Cardiac Catheterization
WHAT IS CARDIAC CATHETERIZATION?
Cardiac catheterization is a procedure to examine how well your heart is working. A thin, hollow tube called a catheter is inserted into a large blood vessel that leads to your heart.
√ Cardiac catheterization is performed to find out if a patient has disease of the heart muscle, valves or coronary arteries.
√ During the procedure, the pressure and blood flow in your heart is measured.
√ Coronary angiography is also done during cardiac catheterization. A contrast dye is injected through the catheter, and X-ray images show the dye as it flows through the heart arteries, showing where arteries are blocked.
WHY HAVE CARDIAC CATHETERIZATION?
This procedure provides information about heart function, identifies problems and allows for procedures to open blocked arteries. During cardiac catheterization the doctor may:
√ Take X-rays using contrast dye injected through the catheter to look for narrowed or blocked coronary arteries called coronary angiography or coronary arteriography.
√ Perform a percutaneous coronary intervention (PCI) such as coronary angioplasty with stenting to open narrowed or blocked segments of a coronary artery.
√ Check the pressure in the four chambers of the heart.
√ Take samples of blood to measure the oxygen content in the four chambers of the heart.
√ Evaluate the ability of the pumping chambers to contract.
√ Look for defects in the valves or chambers of the heart.
√ Remove a small piece of heart tissue to examine under a microscope (biopsy).
WHAT ARE THE RISKS?
Cardiac catheterization is usually very safe. A small number of people have minor problems. Some develop bruises where the catheter had been inserted and others can have side effects from contrast dye.
HOW DO I PREPARE FOR CARDIAC CATHETERIZATION?
√ You will be given instructions about what to eat and drink during the 24 hours before the test.
√ Usually, you will be asked not to eat or drink anything for six to eight hours before the catheterization procedure.
√ Tell your doctor about any medicines, vitamins or supplements you take. The doctor may ask you not to take them before your procedure. Don’t stop taking your medicine until your doctor tells you to.
√ Tell your doctor or nurse if you are allergic to anything, especially iodine, shellfish, latex or rubber products, medicines like penicillin, or X-ray dye.
√ Arrange to have someone drive you home after your procedure.
√ If you usually wear a hearing aid, wear it during your procedure. If you wear glasses, bring them to your appointment.
WHAT HAPPENS DURING CARDIAC CATHETERIZATION?
A doctor with special training performs the procedure with a team of nurses and technicians. The procedure is done in a cardiac catheterization lab.
√ Before the procedure, a nurse will put an IV line into a vein in your arm so you can recieve medicine to help you relax, but you’ll be awake and able to follow instructions during the procedure.
√ The nurse will clean and shave the area where the doctor will be working. This is usually in the groin area.
√ A local anesthetic is usually given to numb the needle puncture site.
√ The doctor will make a needle puncture through your skin and into a large blood vessel. A small straw-sized tube will be inserted into the vessel. The doctor will gently guide a catheter into your vessel through the sheath. A video screen will show the position of the catheter as it is threaded through the major blood vessels and to the heart. You may feel some pressure in your groin, but you shouldn’t feel any pain.
√ Various instruments may be placed at the tip of the catheter. They include instruments to measure the pressure of blood in each heart chamber and in blood vessels connected to the heart, view the interior of blood vessels, take blood samples from different parts of the heart, or remove a tissue sample from inside the heart.
√ When a catheter is used to inject a dye that can be seen on X-rays, the procedure is called angiography.
√ When a catheter is used to clear a narrowed or blocked artery, the procedure is called angioplasty or a percutaneous coronary intervention (PCI).
√ The doctor will remove the catheters and the sheath. Your nurse will put pressure on the site to prevent bleeding. The procedure lasts about an hour.
WHAT HAPPENS AFTER CARDIAC CATHETERIZATION?
You will go to a recovery room for a few hours where you must lie flat.
√ Pressure will be applied to the puncture site to stop the bleeding.
√ Your heartbeat and other vital signs will be monitored during your recovery.
√ Report any swelling, pain or bleeding at the puncture site, or chest pain.
√ Before you leave the office, you will receive written instructions about what to do at home.
CALL YOUR DOCTOR IF:
√ Your leg with the puncture becomes numb or tingles, or your feet feel cold or turn blue.
√ The area around the puncture site looks more bruised.
√ The puncture site swells or fluids drain from it.
CALL 911 IF:
√ The puncture site swells up quickly.
√ Bleeding from the puncture site does not slow down when you press it firmly.
STRESS TESTING