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Had coronary angiogram done. Can any online doctor helps to read the report?

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Cardiologist, Interventional
Practicing since : 1996
Answered : 192 Questions
My father had a CAG Yesterday. I can upload the files to internet. Is there any way that I can get the files evaluated
Posted Sun, 14 Apr 2013 in Hypertension and Heart Disease
Answered by Dr. Raja Sekhar Varma 4 hours later
Thank you for the query.

I understand that your father, 59 years of age, known diabetic since 15 years had a coronary angiogram done recently.

From the files that were uploaded, there is significant triple vessel disease seen in the CAG done via the femoral route.

The left main artery is reasonably normal and branches into LAD and LCx arteries.

The LAD is the most important branch of the left coronary artery and this vessel has significant calcification. There is also significant blockage of nearly 90% severity in the mid part of the vessel after a septal and a diagonal branch. The distal part of the vessel may have an intramyocardial course with mild plaques and looks graftable. The diagonals are small in size.

The left circumflex artery is nondominant and has a lesion of approximately 50% severity proximally followed by a significant blockage more distally. A major OM branch has significant blockage. The OM branches look graftable.

The right coronary artery is dominant. There is a proximal severe stenosis followed by near total occlusion at the mid segment. The distal branches can be seen faintly and may be graftable.

I do not know the clinical details or his symptoms or the presentation. From the CAG picture, I feel that CABG surgery is probably appropriate. However, before a decision is taken, the clinical features, ECG, echo, TMT, etc should be considered.

Also, I should point out that there will be some discrepancies when the files are uploaded like this as zip files consisting of dicom frames. The dicom reader could not read some frames. The full CD of dicom images is essential for diagnostic quality of interpretation. Also, since I do not know the catheter size used, I cannot comment on the size of the vessels.

These caviats apart, the CAG shows triple vessel disease that can probably be tackled with CABG surgery. However, this does not hold true if he is having an acute heart attack. If this is the case, the most appropriate treatment would be to tackle the culprit vessel with angioplasty and wait for full recovery from the heart attack before deciding the next course of action.

Needless to say, optimization of the cardiac medicines and the anti-diabetic medicines, in addition to lifestyle measures and daily exercise are a must.

I hope this answers your query. Feel free to ask me for any further, specific clarifications.

With regards,
Dr Raja Sekhar Varma, MD, DM
Consultant Interventional Cardiologist
Above answer was peer-reviewed by
Follow-up: Had coronary angiogram done. Can any online doctor helps to read the report? 3 hours later
Please find the reports in the email sent to your inbox...
Answered by Dr. Raja Sekhar Varma 17 minutes later

The files that you have sent as attachments to my inbox contain the angiogram images only. Based on these images, I have given my report as above. There are no other reports available to me.

Dr RS Varma
Above answer was peer-reviewed by
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