heart cath and aneurysms

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K

Karen

Well-known member
Joined
May 1, 2005
Messages
139
Location
Salem, Utah
I understand that echos do not definitely show whether or not a person has an aortic aneurysm and that a CT scan with contrast is the test that would be done to check this out. But can a heart cath detect an ascending aortic aneurysm? I'm scheduled for a right and left heart cath for next Tuesday. In one of the articles I read about heart caths, I got the impression that an aneurysm COULD be diagnosed from just the heart cath...

Thanks for any info...
Karen
 
Neither an echo, or the numerous caths, or whatever they put down my throat right before surgery caught my aneurysm. It wasn't until they got inside did they find out it was gonna blow.
 
I could be wrong but I think that only a CT scan will show an aneurysm (other than exploratory surgery). :eek:
 
They passed a Cath right through my dissecting aneurysm and never saw it! So no, a Cath will not see it, only a CT Scan.
 
Karen said:
I understand that echos do not definitely show whether or not a person has an aortic aneurysm and that a CT scan with contrast is the test that would be done to check this out. But can a heart cath detect an ascending aortic aneurysm? I'm scheduled for a right and left heart cath for next Tuesday. In one of the articles I read about heart caths, I got the impression that an aneurysm COULD be diagnosed from just the heart cath...

Thanks for any info...
Karen
Click to expand...
(this poster is having problems posting so I can't give complete answer-try to
edit later)
Karen the short answer to your question is yes.
A right heart cat. goes in a vein in your leg up to your right atrium to measure the pressures of the right atruim and right ventircle- to check function of tricupid and pul. valves. A left heart cat goes up your artery past the aortic artery in to the left ventricle to measure pressures in the left
ventricle and left atrium- to check function of the arotic valve and the mitral
valve. To check for AA, some dye is injected in the aortic artery which gives the wall of the artery more contrast and then the separation of the layers or the bulging is more prominent. A CT will show this and some of the new echo
devices that use special dyes can show this.
 
The 2 1/2 months leading up to my surgery...My PCP was helping me to try to find out why I was burping, ect..so..I saw many doctors..ENT....Gastro man..Had an echo done.....PCP then said..MRI..I think he was then down to a high b/p reading thinking I had something wrong with my kidneys.A test (flourscopy) sp..showed aerophagia..that I was swallowing (sp) air.. habit...Then asked to see Cardio..A chest x-ray and then a Cath of heart..showed my aneurysm.... In other words..I went from burping to surgery :p I really think that my PCP and Cardio..were together on things the last week..and just didn't want to scare me until I had the Cath of heart..Right after that..they came to my bedside and told my family..a 5.0 aneurysm was found and wanted to do surgery then.. Had it 4 days later..I Do know..the echo was done 2 months before..and nothing showed up... :confused: Still have aerophagia but I can control it..No caffiene, ect. A side note..burping came right after my Mama died..I think she was looking after me. :) So what is the difference in a CT scan and a heart cath?I think I had a CT scan earlier, too..Just the Cath of heart showed mine.. I had no other symptoms..SOB. ect..Bonnie
 
A TTE (transthoracic echocardiogram) of the heart will not show an aortic aneurysm only because it's looking at the heart, not the aorta. When they do a TEE (transesophageal echocardiogram) they can get a closer look at the heart and aorta--my aneurysm was initially diagnosed by TEE. When they do a pediatric TTE of the heart they do additional views that they don't do on an adult (for instance they break-away the examining table under the shoulders and get a top-down view of the aorta), so that should show an ascending aortic aneurysm as well. A $200k machine doesn't show as good a picture as a $500k machine, so that's another reason an aneurysm may not show up. A CT or MRI with contrast (MRA) seem to be considered the gold standard for evaluating the ascending aorta, yet a CT (I don't know about an MRA) is not apparently definitive (or maybe even useful?) in evaluating the function of the valves (at least not for insufficiency). I would think a cath would do a fine job of showing the anatomy of the aorta as long as contrast is being used but there is always the risk of damaging a fragile aorta by running a catheter through it (isn't there?), so I would think a cath would be useful in assessing an aneurysm, but not the first choice unless there is some other compelling reason to be in the aorta with a catheter.
 
