• Cardiac Catheterization

    What is Cardiac Catheterization?

    Cardiac Catheterization is an invasive test that shows:

    • How well the heart is pumping;
    • If any of the coronary arteries are blocked;
    • If the heart valves are working properly;
    • If you were born with a heart defect; and
    • If the heart has been damaged by disease.

    Before the Procedure

    Report any allergies you have. It is important to report allergies to shellfish since X-ray dye contains iodine. If you are allergic to iodine, you may be given medication to prevent a reaction. Tell your doctor if you are pregnant, taking aspirin or taking blood thinners. Do not eat or drink anything at least 8 hours before this procedure. You may however, take your medication with sips of water after checking with your doctor.

    The area where the catheter is inserted will be cleaned and shaved. You will be awake for the procedure, in some circumstances, medication may be given to help you relax.

    This procedure is done in a special area of the hospital. This area is intentionally kept cool. In this area, you will see an X-ray camera and monitors that look like TV screens. These monitors let your doctor see your arteries and your heart as the procedure is being done. EKG patches will be placed on your chest to monitor your heart. The area where the catheter will be inserted is numbed. A small opening is made in the artery in this area.

    During the Procedure

    A small tube called an introducer sheath, will be placed in the artery. The catheter passes through this tube and is guided to your heart. Once the catheter is in place, X-ray dye is injected through the catheter so your doctor can take an x-ray of your heart. As the dye is injected, you may feel a warm sensation for a few seconds. After reviewing the X-rays, your doctor may decide that a non-surgical procedure (such as an angioplasty or stent) or bypass surgery may be needed to improve blood flow to your heart.

    If your doctor determines that a non-surgical intervention is needed, it can be done at the time of the catheterization. Several specialized pieces of equipment may be used such as:

    • Angioplasty: During angioplasty, a balloon-tipped catheter is placed in the artery. The balloon is inflated to compress the fatty deposits against the artery wall. You may feel some chest discomfort when the balloon is inflated. Tell your doctor if you do.
    • Stenting: Your doctor may also use a stent, which is a small coil or mesh tube which is used to keep the blocked artery open. The stent is placed in your artery and a balloon is inflated inside the stent, causing the stent to expand. The stent stays in place permanently, but the balloon is removed.
    • Rotablation: If the blockage is hard from calcium, the doctor may use a special rotating catheter, called a rotablator, to smooth away the blockage.
    • Intravascular ultrasound: Intravascular ultrasound (IVUS) may be used if your doctor needs more information about the blockage. IVUS looks at the inside of the artery to determine the type of the blockage.
    • Pressure wire: A pressure wire may be used to determine if blockage has significantly decreased blood flow to the heart.

    After The Procedure

    You will be told when you can get up and move about. You may be asked to drink extra fluids to flush out the X-ray dye that was injected into your artery. Tell your doctor or nurse if you have:

    • Chest pain or discomfort in your neck, jaw, arms or back;
    • Shortness of breath;
    • Weakness or dizziness; and/or
    • Discomfort or bleeding at the insertion site.

    If your groin was used as an insertion site, the catheter and sheath may be removed when the procedure is done, or may be left in place for a while. If the sheath is left in place, you must lie flat (keeping your leg straight) until the sheath is removed. When the sheath is removed, pressure and/or a sealing device may be used to close the opening in the artery. A dressing will be placed over the insertion site.

    If your arm or wrist was used as an insertion site, the catheter and sheath may be removed at the same time. A pressure bandage may be placed over the insertion site. You will need to avoid moving your arm or wrist for a short period of time.

    During Your Recovery

    Your doctor will tell you when you can go home. If you had an angioplasty or stenting, you will stay overnight. If an angioplasty was not performed you may go home the same day as your procedure. Many people can return to their usual activities in 1 or 2 days. Ask your doctor when you can resume sports, exercise, sexual activity and work. Talk to your doctor if you have any questions.

    Incision Care

    You will have a small incision where the catheter was inserted. This area may look bruised and slightly swollen. There may be a small lump under the skin. This is normal and will heal in a few days. Call your doctor if you have:

    • A large amount of bruising or swelling around the incision;
    • Severe pain or coldness around the incision site or the involved limb;
    • Bright red bleeding in the incision area;
    • Warmth, redness or tenderness around the incision; and/or
    • A temperature of 101.5 F or more.

    Follow up with your doctor as instructed. After You Go Home

    Your doctor may prescribe medication to help your heart and blood vessels. Tell your doctor about all of the other medications (prescription and nonprescription) you take. Take your medication exactly the way your doctor tells you to.

    Your doctor may also suggest that you change some of your lifestyle habits to prevent a heart attack, stroke or other health problems. Some risks cannot be controlled such as age and family history. Here are some things, though, that you can do:

    • Give up tobacco;
    • Control high blood pressure (with diet, exercise and medication-if prescribed);
    • Control high blood cholesterol (with a low-fat diet, exercise and medication-if prescribed);
    • If diabetic, control blood sugar;
    • Exercise regularly;
    • Maintain a healthy weight; and
    • Learn healthy ways to manage stress.

    Being committed to making healthy lifestyle changes and taking care of yourself is your best defense against future health problems.