Serious Medical Question

VicS

VicS

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SWMBO has to have an angiogram! She is wondering whether to go privately for an Electron beam angiogram. It'll cost us just over £1k but the advantages over a conventional angiogram sound good.

We would be interested to hear from anyone who has done this already, or who has looked into it and decided against it or from the health professionals who have any opinions or experience before dashing off to the GP to get a referral.
 
I can't comment on the clinical side, except to say that electron beam angiography seems to be able to find some problems (calcification?) which are not otherwise easy to spot.

However, I'm a bit cynical about the drumming up of private business. In my work with the NHS I continuously come across patients who've been persuaded to go private to save a couple of weeks waiting, after hearing erroneous waiting time stories from the doctor, e.g. being seen in a fortnight privately, when they'd have been seen in less than 4 weeks on the NHS.

There are, of course, real waiting time horror stories but not often in the areas where people have been persuaded to go private.

As your GP will have a choice of 4-5 hospitals to send your wife to then it might be worth asking the GP which of those hospitals do electron beam, and how long the wait will be. It might still be worth the 1K once you find out, but it's worth a try.
 
Do you mean electron beam computer tomography? (EBCT is less "invasive" than convention coronary angiography.) Not my area of expertise, but EBCT is not likely to differ from other diagnostic techniques in that its value is greatly dependant on the particular circumstances of the case, especially the pre-test probability of the abnormality being sought. An investigation like this one with a high sensitivity but low specificity is better for ruling out disease than ruling it in. Ask what other tests would be required in the event that this one is (a) positive, (b) negative.
 
I'm treading on thin ice here, but if the need for an angiogram has been diagnosed, surely that was at the consultant level, rather than at the GP level? If the former he would have a pretty good idea as to the outcome of the investigation, merely confirming as to what, where.

If that indicates the fitting of stents that is done at the same time, through the same hole and is not as frightening as you would think.

If on the other hand the GP or consultant can't or wont give a reasonable course of action, then perhaps you need a second opinion.

Perhaps I'm lucky with my own GP practice, she gave me a choice of specialist and the one I chose was honest enough to say what he suspected before anything got invasive.

Any use?

Edit:

Just seen your last post - when I had mine done there was no anaesthesia or sedation just a local in the "midlands" region (if you saw that lovely film about the Windmill over Christmas)
 
I went the conventional Angio route --- tube via the groin ---no problems whatsover took some lovely pics showing three semi blocked arteries!
Booked in for triple bypass in early Nov. In and out within 6 days -- came off the Warfarin just in time for Christmas imbibing and now can`t wait for the Spring to go sailing without the hangup of Angina Chest pains when doing anything energetic.
All done on the NHS cardiac unit at Bristol BRI which I must say was bl--dy marvellous.
/forums/images/graemlins/smile.gif /forums/images/graemlins/smile.gif /forums/images/graemlins/smile.gif
 
I'm not a medic - I'm a patient.

<span style="color:red"> </span> If you have the angiogram by the conventional method and they find a problem repairable by angioplasty they do it there and then and you leave hospital the same day in most cases.

If they use a less invasive method to do the angiogram - such as going through the arm instead of the groin the smaller artery size means that they can do the angiogram but not the angioplasty if it turns out you need it - 'cos they have to go through the groin.

If you have the EBA the same applies. they can do the angiogram but if they find something that they need to repair by angioplasty they can normally only do it through the groin. Which normally means going away and then coming back another time for the groin access angioplasty.

As they'll already have a good idea of what's wrong from the treadmill tests if they suggest a conventional procedure through the groin my personal choice would be to get it all done at once.

This is based on my opersonal experience where I had the first angiogram done throgh the arm and then had to come back a week later to have the repair procedure done.

I base this view on my personal experience of having had three angiograms via the groin, three angioplasties via the, groin one angiogram via the arm and three Coronary artery bypass grafts through the sternum. This view may not be applicable to you.

Best of luck with whatever procedure you decide.
 
[ QUOTE ]
Quote:
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Do you mean electron beam computer tomography
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Yes, what we have been looking at is this: http://www.europeanscanning.com/eba.shtml?gclid=CNTq-L2RuokCFQdoXgodjywsNg.