I had the catheterization....They told me I had the blockage in 3 arteries and there was a problem with the Aortic valve. Then they sent me down for a Chest X-ray and an Echo. My Surgeon came in because he wanted to see what the Echo showed and they were able to see and show me the problem with the valve, They also measured across the valve at the Aorta? I knew when the young lady doing the echo was really quite before the doctor came in that she had found a problem.They showed me the valve opening and closing on the echo. They also showed Blue and red on the echo. Was this blood flow? leakage? The doctor also told me that they would look at it again from the inside after I was out..I guess thats the TEE I see you guys talking about. I spent most of the day on thursday having tests. Had the surgery on Friday. After the Echo, I had the CT scan. So they looked at it every way they could before they did the surgery. I don't know if it was better or worse not having to wait long before they did my surgery.
 
As pjmomrunner points out, the MRA or the CAT are better for determining the state or existence of an aneurism, although they can sometimes be caught by catheters (angiogram) and even echocardiograms, whether standard (looking through the chest from the outside) or TEE (from inside the throat). They can be measured during an angiogram session - if the interventional cardiologist is looking for it.

However, echoes and angiograms are much better for determining valve and overall heart functionality.

I would choose the MRA to look for an aneurism, rather than the CAT, as there is no radiation. I'm claustrophobic, and I've had an MRA. It's not bad at all.

Best wishes,
 
Bob

Bob

The only bad test I had was the MRA..Nurse gave me 2 ativans..take one ..1 hour before and 1 when you arrive...Didn't take the last one.. :eek: After I got in the tube..I wished I had taken it..Very scary... Tech was far away..in sound..Felt like I was in a coffin....If I ever have to have another one..I will take the 2nd or 3rd or 4th.. :D Just knock me out.. :D .I heard they do have the open topMRA'S..but..not as good. :confused: Hope I never have to have another one. Bonnie
 
Good point. The contrast dyes they use for either the MRA or the CAT scan can be problematic, and that's a good thing to keep in mind.

When I had a CAT scan, a doctor was required to be present because some people have a fatal reaction to the dye. For whatever reason, his presence was not required for the MRA.

I didn't have trouble with the MRA because the tube ends were open, and my head was at the edge of one opening. I was at a partially upright angle in the tube, which helped me feel more in control. And most importantly, there was a good-sized fan inside and plenty of air rushing by my head, so I didn't feel trapped or suffocated.

Best wishes,
 
new question about dye

new question about dye

I appreciate all the replies to this question... Except now I'm wondering about the dye used in the heart cath. Pam and Bob, you were talking about reactions to the dyes used in the CT scan or MRA? What about the the dye used in the cath? With the problems I've had with aspirin and other drugs, I always have in the back of my mind a concern for an unusual reaction to stuff that shouldn't be a problem. I'm a little unsettled at the suggestion of a possible "fatal reaction..." Just when I thought I was about "ready" to get this cath done! :)
 
I'm not certain, but I believe the dye used for the catheter angiogram might be similar to that used in a CAT scan, as they are both viewed via X-Ray. I believe less is used for the catheter angiogram. It is not uncommon for patents to have a mild reaction to the dye.

The contrast dye used in an MRA would contain something that would affect or be affected by a magnetic field or radio waves. A very small segment of the population (PamO!) have a reaction to the MRA contrast dye. Unlike x-rays, the fields generated by an MRI unit have never been shown to have any deleterious effect on a patient.

Both dyes can create a sensation of heat, cold, or numbness when injected, that can be unpleasant, but not painful. My own response has been that it's similar to the unfortunate sensation you get when a toddler's diaper leaks onto your pants leg.

In any event, a catheter angiogram is not done by a technician. It's done by an interventional cardiologist, so by definition, a heart doctor is right there. Aspirin sensitivity itself is probably not related to sensitivity to the dyes, or they would be even more troublesome than they are.

However, it wouldn't hurt to note to your IC before the procedure that you have some chemical sensitivities. If getting an MRA or CAT scan, stay in sight of hospital personnel for fifteen minutes or so after the procedure, to avoid Pam's predicament.

Best wishes,
 
I think that different doctors have their own "gold standard" preference. Jerry's aneurysm was found during a routine echo; then they immediately did a TEE. A visit to the surgeon in Springfield who had done his AVR took those results as gospel, never offering to do any further testing. The aortic specialist in St Louis we subsequently saw ordered a CT scan. It measured the same as the other 2 tests. Six months later another CT was done with no appreciable change. I point blank asked the specialist if CT was the best test that could be done and he said "yes."
 
My aneurysm was first discovered on a TEE. Then I had the CT scan without constast every 6 months until it was fixed.
Kathy H
 
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