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Cardiac Catheterization

 

Cardiac catheterization (also called cardiac cath, coronary angiography or heart catheterization) gives your doctor a view of the valves, the heart muscle and coronary arteries at work. If your doctor finds a problem during a catheterization, he or she may treat it right away.

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We will explain what you can expect:

We will also describe the types of nonsurgical treatments that can be done during catheterization and what each does. Heart catheterization is not the same as heart surgery, though the procedure is typically performed in a hospital and does require some recovery time.


 Before Your Cardiac Catheterization

  • Your doctor will answer your questions.
  • Tell your doctor or nurse if you are allergic to any of the following: shrimp or other shellfish, iodine, Betadine®, IVP dye.
  • Your nurse will ask you to sign a consent form. If you have any questions or concerns about your cardiac cath procedure, please talk them over with your nurse.
  • Do not eat for 6 to 8 hours before the test. If you need to swallow pills or are thirsty, drink water in little sips.
  • If you take daily medications, your doctor may have the hospital staff hold some of them until after your cardiac cath.
  • Your nurse will ask if you have to go to the bathroom. Even if you don't feel an immediate need, go! You will be lying on your back for several hours, which can be very uncomfortable if you have a full bladder.
  • We will start an intravenous (IV) line in your arm or hand. You will receive medications and fluids through this IV during the catheterization.
  • Your family will probably be able to stay until we take you to the cath lab . Then, a nurse will show them to a waiting area and  we will keep them informed about your progress.

 During Your Cardiac Catheterization

Cath lab staff will check your blood pressure, heart rhythm, the pulses in your feet and your blood-oxygen levels.

In the cath lab, you will lie on an X-ray table surrounded by several machines. During the procedure, the staff will use these machines to monitor your heart.

The temperature in the room may feel cool at first. The cool temperature will help you from getting too hot when we cover you with sterile sheets.

To protect you, the doctor and staff will wear sterile gloves, protective clothing and masks.

We will wash your skin and shave your groin and/or on your arm where the catheters will enter your body. Then we will cover the areas with sterile towels and sheets to make sure they stay clean. Please do not touch these areas.

You will be awake for the cath, but the doctor will give you a local anesthetic to numb the areas around the insertion sites. Your skin around the areas will sting for a minute, then will become numb.

The doctor will place 1 or 2 plastic tubes (sheaths) through your skin at the insertion site(s). These sheaths protect the skin and help guide the catheters into the major blood vessel.

You might feel a gentle pressure as the doctor moves the catheters through your arteries to your heart, but it should not be painful. If you feel any discomfort at the insertion sites or have any chest pain, tell your doctor. We can give you more medication through your IV to ease any discomfort.

The doctor will inject a contrast dye through the catheter into the coronary arteries and your heart.

You may feel a warm sensation, nausea or have the urge to urinate when the contrast dye is injected. These sensations are normal and should pass quickly. If you have any chest pain, tell your doctor.

We will ask you to cough or to hold your breath so we can take X-rays.

If the cath shows that you have a blockage or narrowing, your doctor may perform one or more of the following treatments:

  • Percutaneous Coronary Angioplasty (PTCA)
  • Coronary Stent
  • Brachytherapy
  • Coronary Atherectomy
  • Coronary Rotablator

If the cath shows that you have valve disease, the doctor may use a nonsurgical procedure called balloon valvuloplasty to correct the problem.

NOTE: New treatments for CAD and valve problems become available each day. If your doctor uses a technique that is not described, it may be a new treatment. In that case, your doctor will give you more information.

After your heart catheterization is completed, your doctor will decide to remove the sheaths or leave them in place. If your doctor removes them, the area will be sealed either with a pressure dressing or a closure device.

  • Pressure dressing — Before applying the pressure dressing, the nurse will put pressure on the insertion site area for 15 minutes or longer to prevent bleeding.
  • Closure device — A closure device is a plug that will dissolve in your body within about 6 weeks. Some closure devices will leave a small knot about the size of an olive pit under the skin for about 6 weeks after the cath.
  • If your doctor leaves the sheaths in place, you will remain on "bed rest." Once the sheath is removed and your doctor gives the OK, you will be able to get out of bed and walk with your nurse's help.

After Your Cardiac Catheterization

Cath lab staff will return you to your room or a special monitoring area, and your family may visit.

Your nurse will check your blood pressure, heart rate, pulses in your feet, and the insertion site often.

Do not bend your leg or sit up until your nurse tells you it's OK to do so.

  • You may move your ankle and wiggle your toes to relieve stiffness.
  • You will be able to bend your other arm or leg.
  • If you wish, we can raise the head of your bed slightly.

You will be able to eat shortly after returning to your room.

Drink plenty of fluids to flush the contrast material from your body.

Please tell your nurse if you have any concerns or questions, if your dressing comes loose, or if you feel any of the following:

  • Discomfort at the insertion site
  • Any sudden warmth or oozing under your dressing
  • Any numbness or tingling in your leg
  • Any lower back pain

When your doctor gives the OK, you will be able to get out of bed and walk with your nurse's help.

When your doctor or nurse removes the dressing at the insertion site, you may notice that the area is black-and-blue or swollen. This is normal and won't last long.

If you have to sneeze or cough, place your fingers over your insertion site and hold it firmly.

If your doctor used a closure device, your nurse will give you information about how to care for the area. For about 5 to 7 days you will have a noticeable knot under your skin. This knot will go away gradually in about 6 weeks.


Home care

For the next 2 days, take it easy.

  • If the catheter was inserted in your arm for your cath, you should stretch and bend the arm, but avoid strenuous movement.
  • Do not bend over, strain or lift objects (10 pounds or more).
  • Limit the number of stairs you climb.
  • If you have to sneeze or cough, place your fingers over your insertion site and hold it firmly.

If you have a dressing follow these safeguards:

  • You should be able to shower 24 hours after your cath. Do not swim or sit in a bath tub or jacuzzi until your doctor says it's OK.
  • Leave the dressing on your groin or arm until the next day.
  • Removing the dressing can be difficult. It is best to remove it in the shower. Soak the area thoroughly with soap, then gently peel the dressing away from the skin a little at a time.

If you have bleeding at the insertion site, apply pressure with a clean folded cloth until the bleeding stops. Call your doctor or 911 immediately if you experience severe pain or notice bright red blood or severe swelling at the insertion site.

If you had treatment in addition to your catheterization, your doctor will
prescribe medication to prevent blood clots.

  • Take only the amount of medication your doctor has ordered.
  • Do not take additional aspirin or products that contain aspirin for pain relief. Follow your doctor's instructions for dealing with pain.

Most patients return to their usual routines within 2 or 3 days. Ask your doctor when you can start driving and can return to work.

Call your doctor if you have any of the following symptoms:

  • Severe pain or bleeding at the insertion site
  • Chest pain or discomfort
  • A temperature of 100°F or higher
  • Increased redness or swelling at the insertion site

 

For More Information 

podcasts Podcast: Catheterization 
video Video: Cardiac catheterization 
question mark Learn more about cardiac catheterization  


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