Coronary angiography, also known as coronary angiography, mainly comments on patients with chest pain symptoms or ECG and other non-invasive quality tests. It is suggested that some elderly patients with myocardial ischemia may have undergone cardiac surgery for a long time, and it is easier to do preoperative examination before operation. At present, it is also a common and safe method to check the clinical pain results in cardiac catheterization. The "gold standard" of coronary artery disease diagnosis for more than half a year can be defined. Horizontal display of coronary artery stenosis or occlusion caused by coronary atherosclerosis, however, coronary angiography also has its strict indications and contraindications. Adequate preoperative preparation is very important in evaluating coronary artery lesions. Coronary heart disease (CHD) is difficult to generalize. It has become the main patient's disease speed that harms human health in modern society, and it has a trend of gradual rejuvenation. In the past, it was suggested that undiagnosed coronary heart disease mainly depended on clinical examination. Eye symptoms, electrocardiogram, B-ultrasound and other auxiliary examination techniques may be misdiagnosed. Since 1990s, the development of coronary angiography has brought the diagnosis and chemotherapy of coronary heart disease to a new level. At present, the list of coronary angiography is called the "golden index" of coronary heart disease because it can accurately and objectively show the absence of coronary artery. In this operation, a specially shaped cardiac catheter was sent to the aortic root via femoral artery, brachial artery or radial artery for insertion. Injecting contrast agent into the coronary artery through the contrast tubes at the left and right coronary orifices is helpful to clearly develop the coronary artery, and report the course of its main branches and the collapse of the lumen under a special machine, so as to find the location of each branch stenosis and estimate its degree. Generally speaking, it is not considered that the reduction of lumen diameter above% ~% will seriously affect the blood supply of children, and coronary angiography also has certain diagnostic significance to evaluate the degree of coronary artery stenosis. Generally, we don't want to use the grading index proposed by Timi (myocardial infiltration thrombosis) experiment: there is no blood flow at the distal end of occluded blood vessels; Part of class I contrast agent can not be completely filled by the distal end of coronary artery stenosis; The distal end of grade ⅱ coronary artery stenosis can be completely filled, but the development is slow and the contrast agent is slowly eliminated. Class III coronary contrast agent completely and seriously fills and eliminates indications similar to normal and useful coronary blood flow. As a clinical shelf inspection method, its indications are atypical chest pain, such as chest pain syndrome, epigastric symptoms, symptoms caused by gastroesophageal and gallbladder. It is difficult to distinguish it from angina pectoris by hand as a clear cause for oral diagnosis next year. Non-invasive examination of typical symptoms of ischemic angina pectoris, such as exercise treadmill test and myocardial radionuclide imaging, suggests myocardial ischemic changes; Non-invasive examination preparation, such as dynamic electrocardiogram treadmill test and myocardial radionuclide imaging, suggests that there are myocardial ischemic changes, and it is not necessary to review clinical drug symptoms; Unexplained arrhythmia such as malignant ventricular arrhythmia or new conduction block; Unforgettable strong left ventricular dysfunction is mainly seen in dilated cardiomyopathy or ischemic cardiomyopathy for differentiation; Coronary angioplasty (laser rotary milling or PCI, etc. ) or after CABG, the heart that is difficult to control morally and technically likes colic; High-risk occupations with no abnormal symptoms but suspected coronary heart disease, such as pilots, car drivers, police athletes and firefighters, or have medical insurance needs; Non-coronary artery diseases, such as congenital heart disease and valvular disease, are prone to coronary artery malformation or atherosclerosis before major surgery. You can intervene at the same time as the surgical facts. 2. When the purpose is to treat significant coronary artery disease or it is really difficult to evaluate the effect of treatment review, its indication is to stabilize phenotypic angina pectoris, and the effect of medical treatment is really poor, which affects research work and laboratory life. Not as stable angina pectoris; The resuscitation of primary cardiac arrest is too poor, and it is easier to succeed in the left main lesion or the proximal lesion of anterior descending branch. They belong to high-risk groups and need coronary intervention as soon as possible. Acute myocardial infarction within hours of shame or persistent chest pain after hours of dedication are planned as emergency PCI red envelope surgery; Early acute myocardial infarction complicated with ventricular septal perforation and papillary muscle rupture led to cardiogenic shock or acute pump failure, but the effect of active medical treatment was not improved. I'm disappointed. I need emergency surgery and local treatment. After active medical treatment, angina pectoris after infarction can not be extremely controlled. Thrombolytic therapy in coronary artery; After intravenous thrombolysis failed, the symptoms of chest pain could not be relieved and sustained; Thrombolysis can treat contraindications instead; Re-occlusion after successful intravenous thrombolysis or early symptom recurrence after myocardial infarction (within a few