What is cardiac catheterization?
Cardiac catheterization is a diagnostic test used to evaluate the heart and coronary arteries. A long, thin, flexible tube called a catheter is put into a blood vessel in your arm or groin and threaded to your heart. Through it, your doctor will inject a special contrast (dye), which traces the movement of blood through your arteries and can be visualized on an x-ray. The test is called coronary angiography. The dye can show whether plaque has narrowed or blocked any of your coronary arteries. Over time, plaque can restrict blood flow to your heart. When plaque builds up in the coronary arteries, the condition is called coronary heart disease (CHD) or coronary artery disease (CAD).
Are there any tests I need to have before the Cardiac Catheterization takes place?
Yes, there are. They include blood tests, urinalysis, a chest x-ray and an EKG. These tests are given to ensure optimal and safe conditions during your cardiac catheterization procedure.
Where does the procedure take place? Is it painful? Can I eat before the procedure? Can I continue taking the medications I'm on?
All good questions. Cardiologists (heart specialists) usually do cardiac catheterization in a hospital. You're awake during the procedure, and it causes little to no pain. However, you may feel some soreness in the blood vessel where the catheter was inserted. You will be instructed not to eat or drink on the morning of the procedure; unless your procedure is much later during the day; in which case, a light breakfast may be allowed. Your physician will tell you what medicines you may or may not take. It is generally acceptable to take blood pressure medications and heart medications with a small amount of water. However, blood thinners (such as Coumadin), Diuretic (such as Lasix) and certain meds for Diabetes are not allowed.
What if my Cardiac Catheterization is being done on an outpatient basis?
If you're scheduled as an outpatient, you will have received a phone call in advance in order to preregister for the procedure. On the day of your procedure, plan on arriving 1 – 1 1/2 hours prior to the procedure. Please arrange for someone to drive you to and from the hospital. We cannot allow patients to drive after the procedure. Report to the Admitting Department on the first floor of the Hospital, just beyond the main entrance lobby. There, your information will be verified, and you'll sign some papers. You will then be directed to the Short Stay Unit, which is also located on the first floor, just steps away from the main elevator. The nursing staff will ready you for your procedure. They'll take your blood pressure, pulse and temperature and verify your medical history and medications. The site your doctor is preparing to use for the procedure will be washed and prepped. An intravenous needle will be placed in your arm. Additional blood work may be drawn. When it's time for your procedure, you may be given some medication to help you relax, and you will be sent to the Cardiac Cath Lab. Your family will accompany you to the 4th floor and be directed to a waiting area just outside it. After your procedure, and with your permission, the doctor will speak with your family.
What is the actual procedure like?
Lawrence General Hospital is equipped with a brand new state of the art catheterization suite with Siemen's imaging and McKesson hemodynamic monitoring systems. Our staff has many years of cardiac catheterization lab, critical care and angioplasty experience. Our interventional physicians are on staff at Lawrence General as well as other Boston area hospitals, such as Beth Israel Deaconess, Lahey Clinic, St. Elizabeth's and Mass General, to name a few. Your own cardiologist will be performing your diagnostic procedure. He or she will determine which site (groin or arm) will be appropriate for your procedure. Once you are situated on the cath lab procedure table, you will be connected to monitoring equipment. Your groin area/arm will be prepped, and you will be covered with a sterile drape. The procedure itself doesn't take too long. Generally speaking, once we have access to the artery of choice, it takes only about 20-30 minutes to take the pictures.
After your doctor completes the diagnostic part of the catheterization, he or she will let you/your family know of the results. If it is determined that there is a need to perform an angioplasty or stenting, one of the interventional doctors will be notified. Lawrence General has strict guideline to follow regarding angioplasty procedures. If you meet all the criteria, we will go ahead and repair the blocked area in your heart. This procedure is known as a PCI (Percutaneous Coronary Angioplasty). Stenting will be done in order to keep the area from closing off.
What happens after the procedure is completed?
Once the procedure is completed, you'll be moved to a special care area to recover. You'll rest there for several hours or overnight in some instances. During this time, your movement will be limited to avoid bleeding from the site where the catheter was inserted. Nurses will monitor you closely. They'll check your heart rate and blood pressure regularly and check for bleeding from the catheter insertion site.
A small bruise may develop on your arm or groin at the site where the catheter was inserted. That area may feel sore or tender for about a week. By all means let your doctor know if you develop problems such as:
- A constant or large amount of bleeding at the insertion site that can't be stopped with a small bandage
- Unusual pain, swelling, redness, or other signs of infection at or near the insertion site
Your doctor will provide a plan or care and/or follow up for you. Talk to him/her about whether you should avoid certain activities, such as heavy lifting, for a short time after the procedure.