Less Invasive Imaging Modalities Versus Invasive Coronary Angiography in CAD Diagnosis - Essay Example

Less Invasive Imaging Modalities versus Invasive Coronary Angiography in CAD Diagnosis Student’s Name: ID Number: Lecturer: Date: Diagnostic Value of Less Invasive Imaging Modalities Compared To Invasive Coronary Angiography Introduction Coronary artery disease is the highest killer ailment in most developed countries across the world hence accounts for significant percentage of deaths in a year. In addition, the disease is also increasing at alarming rate in developing countries (Montalescot, Gilles, Udo, Stephan, Felicita, Chris, Andrzej, Raffaele, 2013). It refers to a situation whereby arteries become stiff and hard to an extent that they prevent efficient flow of blood and other essential nutrients to the heart (Jolicoeur, Raymond, Tim, Greg, Martial, Micheal, and Philippe, 2012) Note that arteries are the main suppliers of oxygen and other nutritional elements to the heart. Insufficient supply of these nutrients has negative impact to the heart’s function. In this case, the heart cannot pump the oxygenated blood efficiently to other parts of the body. In this case, the disease is a potential threat to individual survival and leads to either death or severe disability. Basically, heart arteries have smooth texture and are also elastic in nature. This allows efficient passage of oxygen and nutritional elements to the heart (Montalescot, Gilles, et al, 2013). However, coronary artery disease arises when this smoothness and elasticity is affected. There are various factors that may lead to this disease namely excessive smoking, high rate of cholesterol in blood vessels, diabetic condition and chest radiation among others (Jolicoeur, Raymond, et al, 2012). Any of these factors causes internal injury to the coronary artery. Plagues may also pile along the inner walls of the artery hence causing blockage. Such blockage restricts blood flow to the heart and subsequent starvation of major nutrients hence development Coronary Artery Disease (CAD). During the early stages of coronary artery disease, there may be no noticeable symptoms. Nevertheless, it starts showing signs as it advances. Some of the symptoms include pain in the chest and breathing difficulty especially during physical exercises (Jolicoeur, Raymond, et al, 2012). Other signs of CAD are excessive nausea, uneven heartbeat, regular dizziness as well as sweating. Pain in some upper parts of the body may also serve as reliable symptoms such as left side of the shoulder, back or even jaws (Montalescot, Gilles, et al, 2013). Physical examination is an essential part of CAD diagnosis and may be carried out along with medical history of the patient (Hulten, Eddie, and Daniel, 2013). Basic physical checks include examining blood pressure, deposits of fats under the skin, colour of the skin and circulation of blood. The doctor may also examine pulses in several areas such as wrist and the neck among others (Jolicoeur, Raymond, et al, 2012). Advanced physical examination is also necessary where the doctor uses stethoscope to listen to breath sounds in the chest and abdomen. The tool is also vital in checking abdominal blood flow and breathes sound in lungs. Diagnosis and treatment of coronary artery disease is important due to its effects to the heart and other parts of the body. When one stays with the disease for long period, the patient is likely to endure excessive pains in different parts of the body (Montalescot, Gilles, et al, 2013). Invasive coronary angiography is the procedure for conducting examination of blood vessels of the heart (Hulten, Eddie, and Daniel, 2013). Usually, the doctor inserts a catheter into the groin and injects dyer to fill vessels. Using x-ray images, the doctor is able to trace blockages and narrowing in blood vessels. During this process, the doctor uses various methods to unblock and fix the narrow blood vessels (Sun, 2013). In respect of this, the procedure has both diagnostic and treatment value to the patient hence a gold standard procedure. Due to sensitivity of the CAD diagnostic procedure, advanced imaging modalities have been developed to improve diagnostic and therapeutic value. This is backed by more advanced technology which aims at improving performance especially during diagnosis stage (Montalescot, Gilles, et al, 2013). This paper provides details of less invasive modalities to imaging coronary artery disease and their role in improving diagnosis results. Diagnostic Value of Less Invasive Modalities There are various types of Less Invasive Modalities that are used in imaging and diagnosis of Coronary Artery Disease. Basically, these modalities have several improvements compared to invasive coronary angiography (Lan, Chen, and Liu, 2013). Backed by advanced technology, these modalities are able to produce quality image which is an essential aspect in successful diagnosis and subsequent treatment of CAD (Powell, and Cosson, 2013). Diagnostic value of each less invasive modality is discussed below. Electrocardiography (ECG) Electrocardiography (ECG) plays an important role in CAD diagnosis. It records heart’s rhythm by assessing electrical activities in this body organ. The procedure is able to detect any abnormal activity within the heart especially irregular rhythm (Lan, Chen, and Liu, 2013). In most cases, ECG is carried out when the patient is undertaking simple exercises. In case the patient feels pain in the chest during this exercise, ECG ascertains the cause of that pain and the doctor may interpret whether it has anything to do with coronary artery disease. The procedure is ideal during the diagnosis of suspected CAD (Nayar, Anjeli, Slim, Bryan, and Kenneth, 2013). The procedure has significant diagnosis value in terms of sensitivity and specificity. X-Ray X-ray is another essential non-invasive imaging modalities used for diagnosis of coronary artery disease. The x-ray technique concentrates on the heart, lungs and also chest walls. It produces several images taken from different angles to allow the doctor analyse them in reference to recorded symptoms. X-ray identifies symptoms