is inserted into a blood vessel in the groin or just above the elbow and guided to the area to be examined. An iodine dye is injected into the blood vessel to provide contrast and make the x-ray image more clear. The images are studied by a cardiologist to determine what, if any, problems exist and to decide on the course of treatment.
Two variations of the normal angiogram are the computed tomography angiogram (CTA) and the magnetic resonance angiogram (MRA). These tests are less invasive than the normal angiogram. Some of these tests, depending on the specific nature, require the use of a contrast dye. A CTA also involves radiation exposure. Your cardiologist will decide on which option is best for you.
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Why it is done
The common reasons are to:
- Find problems that affect the flow in the blood vessels. These include tears in the vessels, weaknesses in the vessel walls and narrowing that restricts the flow.
- Find changes in the blood vessels in organs that may be damaged or injured and which contribute to the problem.
- Reveal the pattern of blood flow to a tumor. This will help in determining the way the tumor is spreading and will assist in deciding on the course of treatment.
- Understand the condition of diseased blood vessels in the leg which can result in severe pain when walking.
- Examine the nature of atherosclerosis in the coronary arteries.
- Locate the source of internal bleeding as occurs when an ulcer is present.
- Show the location, condition and number of renal arteries before a kidney transplant is performed.
Q. Doctor, my wife has been diagnosed with Osteoporosis. What does this mean and what treatment should she receive?
A. Osteoporosis is a condition in which the bones become brittle and weak and thus more prone to fractures. In some cases even a mild fall can cause bones to break. In the most severe cases, even a hard spasm of coughing can result in a fracture. Bone is tissue that is constantly being broken down and replaced. When the replacement cannot keep pace with the bone loss, it is called Osteoporosis. Fractures of the hip, spine and wrists are among the more common, but any bone can be affected. The condition affects both men and women. However, older women, especially those who are past menopause, are most at risk.
When you are young, your body will produce new bone faster than it is lost. This results in high bone mass and strong bones. The early 20s is when the bone mass is usually the highest. Those who have been healthy in their youth, had a good diet and proper exercise will have stored up a lot of bone mass which will reduce their chances of contracting Osteoporosis.
Also Read: Treatment for Osteoporosis
The Treatment
The treatment will depend on the results of a bone density test which will reveal the amount of bone mass loss. Bone density testing is done using DEXA scan and based on this, the risk of fractures will be evaluated. If the risk is low, the treatment could be limited to changes in your wife’s diet and lifestyle to stop or reduce any activities that could put the bones at risk. If the risk is higher, medication in the form of bisphosphonates may be prescribed. The medication can be taken both orally and intravenously. Also long term injections will remove the need to remember and monitor weekly or monthly oral medication schedules. Your doctor will decide on what is best for your wife.
Also Read: What Women should know about Osteoporosis
In the case of women, if the problem has set in soon after menopause, hormone therapy can be effective. Estrogen can help to maintain bone mass. However, because of the possible side effects, this is usually prescribed only if the menopausal symptoms also require treatment.
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