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When You Need to Have
a Cardiac Catheterization: A Patient Guide
What is cardiac catheterization?
It is a diagnostic procedure which is performed in order to detect problems with the heart
and its blood supply. A long, thin tube (a catheter) is inserted into the heart, with it,
the doctor measures pressures and injects dye and x-ray pictures are taken. It will help
your physician determine which treatment is most appropriate for you.
The catheterization procedure will provide a great deal of information about your heart
function. It shows the heart's pumping ability, the pressure within the various heart
chambers, detailed structural information about the heart and blood vessels, and the
pattern of flow within the heart and major blood vessels.
Tell your doctor about allergies?
Because an iodine-related dye is injected into your bloodstream during the procedure,
please advise your doctor if you have a history of being allergic to shellfish,
medications, x-ray dye or IVP dye..
How long does the procedure take? Are there any other
tests involved? Will I have to stay overnight in the hospital?
The catheterization itself normally takes one to two hours; however, prior to your
procedure you will need to have some blood tests, chest x-rays and an ECG
(electrocardiogram) performed either before, or the day of the catheterization. Heart
catheterization is often an outpatient procedure.
Will this take place in the operating room?
Generally, cardiac catheterization takes place in a specialized cardiac catheterization
laboratory. This is a sterile environment (all medical personnel will wear gowns, masks
and gloves), and there is equipment present which is specific to this type of procedure.
Some of the specialized equipment includes an x-ray movie camera which takes pictures of
your chest from various angles; there will also be a television monitor present that will
allow the doctors to see your heart as it functions. Your heart and blood pressure will be
monitored throughout the procedure.
Where and how do they insert the catheter? Will I be
under general anesthetic? Does it hurt?
The normal points of entry are either the groin area or the forearm. The immediate skin
area is numbed with a local anesthetic, which is administered through a needle. You will
feel an initial pin prick as the needle is inserted, and then a burning sensation as the
anesthetic is injected. You may also feel pressure when the catheter itself is inserted,
and/or exchanged with other catheters during the procedure.
Once the initial needle is inserted, a guide wire is passed through the needle and the
needle itself is removed. Next, a small plastic tube (catheter) is threaded over the wire
and guided through the vessel and into the chambers of the heart. The doctor uses an x-ray
to confirm the desired location of the catheter tip, and then removes the guide wire. The
catheter is connected to special equipment that records pressures in the different heart
chambers.
You will be awake throughout the entire procedure; in fact, the physicians will require
your cooperation at various times during the testing, to perform certain basic functions
(e.g. exhale, cough, hold your breath).
You may be given a mild drug to make you sleepy (mild sedation).
There will be several periods when x-ray sensitive contrast dye will be injected, via
catheter, into your bloodstream. At these moments (approximately 30-60 seconds each) you
will probably feel a warm sensation that spreads from head to toe.
Once the testing is complete, the catheters will be removed and pressure will be applied
for approximately 15 minutes. You will then be taken back to your room.
How long does recovery take?
You will likely be allowed to go home the same day or the next day; however, the first few
hours after the procedure are very important, and you must follow the hospital staff's
directions very closely.
If the point of insertion was your groin: You will be required to lay
flat on your back for a minimum of four hours, once you are returned to your hospital
room. It is important that you pay careful attention to your doctor's instructions not to
sit up or bend your legs, in order to minimize the chances of bleeding. After a few hours,
if there has not been any bleeding at the site of catheter insertion, the hospital staff
will assist you in turning onto your side. You will likely be allowed out of your bed in a
few hours.
If the point of insertion was your arm: You will be permitted to get out
of bed within two hours; however, you must keep your arm straight using a stiff armboard.
Your blood pressure and pulse will be taken frequently by the nursing staff, and the site
of insertion will be checked for bleeding.
You will be encouraged to take in many fluids, first intravenously and then orally.
If you experience any back pain or discomfort during recovery, ask your nurse for pain
medication. If you feel any pain in your chest, or see any bleeding at the point of
insertion, notify the hospital staff immediately.
The first time you get out of your hospital bed you will require assistance from a nurse,
as you may feel light-headed.
If there are no further complications, you will be permitted to go home.
When will we know the results of the catheterization?
Your doctor will be able to discuss the findings of the test either the same afternoon or
the day after your procedure; a plan of therapy can then be discussed. |
