2. Angiography Excessive Commercialisation

3. Complications of Angiography 1.Death 2.Myocardial Infarction Factors predisposing Unstable angina Angina at rest Recent sub-endorcardial MI Insulin dependent diabetes mellitus

4. 3. Neurological Transient Persistent (Stroke) A-V fistulae Haematomas with vascular and neural Compression Delayed haemorrhage

5. 4. Local, Brachial and Femoral Complications a. Brachial Arterial thrombosis Median n.injury Late arterial bleed Bacterial arteritis Local cellulitis, phlebitis. b. Femoral Arterial or venous thrombosis Distal embolization False aneurysm

6. 5. Perforation of the heart or great vessels 6. Vaso-vaga; reactopms 7. Arrjutj,oas and conduction disturbances 8. Phlebities infection, fever 9.Pyrogen reaction 10. Hypotension 11. Allergic shock Hypotension/anaphylaxis

7. 12. Other Complications Pulmonary oedema Pulmonary artery perforation Pulmonary haemorrhage Coronary artery dissection Systemic or pulmonary embolization of Vegetations Pulmonary embolism Catheter entanglement

8. 13. Drawbacks High costs and risks involved Invasive procedure

9. Bypass Surgery a road destined to close Coronary artery bypass grafting (CABG): Coronary artery bypass surgery is another expensive surgical procedure which is a more extensive, mutilating and aggressive process of temporary solution to coronary artery disease. In this operation, the chest is opened in the centre in front. Blood vessels from the leg are surgically removed and used to bypass the coronary arteries.

10. Complications of CABG 1. Respiratory complications Alveolar dysfunction Pulmonary oedema Infection Phrenic nerve injury Prolonged ventilatory insufficiency 2. Post – operative hypertension

11. 3. Heart attack (myocardial infarction) during operation 4. Cardiogenic shock 5. Left ventricular failure 6. Cardiac tamponade 7. Septic shock 8. Arrhythmias Atrial fibrillation Atrial flutter Ventricular fibrillation 9. Blood clotting disorders

12. 10. Wound infection, non-healing of wound 11. Peripheral vascular complications 12. Rental failure 13. Gastro-intestinal complications Bleeding in the stomach, duodenum, shock liver syndrome 14. Reblockages 15. Damage the brain during the heart – lung machine running the blood supply to the brain.