Diagnostics

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Cardiac Catheterization

  • Purpose of Test:

    Helps doctors diagnose a heart problem accurately and allows them to choose the most effective treatment.

  • What to Expext During Procedure:

    You will be taken to the cath lab in a wheelchair or on a moveable bed. Then you will be helped onto an x-ray table. The table has a large x-ray camera above it and television screens close by. There are are also heart monitors and other instruments.

    The cath lab team generally includes a cardiologist, an assistant, nurses, and technologists.

    Once you are positioned on the x-ray table, you will be connected to several monitors and then covered with sterile sheets. The staff will be wearing sterile gowns, gloves, and possible masks.

    The site where the catheters will be inserted is usually in the groin. Sometimes it is in the wrist or arm. The site is cleansed thoroughly. A local anesthetic is injected into the skin with a tiny needle to numb the area. This may cause a stinging sensation. A small incision is made in the skin, and a needle is used to puncture the blood vessel (usually an artery). A guide wire is threaded into the artery. A short plastic tube, called a sheath, is then slipped over the guide wire and into the artery. The guide wire is then removed.

    Once the sheath is in place, doctors can insert and remove several different catheters without having to use a needle each time. The catheter is inserted into the artery and guided toward the heart, while the staff watches its progress on a TV screen. The catheter may be removed and replaced several times. This is done to reach each of the heart chambers or coronary arteries.

    Once the catheter is inside the heart, the doctors can measure the pressures in the left ventricle and take pictures of the coronary arteries and left ventricle.

    You may be given medication to help you relax and make you drowsy. You may be awake or you may sleep through part or all of the procedure. The staff will be monitoring you at all times.

    You may be asked to take a deep breath and hold it, to keep the pictures from blurring.

    You may also be asked to cough forcefully several times, to help move the dye through the heart. The procedure generally is not painful, although you may feel some pressure as the catheters are inserted. You will not feel the catheters as they move through the blood vessels and into your heart. For many, the most difficult part of the procedure is having to lie still for a long time on a hard table. As x-ray contrast is injected into the heart, you may feel a warm sensation through your body lasting 20 to 30 seconds. You may also feel nausea, chest discomfort, or a mild headache.

    A complete cardiac catheterization procedure usually takes from one to two hours. If you feel pain or discomfort at any time during the procedure, let the staff know.

    After the catheters are removed, the doctor or nurse applies firm pressure to the insertion site for 10 to 20 minutes, to keep the site from bleeding. In some cases, doctors use a compression device to apply pressure to the site. Other times, they may use a vascular closure device to seal off the small hole left in the artery after the procedure.

    You will then be taken to a recovery area or to your room. You will be encouraged to drink liquids to help flush the contrast out of your body.

    If the catheters were inserted in your groin, you will need to lie flat on your back form 2 to 6 hours, so that the site can begin to heal properly. During that time, do not bend or lift your leg. To relieve stiffness, you may move your foot or wiggle your toes.

    The nurse will check your pulse and blood pressure often, and will also check the insertion site for bleeding. If you feel sudden pain at the site or if you notice bleeding, let the nurse know right away.

    The doctor who performed the procedure may give you some preliminary results soon after the test is over. However, a thorough, detailed analysis of all the findings will take more time.

    Most patients go home the same day. Some patients may need to stay for more tests or treatments. When it is time to go home, have a family member or a friend drive you.

    At home, after the procedure limit your activity during the first couple of days at home. You can move about, but do not strain or lift heavy objects.

    Leave the dressing on your groin or arm until the day after the procedure. The nurse will tell you how to take it off and when it is OK to take a shower.

    A bruise or a small lump under the skin at the catheter insertion site is quite common. It should disappear within a few weeks. Call your doctor or nurse if the insertion site becomes painful or warm to the touch, or you develop a temperature over 100 F. Ask you doctor when you can return to your normal activities, and whether there are things you should not do.

    Be sure to check with your doctor or nurse about medications which ones to keep taking and which ones to stop.

  • How to Prepare:

    Generally, you will be asked not to eat or drink anything for 6 to 8 hours before the procedure. This helps prevent nausea. You may have small sips of water to take your medications.

    Check with your doctor several days before the procedure . You may be asked to take medication, such as aspirin, for a few days before the procedure.

    Make arrangements for someone to drive you to and from the procedure. You will not be permitted to drive after the procedure since you may be sedated.

    Pack a small bag incase your doctor decides to keep you in the hospital overnight.

    Bring a list of the names and dosages of all the medications you are taking.

    Tell the doctor or nurse if you have had any allergic reactions to medications or x-ray dye, iodine, or seafood, or if you have a history of bleeding.

    For your comfort, empty your bladder as much as possible before the procedure begins.