Catheterization

Definition

Cardiac catheterization is a test that uses a catheter and an x-ray machine to check the heart and its blood supply.

Possible Complications

If you are planning to have cardiac catheterization, your doctor will review a list of possible complications. Complications may include:

• Bleeding at the point of the catheter insertion
• Damage to arteries
• Heart attack , or abnormal heart beats known as arrhythmia
• Allergic reaction to x-ray dye
• Blood clot formation
• Infection

Some factors that may increase the risk of complications include:

• Allergies to medications or x-ray dye
• Obesity
• Smoking
• Bleeding disorder
• Increased age
• Recent pneumonia
• Recent heart attack
• Diabetes
• Kidney disease

Reasons for Procedure

Cardiac catheterization is used to find the cause of symptoms, such as chest pain, that could suggest heart problems.

Cardiac catheterization helps doctors:

• Identify narrowed or clogged arteries of the heart
• Measure blood pressure within the heart
• Evaluate how well the heart valves and chambers are working
• Check heart defects
• Evaluate an enlarged heart
• Decide on an appropriate treatment

What to Expect

Prior to Procedure

Your doctor may order:

• Blood and urine tests
• Electrocardiogram (EKG)
• Chest x-ray
• Stress test

Talk to your doctor about your medications. You may be asked to stop taking or change the doses of some medications before the procedure.

Leading up to your procedure:

• Arrange for a ride to and from the procedure.
• The night before, do not eat or drink anything after midnight.

Anesthesia

Local anesthesia will be used at the insertion site. A mild sedative may be given 1 hour before the procedure or through an IV during the procedure. This will help you relax.

Description of the Procedure

During the procedure, you will receive IV fluids and medications. An EKG will be monitoring your heart's activity.

You will be awake but sedated so that you will be more relaxed. You will be asked to perform basic functions such as coughing, breathing out, and holding your breath. Tell your doctor if you feel any chest pain, lightheadedness, nausea, tingling, or other discomfort.

The catheter will be inserted into an artery in either the groin or arm. The insertion area will be cleaned, and numbed. A needle will be inserted into a blood vessel. A wire will be passed through the needle and into the blood vessel. The wire will then be guided through until it reaches your heart. A soft, flexible catheter tube will then be slipped over the wire and threaded up to your heart.

X-rays will be taken during the procedure to know where the wire and catheter are. Dye will be injected into the arteries of the heart. This will make the arteries and heart show up on the x-ray images. You may feel warm during the dye injection.

Insertion of Catheter with Guide Wire through the Groin

Copyright © Nucleus Medical Media, Inc.

Once in place, the catheter can be used to take measurements. Blood pressure can be taken within the heart's different chambers. Blood samples may also be taken. Multiple x-ray images will be taken to look for any disease in the arteries. An aortogram may also be done at this time. This step will give a clear image of the aorta. After all the tests and images are complete, the catheter will be removed.

Sometimes, a balloon angioplasty and stenting will be done if there is an area in your arteries that is narrow or clogged. These procedures help to open narrowed arteries.

Finally, a bandage will be placed over the groin or arm area.

How Long Will It Take?

The procedure takes about 30-90 minutes. Preparation before the procedure and recovery after it will add several hours to the total time.

How Much Will It Hurt?

Although the procedure is generally not painful, it can cause some discomfort, including:

• Burning sensation when the skin at the catheter insertion site is anesthetized
• Pressure when the 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 needed.

Average Hospital Stay

0-1 day

Postoperative Care

At the Care Center

• EKG and blood studies may be done.
• If the catheter was inserted in the groin area, you will likely need to lie still in bed and flat on your back for a period of time. If the catheter was in your arm, you will likely be out of bed sooner.
• A pressure dressing may be placed over the area where the catheter was inserted to help prevent bleeding. It is important to follow instructions.

At Home

When you return home, do the following to help ensure a smooth recovery:

• Do not lift heavy objects or engage in strenuous exercise or sexual activity for at least 5-7 days.
• You can make lifestyle changes to lower your risk for further complications of heart disease. These include eating a healthier diet, exercising regularly, and managing stress.
• Be sure to follow your doctor’s instructions .

Call Your Doctor If Any of the Following Occur

Contact your doctor if your recovery is not progressing as expected or you develop complications such as:

• Signs of infection, including fever and chills
• Redness, swelling, increasing pain, excessive bleeding, or any discharge from the catheter insertion site