Cardiac Catheterization: What to Expect

When patients experience heart-related problems, stress tests, electrocardiograms, and physical examinations can provide their health care providers with information about the function of the heart muscle and condition of the valves and surrounding tissues. Physicians may choose to perform a cardiac catheterization, allowing them to see an outline of a patient's arteries and identify those that are blocked, to diagnose heart disease and defects.

Preparation

• To prepare for a cardiac catheterization, the patient needs to stop eating several hours before the procedure. Medical personnel perform routine blood work, a chest x-ray and possibly an EKG on the patient. A nurse checks the patient's pulse and makes marks with a felt-tip pin where the catheter will be plaed. Medical personnel will then place a needle for an intravenous drip (IV) near the patient's wrist.

Time Frame

• Most cardiac catheterizations take place on an outpatient basis. The patient usually arrives at the facility in the morning to have the procedure performed. Though the procedure generally takes about 30 minutes, more time may be required if the cathetrization team encounters technical difficulties. The patient may need to stay in bed up to four hours after the procedure but can generally leave the hospital in the the afternoon.

Procedure

• Medical personnel shave the groin or the arm and clean the area with antiseptic solution to prepare it for insertion of the catheter. A cardiologist then injects local anesthesia to numb the area. Medication may be administered to help the patient relax. However, the patient's need to stay awake during the procedure.

  A doctor makes a small incision in the groin or arm and inserts the catheter into the vein, guiding it to the opening of the artery. The doctor may ask the patient to cough or take deep breaths. The patient should not feel pain, but he or she may feel a warm sensation as the contrast moves through the catheter. The doctor can rotate the camera around the patient's chest to view the artery from different angles. During this procedure x-ray, pictures are recorded on a video.

After

• After the doctor removes the catheter he or she places a tight bandage over the incision to apply pressure to stop the bleeding. Medical personnel will monitor the patients for several hours after the procedure and take blood pressure and pulse readings, check for excess bleeding at the incision site and administer pain medication as the anesthesia wears off.

Safety

• Some patients may experience an allergic reaction to the contrast, which medical personnel can usually bring under control easily. The patient could experience major bleeding after the procedure, but it is more common to experience minor bruising around the incision site, which fades in a few days. Some patients who have severe heart disease could experience closure of the artery, which requires immediate surgery. Serious complications occur in less than four in 1,000 patients and can result in heart attack, stoke and death.