[/ QUOTE ]
I am confused. Electron beam computed tomography (EBCT) is used to detect calcium buildup in heart arteries. It is quite a sensitive test for coronary artery disease, but it is not very specific - in other words it has a high false positive rate. My earlier comments referred to EBCT.

On the other hand, as your link points out, electron beam angiography (EBA), is a different investigation. Like conventional coronary angiography, EBA involves the injection of contrast dye. But whereas conventional coronary angiography requires dye to be injected via a catheter fed towards the heart via an artery, in EBA the dye is simply injected into a peripheral vein (a procedure that involves minimal discomfort).

Presumably the doctor recommending/offering the EBA is the specialist who will be advising on treatment. He or she should be in a position to say whether they regard EBA as equally, more, or less useful and reliable than conventional coronary angiography, and to say what percentage, if any, of people having EBAs subsequently require conventional angiography.

But please bear in mind that these remarks come from a retired doctor who has no specialist knowledge of these areas.
 
Vitalman,

Minor correction, angioplasty can be done from the area just above the wrist, I know from first hand experience. I had 'gram' via groin and 'plasty' via the wrist, seperate visits, I can say that recovery is quicker if the cut is at the wrist.

Some hospitals are approved to do angiograms, but not the 'plasty'. In Mid-Essex, if your regarded as an emergency it's straight to Barts, if not they may just do the 'gram' then keep you waiting for a follow-up appointment at Barts for any 'plasty' !! /forums/images/graemlins/laugh.gif

Moonshine
 
No experience with the EBA as such, but I had a MIBI scan a few months after suffering a heart attack ( on the boat, not the best of places for this), and ensuing angioplasty. For all I know all these tests each give a different, but overlapping picture of the situation.
Conventional angiography gives you were major blockages are. EBA says which hardened arteries have a tendency to block, and MIBI scan tells you were the oxygen actually goes, as well as being a good gauge of the heart muscle damage.
In my own case, the MIBI scan told there was an smaller artery still blocked, apparently "missed" by the conventional angiography. So, as a direct result, a second PTCA followed. On the operating table, it turned out to be a "visual artefact", and the procedure was ended without practical result, but with the inevitable discomfort.
This to prove that more information does not lead necessarily to a better outcome...
But I can feel with you all the uncertainties the situation brings you, and wish the best of results for her.
 
Sorry to hear this. I am deeply sceptical of Health professionals - there always seems to be a 'better' way of doing something - but, it costs. I bleieve the NHS will work if we all insist on it. trouble is they play on our fears. In the 1940s Aneurin Bevan said "I had to stuff the doctors' mouths with gold to make them accept the NHS'. I have even had dentists stealing my gold fillings - takes you back 60 or so years to somewhere in Europe that. Now, the scam is to send you to a doctor who has been accredited (not qualified in) with some diploma as opposed to a short while ago sending you to see a Consultant. The very best of luck to you and your wife
 
Happy New Year Brendan - I only replied as a bit of "tongue in cheek", I don't normsally get involved with these ybw broadsides, I left that job to guys at Jutland and Trafalgar /forums/images/graemlins/smile.gif

And, just out of interest, how many of us on here carry a VERY LARGE flag "W" whilst at sea (plus answering pennant of course) ????? /forums/images/graemlins/confused.gif /forums/images/graemlins/confused.gif

You just might need that big yellow budgie one day? /forums/images/graemlins/shocked.gif
 
LOL /forums/images/graemlins/grin.gif

You have answered a long standing question of 45 years when I started 'bunting tossing' in the RN /forums/images/graemlins/shocked.gif

It stands for WHISKEY . . . .well I never tee-hee /forums/images/graemlins/tongue.gif /forums/images/graemlins/tongue.gif /forums/images/graemlins/tongue.gif /forums/images/graemlins/tongue.gif

I was always under the mistaken idea that 'M' was "I HAVE a medic" and 'W' was " I WANT a medic"!! [The inverse rule applies, M and W]

you live and learn /forums/images/graemlins/grin.gif /forums/images/graemlins/grin.gif /forums/images/graemlins/grin.gif /forums/images/graemlins/grin.gif /forums/images/graemlins/grin.gif /forums/images/graemlins/grin.gif
 
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