Anthony Sciarrino_what to expect_editorial

Heart Catheterization

A guide to heart catheterization

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You are here

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What it checks for

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Preparations

How it travels

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Things to avoid

Benefits

Aftercare

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Call 911 if

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During cardiac catheterization, a long narrow tube called a catheter is inserted into an artery or vein in your groin, neck, or arm.

This catheter is threadedthrough your blood vessel until it reaches your heart.

Once the catheter is in place, your doctor can use it to run diagnostic tests. For example, a dye can be injected through the catheter that allows your doctor to look at the vessels andchambers of the heart with the use of a special X-ray machine.

Cardiac catheterization is classified as a minimally invasive procedure, because no larger incisions are needed to reach the heart. It’s considered to be a safe examination method: only about 1 out of 100 examinations results in complications

Your doctor may ask you to undergo cardiac catheterization to diagnose a heart problem or to determine a potential cause of chest pain.

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Confirm the presence of a congenital heart defect Check for a narrow or blocked blood vessel Look for problems with your heart’s valves Measure the amount of oxygen in your heart Measure the pressure inside your heart

Cardiac catheterization is a medical procedure that cardiologists, or heart specialists, use to evaluate heart function and diagnose cardiac conditions.

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“ The procedure made me feel so much better that it was a positive, not a negative.”

Risks

Benefits

• Bleeding and bruising at the insertion site.

• Allergic reaction to the contrast medium.

• Usually temporary arrhythmia.

• Blood vessel and nerve damage.

• Acute heart attack or stroke.

The common technique is an angiogram, in which doctors inject dye into your heart through the catheter so they can see details of your heart at work.

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Treats heart attacks.

Analyzes heart disease.

Opens blockages in the heart.

Reduces need for a more invasive surgery.

The risk of major complications during diagnostic cardiac catheterization procedure is usually less than 1%, and the risk and the risk of mortality of 0.05% for diagnostic procedures.

During catheterization, doctors use X-rays and other instruments to examine your heart forblockages, measure pressure and blood flow in and around the heart, and collect blood or heart muscle samples.

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Do not eat or drink anything for two hours before the test.

If you have diabetes, discuss this with your doctor. Not eating can affect your blood sugar and adjustments may need to be made to your insulin dosage.

Your doctor will let you know if you can eat or drink before the procedure. In most cases, you won’t be able to have any food or drink starting at midnight the day of your procedure.

Having food and liquid in your stomach during the procedure can increase your risk of complications. You might need to reschedule if you weren’t able to fast.

Also, ask your doctor before taking any medications before the procedure.

Before starting the doctor first needs to know about any other medical problems you may have, such as diabetes, infections, bleeding disorders or allergies. It’s also important to let the doctors know what medication you use.

Before the catheterization begins, you’ll be asked to undress and put on a hospital gown.

You’ll then lie down and a nurse will begin an intravenous line. The IV, which is usually placed in your arm or hand, will deliver medication and fluids to you before, during, and after the procedure.

A nurse may need to shave the hair from around the catheter insertion site. You may also receive an injection of an anesthetic to help numb the area before the catheter is inserted.

When you are prepared and ready for your procedure, we will invite your family member or friend to come to the pre-op room. They can stay with you until it’s time for your procedure

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Cardiac catheterization is a procedure used to show on a computer monitor diseases that affect the heart, the cardiac valves or the coronary arteries. A cardiac catheter is a thin, flexible plastic tube that is moved through a blood vessel until it reaches the heart. X-ray monitoring is used to guide the catheter.

There are two main types of cardiac catheterization

Right heart catheterization: The catheter is inserted through a vein in the groin region or at the elbow and then advanced to the right ventricle and the pulmonary artery. Flow directed catheters have a small inflatable balloon at the tip, allowing them to be carried by the flow of blood. The catheter is used to measure the pressure levels in the right ventricle and the pulmonary artery. A contrast medium is injected through the catheter so that the right chamber, the circulation of blood and the function of the cardiac valves can be examined.

Left heart catheterization: This catheter is advanced through an artery in your groin region, elbow or wrist and into the heart’s left ventricle. After a contrast medium has been injected it’s possible to examine the left ventricle, the aorta, the circulation of blood and the performance of the cardiac valves.

It’s possible to take tissue samples during both of these procedures.