that have no connection with CAD (Lan, Chen, and Liu, 2013). In respect of this, by looking at different images, cardiologist is able to make the final conclusion as to whether the disease is present or not. In this case, x-ray is more of diagnostic modality to CAD. Ultrasound Ultrasound technology uses sound waves to produce image of entire heart. The imaging modality is able to produce precise details of the organ such as thickness in the vessels and activities of the valves. The role of ultrasound in coronary artery disease diagnosis is to trace aspects of abnormality in arteries and the whole organ. By producing images clearly showing thickness in blood vessels leading to the heart, cardiologist is able to detect the disease (Lan, Chen, and Liu, 2013). In addition, ultrasound tests the severity and specificity of the CAD. Computed Tomography (CT) Latest development of Multi Slides Computerised Tomography (MSCT) plays an important role in improving CAD diagnosis and subsequent therapy. Successful diagnosis requires high quality images characterised by clear visualisation of coronary artery (Michele, Gueret, Laissy, and Hamon, 2013). CT recently has recorded impressive results due to high spatial resolution and relatively short scan time. Current CT produces consistent image quality in regard to high sensitivity and specificity (Nielsen, Lene, Nino, Bjarne, Stephan, Jonathon, and Jawdat, 2014). Constant improvement enhances accuracy in diagnosis thus the modality has high diagnostic value. In addition, the procedure takes shorter period compared to others and the patient does not necessarily need admission in health facility (Lan, Chen, and Liu, 2013). Magnetic Resonance Imaging Magnetic resonance imaging technique has several technological advantages over other CAD diagnostic modalities. As non-invasive technique, MRI is excellent in spatial resolution hence making the image clear and elaborate (Lan, Chen, and Liu, 2013). The modality is also perfect in myocardial tissue characterisation hence able to assess abnormality in cardiac activities as well as thickening of walls. In addition, MRI produces 3-D images hence giving finer details of the organ in perspective (Pereira, Bettencourt, Nuno, Andreas, Amedeo, João, Madalena, 2013). The technique is accurate hence high diagnostic value. Nuclear Medicine Nuclear medicine has three major roles in diagnosis of coronary artery disease. It carries out the assessment of heart’s function particularly pumping of blood. The modality also helps in visualising the extent of the CAD as well as actual part of the artery affected by the disease. Furthermore, nuclear medicine conducts the myocardial blood flow assessment. The modality helps the cardiologist to detect the presence of CAD or even risk of the same disease. It is accurate and precise hence high diagnostic value. Invasive Coronary Angiography When using the invasive angiography in CAD diagnosis, the doctor injects dyer into the coronary artery to locate the blockage. After taking several x-ray images, the cardiologist is able to see narrowing and blockage in the arteries (Montalescot, Gilles, et al, 2013). The procedure provides essential information concerning the structure of arteries and entire organ (heart) thus enabling the cardiologist to analyse the problem. It provides thorough diagnostic details to the doctor can fix the blockages to allow passage of blood to the heart (Nayar, Anjeli, Slim, Bryan, and Kenneth, 2013). Invasive coronary angiography is diagnostic procedure as well as therapeutic exercise during follow-up. It implies that cardiologist can use this procedure to schedule subsequent treatment as well as interventional therapies (Hulten, Eddie, and Daniel, 2013). The technique has excellent spatial resolution which leads to high accuracy in diagnosis. Invasive Versus Less Invasive Diagnostic Modalities Emergence of less invasive modalities is a significant boost to diagnosis and treatment of Coronary Artery Disease (Lan, Chen, and Liu, 2013). These modalities have considerable advantages especially to the patient since some of them do not require the patient to be admitted. Invasive coronary angiography requires the patient to stay in hospital for some time after the examination (Sun, 2013). It also takes long period unlike some of less invasive modalities which take even one hour. Although most non-invasive techniques use advanced technology in imaging, invasive coronary angiography still remain relevant in radiology (Hulten, Eddie, and Daniel, 2013). Conclusion The exposure to risk of CAD attack is increasing at alarming rate in most parts of the world. This aspect alone calls for development of efficient diagnostic and treatment modalities. It is advisable for the people to seek early diagnosis to enable early detection and therapies. Late diagnosis is dangerous since doctors may not offer complete treatment due to advanced effects of the disease. Early diagnosis can only be possible when there is effective machines/equipment in medical facilities. In the pursuit to put Coronary Artery Disease under control, cardiologist use conventional imaging modalities such as invasive angiography to diagnose CAD. Although this has several limitations, medical practitioners have recorded significant performance through it. It has both diagnostic and treatment value. In recent past, less invasive modalities have been developed with a view of replacing invasive coronary angiography. These modalities have advanced features such as ability to produce high quality images. Such modalities have high diagnostic value and may replace invasive angiography in future. However, invasive angiography is still the best imaging technique hence cardiologists and radiologists still prefer it over less invasive modalities. Bibligraphy Hamon, Michele, Pascal Gueret, Jean-Pierre Laissy, and Martial Hamon. "DIAGNOSTIC PERFORMANCE OF 64-SLICE COMPUTED TOMOGRAPHY CORONARY ANGIOGRAPHY AS COMPARED WITH CONVENTIONAL INVASIVE CORONARY ANGIOGRAPHY: META-ANALYSIS OF MULTICENTER STUDIES." Journal of the American College of Cardiology 61, no. 10_S (2013). 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