Heart Catheterization
What Is A Cardiac Catheterization?
A cardiac catheterization is an x-ray examination of the heart and
its major blood vessels and valves. Dr. Baker inserts a plastic tube into the
artery and vein by way of the groin or arm and passes it through the body to the
heart.
To make the arteries show up on the film, a special contrast (x-ray dye)
must be injected into the heart and coronary artery vessels through a thin,
flexible tube (the catheter) while the x-rays are taken.
Why Am I Having The Exam?
Your physician has scheduled a cardiac catheterization to
evaluate your heart. The exam can help determine the cause of symptoms such as
chest pain (angina), cyanosis (blue discoloration of the skin), shortness of
breath, irregular heart beats, or syncope (fainting).
Some patients do not have
any of these symptoms, but have had a check-up and a stress test which may have
shown a problem. The catheterization can detect narrowed or blocked vessels
that surround your heart, a bulging artery wall, abnormal heart muscle, and
congenital (birth) defects.
How Do I Get Ready?
Dr. Baker will explain the exam and its risks and ask you
to sign a consent form. He will need to know if you’ve ever had an allergic
reaction to iodine, seafood, x-ray dye, or other medications; and if you suffer
from glaucoma or asthma.
If so, you may receive medications (a steroid or
antihistamine) before the exam to minimize any reaction to the intravenous x-ray
dye.
You may eat or drink as usual on
the day before your procedure. After midnight, you probably will NOT be
allowed any food or liquids until after your cardiovascular procedure. If
your procedure is later in the day, you may be permitted clear liquids
(broth, bouillon, clear juices, or coffee) for breakfast.
If you are on
blood thinner or diabetic medications, please let Dr. Baker know before the
procedure.
What Happens During The Test?
Although the procedure takes only 30-60 minutes, you will
be in the Catheterization lab for about 1 ½ hours for preparation and
monitoring.
In the Lab you’ll be helped onto a table where you will
lie on your back under a large x-ray machine. The procedure room will be cold
and the table is very narrow. You’ll see what looks like a “movie camera” that
is attached to the x-ray arms, and a TV-like monitor of to the side.
The Cath
Lab staff will place adhesive (sticky) electrodes on your chest, arms and legs.
Wire connecting the electrodes to the monitor allow Dr. Baker to watch your
heart rhythm during the exam. The Cath Lab staff will also place an oxygen
monitor on your finger or toe, and a blood pressure cuff on your arm.
Dr. Baker will chose a site for the insertion of the
catheter, usually the groin, but sometimes the arm. (If the arm is chosen as the cath site, a small incision
may be made to obtain access to the artery).
The staff will clean the
procedure area with some antiseptic solution, and cover it with a sterile drape
that will cover most of your body. It’s important that you do not touch the
drape or move once you have been covered.
Next, Dr. Baker will inject a local anesthetic (numbing
medication). You’ll feel the needle prick your skin and perhaps a burning
sensation for a second or so. Once this area is numb, Dr. Baker will insert the
catheter.
You may feel pressure or a brief, sharp pain as it goes in. The
lights in the room will be dimmed so Dr. Baker can watch and guide the catheter
on the TV-like monitor. Dr. Baker will pass the catheter through the main blood
vessel.
As the catheter is moving, you may feel a slight pressure or a
fluttering sensation, but since there are no nerves inside the blood vessels,
you will not feel pain. You may feel your heart skip a few beats as the
catheter is guided into your heart.
When the catheters are in
position, Dr. Baker will slowly inject the contrast dye. You may be asked
to move slightly, breathe deeply, cough, or hold your breath from time to
time to help move the dye through the bloodstream. It is very important to
carry out these instructions promptly.
During one injection, you may
feel a flushing sensation (hot flash) for a few seconds, but this will
pass. Tell Dr. Baker what you are feeling, especially if you are
experiencing any chest pain, nausea, light-headiness, or itching, or if you
have trouble breathing.
The x-ray cameras will rotate
around you to take several views of your arteries. The cameras will come
very close to your face and arms. You’ll hear a whining noise as the camera
takes a picture of the dye’s movement through the blood vessels. Dr. Baker
may ask you to hold your breath while the pictures are taken. You can
breathe again when the “whining” noise stops. At times, you may be able to
watch the TV-like monitor.
A series of x-rays will be taken. The staff will be
moving about the room and will be available to help you as needed. The
catheterization itself usually takes about 30-45 minutes. After Dr. Baker has
taken all of the pictures, you will be returned to the holding area in the Cath
Lab.In the holding/recovery area , the tubes will be removed
from your cath site (groin). Pressure will be applied to the cath site for
about 15-30 minutes, or until the bleeding has stopped. When the bleeding is
stopped and there is no swelling, a dressing (bandage) may be placed over the
cath site. You will go to your room.
While you are in the holding room, Dr.
Baker may visit your family in the waiting room. Your physician will see you
later to give you a full report, after the pictures have been studied.
What Happens Afterwards?
You’ll stay in bed 6-8 hours after the procedure. If the
catheter was inserted through an artery in the groin, keep your leg straight and
lie flat in bed; the head of your bed may be elevated 30 degrees for meals.
If
an artery in your arm was used, the head of the bed can remain at 30 degrees,
but keep your arms straight. If you need to cough, strain, or sneeze, please
hold pressure with your hand over your procedure site. You may also need to use
a bedpan or urinal during this period of time.
Your nurse will frequently check the place where the
catheter was inserted. Your heart rate, blood pressure, and pulse will be
checked. Tell your nurse if you feel nauseated, if your dressing feels wet, or
if you need pain medications.
The nursing staff will let you know when you may
get our of bed with help. Ask about resuming your regular diet. Unless told
otherwise, it is very important to drink plenty of fluids to help remove the
contrast (x-ray dye) from your body. You may be admitted to the hospital based
upon the outcome of this test.
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