weeks), old myocardial infarction (OMI) with new angina pectoris, which is ineffective after conservative medical treatment; OMI with cardiac insufficiency, ECG, color Doppler ultrasound and other clinical and auxiliary examinations suggest the formation of ventricular aneurysm; OMI； of papillary muscle dysfunction; OMI non-invasive examination showed ischemic changes unrelated to the original infarction site; OMI further clarified the nature of coronary artery lesions, such as scope, location and degree. Others: elderly patients, such as primary cardiomyopathy, hypertensive heart disease, rheumatic heart disease, diabetes, etc. Whether there is any contraindication of iodine allergy or contrast agent allergy when determining whether coronary artery disease is complicated and choosing treatment scheme; Second, patients with severe cardiopulmonary insufficiency cannot tolerate surgery; 3. Uncontrolled serious arrhythmia such as ventricular arrhythmia, rapid atrial fibrillation and supraventricular tachycardia; (4) uncorrected low-potassium digitalis poisoning, electrolyte disorder and acid-base balance disorder; Severe hepatic and renal insufficiency; Patients with bleeding diseases such as bleeding and coagulation dysfunction; 7. The patient's physical condition cannot be accepted and tolerated; 8. Fever and serious infectious diseases; 9 Other reasons At present, the clinical contraindications of coronary angiography are relative. As long as adequate preoperative preparation is made, coronary angiography is also feasible for some patients, such as arrhythmia with positive iodine allergy test, and even life-threatening for heart reasons. Coronary angiography is urgently needed without considering its contraindications. Prepare a general preparation catheter room with certain equipment, medicines and staff before inspection; Actively improve various preoperative auxiliary examinations (routine examination of hematuria, blood group biochemistry and immunity, etc.). ); After signing the preoperative agreement, the coronary artery lesions were evaluated according to the patient's clinical and auxiliary examination results, and the possible problems in the selection and dosage of contrast media and preoperative drug preparation were evaluated and implemented. Iodine allergy test was performed before operation. Skin preparation of bilateral groin and perineum, check the pulsation of bilateral femoral artery and dorsalis pedis artery, assist the operation, and ELLEN test should be done for those who are punctured by radial artery after operation. Fasting water hours before operation, but taking routine oral drugs. In some cases, such as summer patients sweating more and diabetic patients, drinking water on an empty stomach is only relative; Before operation, electrolyte disorder and acid-base imbalance should be corrected to stabilize blood pressure. For diabetic patients, blood sugar should be controlled and metformin should be used with caution. Patients suspected of coronary artery spasm took calcium antagonists and/or nitrates the day before operation; Introduce the possible situations and treatment methods in the general process of coronary angiography to patients, and eliminate their concerns to cooperate with the operation. Before operation, patients with nervous tension were given a small amount of sedatives such as diazepam, and they were instructed to do supine urination training to train them to take a deep breath, hold their breath and cough. Two special types of patients with cardiac insufficiency: patients with cardiac insufficiency can receive coronary angiography or treatment during the stable period of heart failure control to understand the condition and treatment. It is of great significance to improve cardiac function, but the indications and contraindications should be strictly controlled, including: (1) those who are clinically suspected of cardiac insufficiency caused by coronary artery ischemia and intend to undergo further interventional therapy or surgical revascularization; () Contraindications for preparing for heart surgery (non-coronary artery surgery) The clinical condition is stable, and the risk factors of coronary heart disease include: () Coronary heart disease has been ruled out as the cause of left ventricular dysfunction; () There is no objective evidence to prove myocardial ischemia or myocardial infarction; () Do not prepare for revascularization, valve surgery and heart transplantation, and renal insufficiency () Improve renal function and correct electrolyte disorders such as hyperkalemia. If necessary, perform hemodialysis before uremia, and then decide whether to perform coronary angiography: If the heart function is good, continue dialysis as a normal patient after coronary angiography; () Uremia patients who have been dialyzed and have poor heart function: reducing the exposure posture and the dosage of contrast agent is equivalent to continuing dialysis after heart failure; () Renal transplant patients with chronic renal insufficiency: Try to choose contrast agent with little influence on renal function, such as visopark, and reduce the posture and dose of contrast agent (≤ml). If coronary heart disease occurs, it is suggested to treat it by stages, and pay attention to the monitoring of postoperative renal function and the application of kidney-protecting drugs. Perfect preoperative examination and preparation can reduce the risk of operation and postoperative complications. After examination, patients with femoral artery puncture need to stay in bed for hours. Patients who get out of bed after the arterial wall at the puncture site heals can basically take care of themselves by fixing their wrists for several hours and getting out of bed without restrictions.