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.
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.
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.
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: 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.
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.
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. Call the nurse if:
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.