Doctors can also check possible causes of arrhythmia. Specialized catheters may be used to measure how much blood the heart pumps in one minute. This can help doctors find out whether the heart is performing poorly.

The doctor punctures a blood vessel and then inserts the catheter to move it up to your heart. While this is done, the situation is monitored on a computer screen. Usually you don’t feel anything because the inside walls of the blood vessels aren’t sensitive to pain.

An x-ray contrast medium is injected through the atheter into the chambers of the heart and the coronary arteries to make them visible on the computer screen.

This may feel warm for a short time. You may also feel temporary heart pain if one of the narrowed arteries is pushed open.

An x-ray contrast medium is injected through the catheter into the chambers of the heart and the coronary arteries to make them visible on the computer screen. This may feel warm for a short time. You may also feel temporary heart pain if one of the narrowed arteries is pushed open.

This usually goes away as soon as the expansion is completed.

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Aftercare Procedures may be performed in the femoral artery in the groin, or in the radial artery in your arm.

When you go home, there will be a bandage over the catheter insertion site.

The morning after your procedure, you may take the dressing off. The easiest way to do this is when you are showering, get the tape and dressing wet and remove it. After the bandage is removed, cover the area with a small adhesive bandage.

It is normal for the catheter insertion site to be black and blue for a couple of days. The site may also be slightly swollen and pink, and there may be a small lump at the site.

Wash the catheter insertion site at least once daily with soap and water.

Place soapy water on your hand or washcloth and gently wash the insertion site; do not rub. Keep the area clean and dry when you are not showering.

Do not use creams, lotions or ointment on the wound site.

Wear loose clothes and loose underwear. Do not take a bath, tub soak, go in a Jacuzzi, or swim in a pool or lake for one week after the procedure.

Ask your doctor when it is safe to return to work, resume sexual activity, and resume driving.

Most people are able to resume driving within 24 hours after going home.

Please review your medications with your doctor before you go home. Ask your doctor if you should continue taking the medications you were taking before the procedure.

If you have diabetes, your doctor may adjust your diabetes medications for one to two days after your procedure. Please be sure to ask for specific directions about taking your diabetes medication after the procedure.

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Your doctor will tell you when you can resume activities. In general, you will need to take it easy for the first two days after you get home. You can expect to feel tired and weak the day after.

Take walks around your house and plan to rest during the day.

It is important for you to be committed to leading a heart-healthy lifestyle. Your health care team can help you achieve your goals, but it is up to you to take your medications as prescribed, make dietary changes, quit smoking, exercise regularly, keep your follow-up appointments and be an active member of the treatment team.

When to seek medical advice • Increased pain, redness, swelling, or drainage from the puncture site.

• Nausea or vomiting.

Be sure to drink eight to ten glasses of clear fluids (water is preferred) to flush the contrast material from your system.

For Femoral Cardiac Catheter Do not strain during bowel movements for the first 3 to 4 days after the procedure to prevent bleeding from the catheter insertion site.

Avoid heavy lifting and pushing or pulling heavy objects for the first 5 to 7 days after the procedure. Do not participate in strenuous activities for 5 days after the procedure. This includes most sports; jogging, golfing, play tennis, and bowling.

You may climb stairs if needed, but walk up and down the stairs more slowly than usual.

Gradually increase your activities until you reach your normal activity level within one week after the procedure.

For Radial Cardiac Catheter Do not participate in strenuous activities for 2 days after the procedure. This includes most sports - jogging, golfing, play tennis, and bowling.

Gradually increase your activities until you reach your normal activity level within two days after the procedure.

A responsible adult MUST drive you home. You will not be discharged unless there is someone available to drive you home.

If you have more than a two-hour drive home, we suggest that you stay overnight in a hotel for your comfort. The Medical Concierge can help you make arrangements.

Then have your family member drive you home the next morning, after you have rested.

During your drive home, stop every hour and walk for five to 10 minutes. If you are traveling home by plane, stand up to stretch your legs and walk in the aisle at least every hour.

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Call 911 If • Chest pain or pressure.

• Any bleeding from the site.

• Feeling weak or faint.

• Trouble breathing.

• Acute heart attack or stroke.

• Coolness, numbness, tingling, or skin color change in the arm or leg with the puncture site.