Cardiac Catheterization

Cardiac catheterization is a general term, which means placement of a catheter in the heart. The catheter in the heart can be used to measure chamber pressures, inject dyes and other medications, passage of wires, balloons, or other devices, measuring oxygen saturations or mapping the electrical conduction.

Cardiac catheterization is performed by a specially trained team of technicians, nurses, and doctors. A long, thin, flexible tube, a catheter, is inserted into a blood vessel in the arm or leg. A special type of x-ray screen, called a fluoroscope, shows the blood vessels and the heart so the doctor can guide the catheter into the correct position.

Heart pressures are measured inside the heart chambers. Samples of blood are taken through the catheter. Other tests depend on your particular problems.

X-ray studies are usually made during cardiac catheterization. Dye is injected through the catheter into different areas of the heart. One type, the coronary angiogram, shows blood flow through the coronary arteries to locate blockages. A ventriculogram shows the size and pumping action of the heart muscle, as well as the opening and closing of the heart valves.

The electrical conduction system can also be tested to pinpoint the cause of irregular heartbeats and test how well the drugs are working to correct them.

Preparation

If the procedure is done in a hospital, you will usually be admitted a day before the procedure. If you are allergic to shellfish or have ever had a reaction to x-ray dye, be sure to tell your doctor. The area where the catheter is inserted, usually the arm or the groin area, is shaved. You are not allowed to have anything to eat or drink 6 to 12 hours before the procedure

How is it done:

Most people are a little nervous to learn that they will be awake during the procedure to follow the doctor's instructions. However, you should experience little discomfort. You are given a sedative before the procedure to help you relax. You will be monitored throughout the procedure.

Some procedure rooms may use tables that move from side to side while the x-rays are taken. In other rooms the table remains in one position while the camera moves around you. In either case, you are securely strapped to the table.

The area where the catheter is inserted is shaved and disinfected, and your arm or leg is strapped down. Sterile towels are placed over you to prevent infection. You usually cannot see what is occurring. After a local numbing medicine is injected, a small incision is made for the insertion of the catheter.

As the catheter is inserted, you will feel a slight pressure. At times during the procedure, the doctor may ask you to hold your breath, cough, and breathe deeply. You may also be asked to breathe oxygen. Medications may also be given during cardiac catheterization. Nitroglycerin is sometimes used to dilate the coronary arteries. If you heart's electrical conduction system is tested, you may be given drugs to speed up or slow down your beat.

Cardiac catheterization takes between 1 and 4 hours, depending on how many tests are performed.

When the x-ray dye is injected, you may experience a flushing sensation and nausea, but this will disappear quickly.

After

After all tests and procedures are done, you'll return to the cardiac care unit (CCU) or a special recovery room. There, you may need to remain lying down for a few hours. Depending on what procedures you had, you will go home the same day or stay overnight. Before you leave the hospital, your doctor will discuss the test results with you.

The sheath may be left in place for few hours to prevent bleeding. Sometimes a special plug, a stitch, or a pressure device is applied to the insertion site.
A nurse will regularly check your pulse and blood pressure. He or she will also check the insertion site for bleeding. While you are in the hospital, you'll remain connected to a heart monitor. An IV line may also continue to give you fluids and medications for a few hours.

Call the nurse if:

• You feel any chest pain or feel discomfort at the insertion site
• The arm or leg closest to the insertion site becomes numb or cold
• You feel warmth or wetness around the insertion site-a sign that you may be bleeding
• You have swelling near the insertion site