A
cardiac catheterization
is a procedure that helps study the function and structure of
your heart. During your catheterization, angiograms (x-ray movies),
pressure recordings and other measurements will help your cardiologist
check for coronary artery disease (disease in the heart's arteries),
valvular heart disease (disease in the heart’s valves), congenital
heart disease (heart disease you were born with), and other conditions.
This is one of the most helpful procedures for giving your physician
a clear picture of your heart’s overall health.
Before you come in for your cardiac catheterization,
your physician will order a series of
tests that may include blood tests, a chest x-ray, and electrocardiogram
(ECG). If you're taking any blood thinners, be sure to notify
your physician before you come in for the catheterization. Do
not stop taking aspirin unless told to do so. Your physician also
will explain the risks of this procedure. Cardiac catheterization
is considered to be a safe procedure. Because it is invasive (done
inside the body) the risk is similar to that of other minor surgery.
Serious problems such as bleeding, heart attack, stroke, or death
— even though many of the patients have significant heart
disease — are extremely rare. Abnormal heart rhythms occur
infrequently, which may require prompt cardioversion (electrical
stimulation of the heart). Be assured that the staff has been
expertly trained to handle any unexpected changes. You'll be asked
to sign a consent form for this procedure. This is a good time
to talk with your physician about any questions or concerns you
may have.
Often a cardiac catheterization is done on
an outpatient basis. Your physician will tell you when and where
to report on the day your procedure is scheduled.
To prepare for your cardiac catheterization,
you should:
• get a good night's sleep the night
before your procedure.
• report for registration one-two
hours before your procedure is to begin.
• don't eat or drink anything, except
for sips of water with your medications, after midnight
the night before your procedure.
(Note: if you have been scheduled in the
afternoon, please ask your physician what you may have to eat
or drink in the morning.)
• remove all polish from your finger
and toe nails.
Procedure
When you arrive, you'll be asked to put on
a hospital gown. You may wear your wedding ring, watch, and glasses
during the procedure, if you desire. You'll also be asked to empty
your bladder. Then you'll be taken to the catheterization lab
in a wheelchair, on a stretcher, or by walking a short distance.
An intravenous line (IV) will be started in a vein in your arm
so medication can be given during the procedure.
Your physician usually inserts the catheter
through your groin. This area will be shaved and scrubbed with
an antiseptic solution. Then sterilized sheets and towels will
cover you entirely, except for your face and a small area over
your groin. It's important that you keep your hands at your sides,
and do not touch the outer surface of the drapes. Your physician
and staff will be wearing masks, sterile gowns, and gloves.
You'll be awake (but sedatives may be given)
for this procedure, but your physician will anesthetize (numb)
the area first so you shouldn't feel pain (although you may feel
a pressure sensation in the area). A needle will be inserted into
the artery (and sometimes a vein), and a small flexible wire will
be passed through the needle into the blood vessel. Then the needle
is removed, and a sheath (a short hollow tube) is inserted. The
catheter (a long, flexible tube) is passed through the sheath
and guided through the blood vessel to the heart.
The catheter doesn't affect the function of
your heart, and you won't feel pain as the catheter moves into
your heart. It's normal to feel a "fluttering" sensation caused
by extra heartbeats. The catheter will be used to inject contrast,
measure pressure, or draw blood samples.
As pressure recordings are obtained, one of
the staff may ask you to hold your breath for
no more than ten seconds and then breathe normally again. As contrast
is injected through the catheter into the arteries, a picture
is taken and you may be asked to hold
a deep breath while the camera is on in order to get a clearer
picture of the heart.
Occasionally, you may be asked to cough two
or three times after the injection has been
completed to help clear the dye out of the arteries more quickly.
For one or two of the pictures, a larger amount of dye will be
injected into the pumping chamber of the heart, and you'll feel
a "flush" or warm sensation throughout your body for a few moments.
Your Recovery
After the procedure, you'll be taken by stretcher
to a recovery area. A staff member will remove the sheath and
apply pressure at the insertion site for about 20 minutes. No
stitches will be necessary. A dressing will be applied and a sandbag
placed on top of it to continue the pressure. While the sandbag
is in place (about two hours), it's important to keep your leg
flat, to lie very still, and not to sit up. You may ask the nurse
to elevate the head of your bed slightly. When it's time to get
up, wait for assistance as you may experience
some dizziness. If you're an outpatient, you'll probably be able
to go home within an hour of getting
up. However, it's very important to stay quiet for a 24-hour period
and to avoid heavy lifting or straining. Occasionally, a "plug"
will be used to seal the puncture site in the leg artery.
While you are recovering, either back in your
hospital room or in a special recovery area, you may visit with
family and friends and have something to eat and drink. A nurse
will check your leg and feet periodically
for changes in temperature and color and for signs of bleeding.
The nurse will also check the strength of your pulse in your feet.
If at any time you notice any unusual discomfort or numbness,
be sure to let the nurse know immediately. If you start feeling
sick to your stomach, or have any discomfort in your chest, arm
or leg, please tell the nurse and you'll be given the appropriate
medication.
Your procedure may be performed in a Mobile
Cardiac Catheterization Laboratory. This is a modern state-of-the-art
laboratory on wheels, which employs a highly skilled staff of
nurses and cardiovascular technologists
who assist the cardiologist in performing the
catheterization procedure. The procedure performed in the mobile
lab will be exactly like those done in the hospital.
You usually are given a preliminary report
before you leave, but your physician will talk with you in detail
after he or she has studied the films and pressure studies. If
you are an inpatient, the results will be explained to you prior
to your discharge. Your own referring physician should receive
a typewritten copy of the results soon.
Your Good Health
Regardless of the results of your study and
the course of treatment your physician recommends,
you play an important role in staying healthy. Be sure to keep
all appointments for exams and follow-up tests. Follow your instructions,
don't hesitate to talk about your concerns, and immediately report
any new symptoms.
As always, if you have any questions about
your health, be sure to ask your physician.
If you are a Munson Healthcare patient and have a compliment,
concern, or complaint, please contact one of our Patient
Liaisons.
A
cardiac