What to expect with cardiac catheterization

What Other Terms Are Used To Describe Cardiac Catheterization?
· Heart Cath
· Angiogram

What Is Cardiac Catheterization?

  • A test performed in the hospital where we insert a tube into an artery in your groin (or in some cases, in your wrist) that is positioned at the top of the heart, where we inject contrast to take images of the arteries supplying blood to the heart muscle
  • This procedure is performed under X-ray guidance in the Cardiac Catheterization Lab.
  • A catheter (a long, thin, flexible tube) is inserted through an artery (blood vessel) in the thigh up into the heart. Occasionally an artery in the arm is used.
  • X-rays (pictures) are taken of the heart and coronary arteries.
  • The patient is given a mild sedative to help them relax but remains awake during the procedure to allow them to answer questions regarding comfort level, any chest pain or shortness of breath.
  • A small area of the groin or arm is shaved and cleansed where the catheter will be inserted.
  • Medication are used to numb this area so a small incision can be made to insert the catheter 
  • The catheter is inserted through the femoral artery in the groin (or an artery in the arm at the wrist).
  • X-ray is used to guide the catheter up into the heart.
  • A colorless dye is injected through the catheter, and X-ray pictures are taken of the coronary arteries.
  • The patient can watch the procedure on the monitor if he wants to.
  • The test takes about an hour.

Why Is A Cardiac Catheterization Done?

  • This test will help the doctor to evaluate:
  • How well the heart muscle and valves are working
  • The extent of damage to the heart after a heart attack
  • Which coronary arteries are narrowed and how severe
  • The extent and degree of the narrowing
  • What treatment is required: medical management, balloon angioplasty (PTCA) with stent or surgery

What Symptoms May Be Experienced During The Procedure?

  • Slight burning from the medicine used to numb the catheter insertion site.
  • Slight discomfort or pressure as the catheter is being inserted.
  • Slight nausea, extra heartbeats, and/or a warm flushing throughout the body (5-10 seconds) as the dye is being injected.

What Happens After The Procedure Is Completed?

  • After X-rays are taken, the catheter is removed.
  • A bandaid or pressure dressing will be placed over the catheter entry site.
  • Firm pressure is applied for 10-15 minutes until the puncture site is sealed.
  • If an artery in the arm is used, pressure will be applied and a clear band will be placed.
  • The patient will be observed for 4-6 hours before discharged home.
  • The insertion site will be checked frequently for signs of bleeding.
  • Blood pressure and the pulse in the leg (or arm) used will be checked frequently.
  • A skin bump where the catheter was inserted may occur. This is only temporary.
  • Bruising to the leg/groin area where the catheter was inserted may occur. The bruising may spread down the leg and is only temporary, resolving in a few weeks.
  • Most patients are discharged in 8 hours with minimal activity restrictions for the next three days. 

What Preparation is Needed?

  • Nothing to eat or drink after midnight.
  • It is important for the patient to ask your doctor:    

     1. How to adjust insulin and food intake prior to the procedure if diabetic   

     2. If you should take your regular medications the morning of the procedure     

     3. Which medications to hold before the procedure

  • Leave all valuables at home.
  • Make arrangements to be driven home since you will not be able to drive for three days.

If you have a stent placed in an artery in your heart...

  • you will spend one night in the ICU for observation before you go home
  • you will be placed on a blood thinner like Plavix or Effient
  • you will need to follow up in clinic in one week
  • you will receive literature about heart disease and diet
  • you will be expected to begin a diet to minimize cholesterol and fat
  • you may need to take cholesterol medication, aspirin, an ACE inhibitor, and a beta blocker

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