- Cardiac Catheterization
- Preparing for Your Procedure
- The Day of Your Procedure
- In the Cardiac Cath Lab
- After the Procedure
- Cardiac Catheterization Discharge Instructions
- Video: Cardiac Catheterization Angiography
Our cardiac catheterization labs
Cardiac Catheterization labs are used for heart catheterizations, peripheral angiograms, angioplasties and stents. Our digital cardiology systems enable physicians to review cardiac catherization images and echocardiograms from workstations throughout the organization.
A cardiac catheterization is a procedure performed by a cardiologist to view the chambers and valves of the heart, as well as the arteries that supply blood to the heart muscle. X-ray dye is injected into these structures of the heart and x-rays are taken. The x-rays are reviewed and the cardiologist will inform you of the strength of your heart muscle, the condition of the heart valves, and if there are any blockages in your heart arteries.
Radial Access – a less invasive alternative
Typically, the catheter is introduced into the body through a vein or artery, usually in the leg, and is guided toward the heart. Although doctors in the United States are increasingly utilizing the radial artery (in the wrist) as an entry point. St. John Providence Health System Heart and Vascular Center of Excellence cardiologists are leading SouthEast Michigan in this technique.
One of the biggest benefits of passing the catheter through the radial artery is the risk of bleeding is greatly reduced. One study, published in The Journal of the American College of Cardiology: Cardiovascular Interventions in 2008, indicated bleeding complications in all patients were reduced by 58 percent with the radial approach compared with utilizing femoral access during coronary catheterizations. This is especially important for women, who generally are at higher risk for bleeding than men. The radial artery is easier to control and bleeding, if any, is minimal.
This approach may also be preferred for older patients as well as those who are obese or suffer from back pain as these patients may have difficulty lying down for the length of time required for a traditional cardiac catheterization. Overall, patients can experience higher levels of comfort when radial access is utilized as they can come back after the procedure sitting up.
To find a cardiologist experienced in radial access cardiac catheterization, click here.
Preparing for Your Procedure
Your cardiologist will discuss the procedure with you, and after a date has been decided, the cardiologists’ office will schedule the procedure with the cardiac catheterization lab.
Before your catheterization, the doctor may send you for blood tests, an electrocardiogram (EKG) and a chest x-ray, or these may be done upon your arrival to the hospital the morning of your procedure.
A member of the Cardiac Cath Lab staff will call the day before your procedure to confirm your arrival time to the hospital, and you will also be given the following important instructions.
- No eating or drinking after midnight (unless instructed otherwise)
- Take morning medications with only sips of water
- If you are diabetic, do not take your insulin or oral diabetic medications (unless otherwise instructed)
- Report to Patient Registration in the Main Entrance of the hospital
If you are already a patient in the hospital, you can expect to be informed of the approximate schedule time of your procedure from the nursing staff.
The Day of Your Procedure
Parking is available at the Main Entrance of the hospital, located off Twelve Mile Road. For your convenience, valet parking is also available at the Main Entrance of the hospital from 6:00 a.m. until 9:00 p.m. There is a nominal charge for valet parking. After registering, an associate from the cardiac cath lab will escort you to the pre-procedure preparation area. A nurse will perform an EKG, start an intravenous line, and your groin area will be shaved to prevent infection. For your convenience a videotape of the procedure is available for viewing before your catheterization. A waiting room is available for your family members while you are prepared for your procedure. After the preparation is complete a family member may wait with you until you are taken for your procedure. Glasses and dentures may be worn during the procedure, but contact lenses, necklaces and watches should be removed and valuables should be given to a family member or a friend. A cardiac cath lab team member will escort you to the procedure room and your family will be directed to the waiting area.
