Cardiac catheterization is a very common diagnostic test performed thousands of times a day.
During a cardiac catheterization, your physician will insert a long, thin tube into a blood vessel in your groin or arm. The tube will be gently directed to the heart and to the origin of the coronary arteries. A contrast agent (dye) is then injected into the coronary artery while x-ray pictures are taken. The contrast agent in the coronary arteries is seen on the x-ray as a thick white line. A disruption of the white line may suggest an area of plaque build-up inside the wall of the artery, or a blood clot in the artery.
During this same procedure, contrast is injected into the pumping chambers of the heart in order to see how well the heart muscle is contracting and how well the valves are working.
Before your Catheterization:
You may be asked to come before your procedure for pre-testing.
Do not eat or drink anything after midnight prior to the day of your procedure, or at least six hours before, except enough water to take your medications.
Arrive at the hospital or out-patient department at least 60 minutes prior to your scheduled procedure.
Blood work • Electrocardiogram (ECG or EKG) • Chest x-ray (Only if the physician require for specific reasons)
Before the procedure, you may be given a mild sedative to help you relax, but not to put you to sleep. An intravenous line will also be started. You will remain awake, but comfortable, throughout the procedure so you can follow the doctor instructions.
You should inform the physician and staff about any allergy to medication or contrast (Dye).
On your arrival at the Cath Lab, you will be asked to move onto an x-ray table. Nurses and technicians will prepare you for the procedure by placing ECG electrodes on your chest, cleansing either your groin area or your arm with antiseptic solution, clipping the hair in that area, and covering you with sterile towels and sheets.
When your doctor arrives, he will inject your groin, or arm, with a numbing medication known as Lidocaine. After this medication has taken effect, your doctor will make a small puncture at the groin (traditionally called the Femoral Approach) or the arm (a newer method called the Trans-radial Approach) where the catheter will be inserted into your artery.
The physician will watch the movement of the catheter by x-ray. You may feel some pressure at the site of the insertion, but not feel the catheter inside your body. Once the catheter has been guided to your heart, the contrast agent is administered into the blood vessels.
There may be several injections of the contrast agent, and the catheter may be moved around during the procedure. This is necessary to get different views of your heart and coronary arteries. A flushed feeling may occur, possibly all over your body, while taking the picture of your heart muscle. This will last only for about 15 to 20 seconds. This is a normal reaction to the contrast agent and is not a cause for concern.
During the catheterization procedure, you may be asked to breathe deeply and cough. The entire time in the cath lab will probably be about 1 hour. Be sure to let your physician know if at any time you feel dizziness, nausea, tingling, numbness or chest discomfort.
Once the catheterization is completed, the catheter is removed and closure device may be placed in the blood vessel if conditions are suitable. This allows early mobility. Some institutions still use firm pressure, applied to the incision in your groin for approximately 20 minutes to stop bleeding. A dressing will be put over the incision.
After your Catheterization:
After the catheterization, you will be returned to a recovery area or your room. You may have to lie flat in bed for 1 to 6 hours, (duration depending on whether a closure device was used), to allow the puncture site to heal.
You will be allowed to resume eating and drinking.
Your blood pressure and pulse, as well as the puncture site, will be checked periodically.
Your physician will discuss your findings with you and your family.
Outpatient cases usually will be discharged with 2 hours post closure devise or small catheter use, or 6-8 hours after large catheters use.
When the dressing is removed, you will notice a small bruise at the catheter insertion site, about the size of a quarter. You also may feel a hard lump there. The bruise may become slightly larger and darker the first few days you are home. The bruise and the lump are the result of the blood vessels normal healing process, and in one to two weeks, will completely disappear. If you are uncomfortable about the size or appearance of the bruise, or are experiencing discomfort, please call our office.
A cardiac catheterization does not cure heart disease, but it does give your physician very useful information about your heart. Following this procedure, your physician can discuss what options of treatment are best for you.