Cardiac Catheterization

Cardiac Catheterization is a procedure when doctors insert a catheter (a long, thin, flexible tube) into a blood vessel toward the heart.

The procedure allows doctors to study how well your heart pumps blood and to examine the coronary arteries, as well as the heart valves.

Cardiac catheterization allows doctors to diagnose heart conditions, such as coronary heart disease, heart valve disease, congenital heart defects, and heart muscle disease.

Benefits of Catheterization

Cardiac Catheterization provides more accurate and detailed information about how your heart is working than other diagnostic tests. This information helps doctors diagnose your problem accurately and allows them to choose the most effective treatment.

Cardiac Catheterization can be prescribed for the following reasons:

  • After a heart attack, to find out how severely the coronary arteries are narrowed or blocked.
  • To evaluate or confirm coronary heart disease
  • To evaluate the cause of heart failure
  • To see how well blood flows through the coronary arteries after angioplasty or bypass surgery.
  • To determine whether treatment can help a patient diagnosed with coronary disease.
  • To determine whether there is a congenital heart defect and evaluate how severe it is
  • To determine if there is significant heart valve disease that might require surgery

Is Catheterization Safe?

The test is generally safe, but because on or more catheters are inserted into your body, catheterization does have a small risk. Most of the complications, if any occur, are minor and temporary. These include nausea and vomiting, allergic skin rash (hives), and irregular heartbeat.

Some people may have bleeding at the insertion site, or swelling and/or bruising in the groin or arm. More serious complications include damage to the heart and blood vessels, blood clots, infection, allergic reactions to the contrast, abnormal heart rhythms, damage to the kidneys from the contrast, heart attack, or stroke. These complications are rare however. Death is very rare. Most patients who have catheterization do not have serious complications. However, you should be aware of the risk involved. If you have any questions about your own risk, ask your doctor.

 Preparation for the Catheterization

  • Do  not to eat or drink anything for 6 to 8 hours before the procedure. You may have small sips or water.
  • If you take medications, tell your doctor. You may be asked to stop some medications (such as aspirin or anticoagulants) for a few days before your catheterization.
  • Bring a list of the names and dosages of all the medications you are taking.
  • Ask someone to drive you to and from hospital. You will not be permitted to drive home after the procedure, since you may be sedated.
  • Pack a small bag in case you will have to stay in the hospital overnight. Take with you a robe, slippers, pajamas or nightgown, and toiletries.
  • Empty your bladder as much as possible before the procedure begins.
  • Tell the doctor or nurse if you have had any allergic reactions to medications or x-ray dye (contrast), iodine or seafood, or if you have a history of bleeding problems.

What to Expect

A complete cardiac catheterization procedure usually takes from  1 to 2 hours.

You will be given medication to help you relax and make you drowsy. You may be awake, or you may sleep through part or all of the procedure. The staff will be monitoring you at all times.

You may be asked to take a deep breath and hold it, to keep the pictures from blurring. You may also be asked to couth forcefully several times, to help move the dye through the heart.

The procedure generally is not painful, although you may feel some pressure at the catheters are inserted. You will not feel the catheters as they move through the blood vessels and into your heart. For many, the most difficult part of the procedure is having to lie for a long time on a hard table.

As x-ray contrast is injected into the heart, you may feel a warm sensation (“hot flash”) through your body, lasting for 20 to 30 seconds. You may also feel nausea, chest discomfort, or a mild headache.

If you feel pain or discomfort at any time during the procedure, let the staff know.

 After You Go Home

  • Limit your activity during the first couple of days at home. You can move about, but do not strain or lift heavy objects.
  • Leave the dressing on your groin (or arm) until the day after the procedure. The nurse will tell you how to take it off and when it is OK to take a shower.
  • A bruise or a small lump under the skin at the catheter insertion is quite common. It should disappear within a few weeks.
  • Ask your doctor when you can return to your normal activities and whether there are things you should not do.
  • Ask your doctor or nurse which medications you can keep taking and which ones you need to stop.
  • Call your doctor if the insertion site begins to bleed, the bruising or swelling increases, or the leg ( or arm) where the catheters were inserted feels cold or numb.
  • Call you doctor or nurse if the insertion site becomes painful or warm to the touch, or you develop a temperature over 100°F.