Role of Non-Invasive Angiography for diagnosis and treatment of CAD

Heart disease is one of the leading causes of death globally. According to the World Health Organization, an estimated 17.9 million people died from CVDs in 2019. Amongst these numbers, coronary heart disease has emerged as one of the most common types of this disease.

India doesn’t fall far behind when it comes to fatality in heart diseases. Indians are known to have among the highest coronary artery disease (CAD) rates in the world. The Global Burden of Disease study indicates that the death rate of age-standardized cardiovascular diseases is 272 per 1 lakh people in India, much higher than the global average of 235. 

Given how widespread coronary artery disease is, it is important to deep dive into the disease and how Non-invasive Angiography can help detect and manage this illness:

• What is Coronary Artery Disease?
• What is Non-Invasive Angiography?
• When is a Non-Invasive Angiography likely to be recommended by your doctor?
• Non-Invasive Angiography – a boon for Heart specialists & surgeons

What is Coronary Artery Disease (CAD)?

Coronary Artery Disease (CAD), also referred to as coronary heart disease or ischemic heart disease, is among the most prevalent types of heart disease in the world. 

CAD is caused by the build-up of plaque in the walls of the arteries that supply blood to your heart (known as coronary arteries) and other parts of your body. Plaque consists of cholesterol, fatty substances, cellular waste products, calcium, and fibrin, among other substances in the arteries. This causes the inside of the arteries to narrow and stiffen over some time, leading to a partial or complete flow of blood (This is known as atherosclerosis).

What is Non-Invasive Angiography?

Before we get into how Non-Invasive Angiography can help those diagnosed with CAD, let us first understand what non-invasive Angiography means. 

A Non-Invasive Angiography is an imaging test used to study the arteries that supply blood to your heart. This type of Angiography uses an X-Ray machine to produce images of your heart and related blood vessels. As the name suggests, this procedure is completely non-invasive and does not require any recovery time, unlike an Invasive Angiography, which is why more doctors and patients prefer this method.

In a Non-Invasive Angiography, a dye or contrast material is injected into the patient’s hand, after which imaging of the heart’s blood vessels is done using an advanced CT scan machine. This procedure has fewer side effects than an invasive angiography and is useful in the early detection and screening of heart disease.
Non-Invasive Angiography is more effective than invasive angiography. It can be used to diagnose several heart conditions and may be recommended by your doctor to determine the cause of chest pain or other symptoms.

When does a Doctor recommend a Non-Invasive Angiography? 

(Applications of Non-Invasive Angiography)

A Non-Invasive Angiography is helpful in the following scenarios: 

• To understand how many of a patient’s coronary arteries are blocked
• To determine the exact location of the blockages 
• To see the extent that the flow of blood is blocked through blood vessels
• To check previous coronary bypass surgery

Non-Invasive Coronary Angiography has increasingly become the preferred imaging tool in evaluating patients at risk for coronary artery disease (CAD). The two most common Non-Invasive Coronary Angiographies are Multidetector Computed Tomographic (MDCT) Angiography and Cardiac Magnetic Resonance (MR). 

Multidetector Computed Tomographic (MDCT) Angiography provides an excellent negative predictive value (≥ 95%) for the absence of coronary artery disease. It is very useful in evaluating allograft vasculopathy, bypass grafts, and degenerative aortic valve disease. In emergency cases, with the help of one single MDCT scan, both cardiac and non-cardiac causes of acute chest pain can be ruled out.

The current cardiac magnetic resonance (MR) technology lacks the spatial resolution of MDCT, limiting its ability to assess coronary vasculature. However, the proximal coronary arteries can be assessed as well as myocardial function and viability. This can be done without any exposure to contrast dye or ionising radiation. Cardiac magnetic resonance is also very useful to characterise coronary plaques and determine whether they have progressed or regressed over time.

How is the advent of Non-Invasive Angiography helping Heart Specialists & Surgeons?

As with any new technology, the increasing availability and usage of non-invasive angiographies have come as a boon for heart specialists and surgeons. Some of the major reasons are:

• A Non-Invasive Angiography may eliminate the need for a patient to undergo surgery. If at all surgery is required, it can be performed far more accurately with the results of the Non-invasive Angiography.
• A CT Angiography could give much more accurate anatomical detail than other imaging techniques, especially for small blood vessels.
• A Non-Invasive Angiography is faster and is likely to have fewer complications.

According to the World Health Organization, about three-quarters of the Cardiovascular disease (CVD)-related deaths that take place globally happen in low- and middle-income countries. This is mainly because people in these countries usually do not have the same access to primary health care programs that many in the developed world do. This makes the early detection and treatment of people with risk factors for CVDs all the more challenging. Hence, due to the late detection, many people die at a young age from CVDs, which could happen in their most productive years.

The advent of technology such as Non-Invasive Angiography is certainly the right step in the early detection and treatment of heart diseases, especially coronary heart diseases. Even in smaller cities like Ranchi, Non-invasive Angiography is now accessible to a large community. Berlin Diagnostics and Day Care, a one-stop solution for all ultramodern services in the health sector, is among those who offer non-invasive angiographies to the residents of Ranchi and nearby cities.

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