Cardiac Catheterization Procedure

Overview

Cardiac catheterization is a very common diagnostic test performed thousands of times a day. We will try to answer some of the questions you might have regarding this procedure. If you are not familiar with the Anatomy of the Heart or with Coronary Artery Disease, we suggest you review these also.

During 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. Dye is then injected into the coronary artery while x-ray pictures are taken. The dye in the coronary arteries is seen by the x-ray as a white line. A disruption of the white line may signify an area of plaque build-up inside the wall of the artery.

This picture shows an obstructed Left Anterior Descending (LAD) artery and stent. During this same procedure, dye is injected into the heart's pumping chambers in order to see how well the heart muscle is contracting and how well the valves are working. Pressure measurements are also taken at this time and are interpreted by your physician and by a computer.

What You Can Expect To Experience

Pre-Catheterization

You will be asked to come to our office before your procedure for pre-testing. This may include blood work, electrocardiogram (ECG or EKG), treadmill test, and chest x-ray. A nurse will make sure we have a complete list of your regular medications and give you instructions. You will be admitted to the hospital the morning of the procedure.  After midnight prior to the day of your procedure, you may be asked not to eat or drink anything, except enough water to take your medications.

About one hour before the procedure, you may be given a mild sedative to help you relax, but not put you to sleep. An intravenous line may also be started. You will remain awake but comfortable throughout the procedure so you may follow the doctor's instructions.

Catheterization

On your arrival to the cath lab, you will be asked to move onto a large ray table, and you will see a lot of equipment around you. Nurses and technicians will prepare you for the procedure by placing ECG electrodes on your chest, cleansing your groin area and elbow with antiseptic solution 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 Xylocaine.

After this medication has taken effect, your doctor will make a small puncture at the groin or arm where he will insert the catheter into your blood vessel. The physician will watch the movement of the catheter by x-ray. You may feel some pressure at the site of the insertion, but you will not feel the catheter inside your body. Once the catheter has been guided to your heart, the dye is administered through the catheter.

The stent in place in the  obstructed vessel.

There may be several injections of the dye, 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 while taking the picture of your heart muscle. When this occurs, you may feel a flush all over your body. This will last only for some 15 to 20 seconds. This is a normal reaction to the dye and is not a cause for concern.

During the catheterization procedure you may be asked to breathe deep and cough. The entire time in the cath lab will probably be less than one 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 firm pressure is applied to the incision in your groin or arm for approximately 10-30 minutes. A large dressing will be put over the incision.

If you feel pain, dizziness, faintness or cold hands or feet, let the nurses know immediately. You may develop a backache from lying flat and you will probably feel cold soon after you come out of the cath lab. These are normal feelings, and they will go away very soon. But be sure to notify the nurses so they can offer you pain medication or extra blankets.

Post-Catheterization

After the catheterization, you will he returned to a recovery area or your room. You may have to lie in bed from 3 to 6 hours unless a percutaneous stitch has been placed in the blood vessel opening. In this circumstance you may be allowed to ambulate much earlier. You will be allowed to resume eating and drinking now. Your blood pressure and pulse, as well as the puncture site, will be checked frequently.

Results

Your physician will discuss your findings with you and your family later that same evening or the following morning.

Discharge

Outpatient cases will be discharged and released later the same day of their procedure. Inpatients will be discharged the following morning.

When the dressing is removed, you will notice a small bruise at the catheter insertion site, no larger than the size of a quarter. You may also feel a hard lump at the insertion site, 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 vessel's 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 precise information about your heart.  Following this procedure, you and your physician can decide what options of treatment are best for you.