Diagnostic procedure done to detect problems with the heart and its blood supply
Parts of the Body Involved
Heart
Leg or arm
Reasons for Procedure
This procedure is generally done as a diagnostic test after a person experiences chest pains or other symptoms that could point to a problem with the heart.
Cardiac catheterization helps doctors to:
Identify narrowed or clogged arteries leading to or within the heart
Measure blood pressure within the heart
Evaluate how well the heart valves function
Determine how well the four chambers of the heart function
The night before, do not eat or drink anything after midnight (except for liquids taken with medication).
During Procedure
IV fluids and medications
Fluoroscopy
EKG
Anesthesia
Possibly a sedative
Anesthesia
Local anesthesia applied to the insertion site, and possibly a mild sedative given one hour before the procedure or via IV during procedure
Description of the Procedure
You'll be awake, but given sedation so that you'll be more relaxed and less anxious. Your doctor asks you to perform basic functions such as coughing, exhaling, and holding your breath. A clear plastic hood may be placed briefly over your head to measure the air you exhale and determine your heart's pumping efficiency. If you feel any chest pain, dizziness, nausea, tingling, or other discomfort, tell your doctor.
The catheter is threaded over a guide wire, inserted into an artery in your arm or leg, and fed up and into the heart. Your doctor watches the threading and placement of the catheter via a fluoroscope, which is a type of x-ray that takes pictures of moving organs.
Once in the heart, the guide wire is removed. The catheter is then used to measure blood pressure within the heart's different chambers and to take blood samples.
Dye is injected though the catheter and into the coronary arteries. Multiple x-ray images are taken to allow identification of any disease in the coronary arteries. An aortogram, which gives a clear image of the aorta, may also be performed at this time. The catheter is then removed.
After Procedure:
EKG and blood studies are done.
If catheter was inserted in your groin, you will be required to lie flat on your back for at least six hours. During this time a catheter may be inserted in your bladder to assist with urination.
A sandbag may be placed over your groin to exert pressure on the artery used for catheterization and prevent bleeding.
If the catheter was inserted in your arm, you will be required to keep your arm perfectly straight using a stiff arm board, but you will be allowed out of bed within 2 hours.
You will be encouraged to drink lots of fluids to flush the x-ray dye from your system.
How Long Will It Take?
The actual procedure takes 1-2 hours, and the preprocedure tests take 1-2 hours.
Will It Hurt?
Although the procedure is generally not painful, it can cause some discomfort, including:
Burning sensation (when skin at catheter insertion site is anesthetized)
Pressure when catheter is inserted or replaced with other catheters
A flushing feeling or nausea when the dye is injected
Headache
Heart palpitations
Pain medication will be given when necessary.
Possible Complications
Complications are rare, but can include:
Blood clots, possibly resulting in
heart attack,
stroke, kidney damage, lung injury, or damage to arms or legs
Accumulation of fluid in the heart sac that can interfere with the heart pumping and adequately circulating blood, called pericardial tamponade
Average Hospital Stay
0-1 days
Postoperative Care
If you are diagnosed with heart valve disease, you may be given antibiotics to avoid valve infection or endocarditis. Take all of the antibiotic prescribed, even if you do not feel ill.
Do not lift heavy objects or engage in any strenuous exercise or sexual activity for a minimum of 24 hours.
Change the dressing around catheter incision area as instructed.
Take medications as instructed.
Use acetaminophen for pain relief, not aspirin or ibuprofen.
Use an electric heating pad or warm compress to relieve pain at the catheter insertion site.
Bathe and shower as usual, but keep the wound dry and covered with a bandage for the first 2-3 days after surgery.
Outcome
The test results are generally available within 24 hours of the procedure. At that point, your doctor will discuss the findings and suggest appropriate treatment options. In some cases, the results can indicate an immediate need for surgery.
Call Your Doctor If Any of the Following Occurs
Signs of infection, including fever and chills
Extreme sweating or nausea
Leg feels cold, turns white or blue, or becomes numb or tingly
Redness, swelling, increasing pain, excessive bleeding, or discharge at point of catheter insertion
Extreme pain, including chest pain
Difficulty breathing
Cough, shortness of breath, chest pain, or severe nausea or vomiting
RESOURCES:
American Heart Association http://www.americanheart.org
Heartinfo.org http://www.heartinfo.org
CANADIAN RESOURCES:
Heart and Stroke Foundation of Canada http://ww2.heartandstroke.ca/Page.asp?PageID=24
University of Ottawa Heart Institute http://www.ottawaheart.ca/UOHI/Welcome.do
References:
American College of Cardiology website. Available at: http://www.acc.org/. Accessed October 14, 2005.
Heartinfo.org. Center for Cardiovascular Education website. Available at: http://www.heartinfo.org/. Accessed October 14, 2005.
Medical encyclopedia: cardiac catheterization. Medline Plus website. Available at: http://www.nlm.nih.gov/medlineplus/ency/article/003419.htm. Accessed October 14, 2005.
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