In the Cardiac Cath Lab
The cardiac cath lab team will greet you, review the procedure with you and answer any questions you may have. They will also attach you to heart, blood pressure and oxygen monitoring equipment. The cardiac cath lab team will clean the area where the catheters are to be inserted with a disinfectant and then cover you with a sterile drape to minimize the risk of infection. The cardiologist will administer a local anesthetic to the area where the catheters are to be inserted to minimize any discomfort, however, you may feel some pressure during the procedure. The catheters are then inserted and guided up to the heart and dye is injected into the heart arteries and the x-ray pictures are taken. When x-ray dye is injected into the main pumping chamber of the heart, you may feel a warm sensation, which may last approximately thirty seconds. The cardiologist may ask you to hold your breath for a few seconds during an x-ray picture, and may ask you to turn your head from one side to the other so the x-ray camera can move. You may also be asked to cough during the catheterization to help clear the x-ray dye out of the heart arteries. If you are asked to cough, turn your head to the side and cough strongly several times. If at any time you feel pain or discomfort, please inform your cardiologist or the nurse.
After the Procedure
When the procedure is completed, the catheters will be removed. The area where the catheters were placed may be sealed to stop the bleeding with a closure device your cardiologist will place, or a cardiac cath lab team member will hold pressure with their hand until the bleeding has stopped. Your cardiologist will decide after the x-ray pictures have been taken which method to stop the bleeding is best for you.
In order to prevent bleeding from the puncture site, you will be instructed to lie flat for one to six hours depending on which method was used to seal the area. During this time, it is important that you do not bend your leg or try to sit up, since this could cause bleeding. You will also be encouraged to drink plenty of fluids to help eliminate any remaining dye from your body. If you experience chest pain, difficulty breathing or any other discomfort, please notify your nurse immediately.
In some cases, treatments are performed immediately after the cardiac catheterization. Your cardiologist will discuss the results of the x-ray pictures taken with you, and may recommend continuing with treatment while you are still in the cardiac catheterization laboratory. On the other hand, your cardiologist may recommend further discussion before a treatment option is selected, and the procedure would be completed.
Cardiac Catheterization Discharge Instructions
- Take your medications as listed on your discharge instruction sheet.
- If there is a new medication listed, be sure you understand what it is for and how to take it.
- If a medication you were taking is not on the list, be sure to ask if you should stop it or continue taking it.
- If the dose of a medication is different than you were taking before, be sure to ask which is the correct dose to be taking.
- If you have any problems or side effects caused by your medications, call your physician.
To allow healing and to prevent bleeding, avoid any strenuous activity for four days. You should not drive for 48 hours. Avoid lifting objects heavier than five pounds, excessive bending at the wound site, or sitting for long periods with your arms or legs bent. Sexual activity may be resumed but avoid positions which would increase pressure on the wound.
Discuss with your doctor what kind of exercise and activity program is right for you. What you will be able to do depends upon how severe your heart disease is. For most people, some form of exercise will help to lower your risk of further heart disease. Ask your doctor about enrolling in a cardiac rehabilitation program and about what type of exercise would be best for you.
It is important that you check your wound every day for the next five to seven days. A band-aid may or may not be left over the site. You may remove it after two days. You may notice some bruising, soreness or a small bump. The soreness should lessen in a few days. Take showers, no baths, until your wound is completely healed. Wash the sound area with mild soap and water daily and pat dry with a towel.
Call your doctor if you notice any of the following:
- Bleeding or increased swelling at the puncture site
- Drainage (either pus or blood)
- Increased in soreness around the wound
- Temperature over 100°F
- Numbness, coldness, or tingling pain in your arm or leg below the wound
- Light headedness, dizziness, weakness of arms or legs, or difficulty with speech
- Chest pain, pressure, tightness or burning in the chest, arm, jaw or stomach
Although this occurs very rarely, if you should develop bright red bleeding, or feel a “pop” inside, or notice sudden increasing swelling larger than a walnut, you should lie down and place pressure just above the site. If is best if someone does this for you. Hold firm pressure for a minimum of 15 minutes. Call your doctor, or have someone call for you. If he/she is not available, go to the nearest Emergency Room.
Call your cardiologist or go to the nearest hospital emergency department if the following changes occur:
- Bleeding or increasing swelling at the wound site.
- Dizziness, faint feeling, sweating or difficulty breathing.
- Increased angina or frequent sensations of pressure, burning, pain or other discomfort in the chest, arm, jaw or stomach.