Cardiac Catheterization

What is a Cardiac Catheterization?

Cardiac Catheterization is a diagnostic and sometimes therapeutic procedure that allows physicians to evaluate the functioning of the heart, coronary arteries, and great vessels. It involves the insertion of a thin, flexible tube called a catheter into a blood vessel, usually in the arm or groin, which is then guided to the heart. This procedure is used to diagnose and treat certain cardiovascular conditions without the need for open-heart procedure.

Why is the Procedure Performed?

Cardiac Catheterization is performed for several reasons, including:

• To diagnose and evaluate heart diseases, such as coronary artery disease, heart valve disease, and congenital heart defects.
• To assess heart muscle function.
• To determine the need for further treatment options like Coronary Intervention or bypass procedure.
• In some cases, it is used to treat heart disease during the procedure itself, such as opening blocked arteries with angioplasty or repairing certain types of heart valve diseases.

How is the Procedure Performed?

The procedure is carried out in a specialized room called a catheterization laboratory, or "cath lab," under moderate and local sedation. Here is a general outline of the process:

• Preparation: The area where the catheter will be inserted (usually the groin or wrist) is prepped and numbed with a local anesthetic.
• Insertion: A small incision is made in the skin, and the catheter is inserted into the blood vessel and carefully guided toward the heart, with the aid of X-ray images.
• Diagnosis and Treatment: Contrast dye is injected through the catheter to make the heart and blood vessels visible on X-ray images, allowing the physician to diagnose any issues. If necessary, treatments such as balloon angioplasty or stent placement can be performed during the catheterization.
• Completion: After the examination and any treatments are completed, the catheter is removed, and pressure is applied to the insertion site to stop bleeding.

What are the Risks and Benefits of the Procedure?

• Benefits:
  • Provides detailed and accurate information about heart function and coronary arteries.
  • Can diagnose a wide range of heart problems.
  • May combine diagnosis and treatment in a single procedure.
  • Less invasive than open-heart procedure, with a shorter recovery time.
• Risks:
  • While generally safe, risks include bleeding at the catheter insertion site, infection, allergic reactions to the contrast dye, damage to blood vessels, heart attack, stroke, and in rare cases, death.
  • The likelihood of complications varies depending on individual health factors, including the presence of chronic kidney disease, diabetes, or other conditions.

Preparing for Cardiac Catheterization

What to Expect During the Procedure

• During Cardiac Catheterization, you will receive moderate and local sedation. The insertion site will be numbed, so you should feel minimal discomfort. You may feel a warm sensation when the contrast dye is injected or a brief moment of discomfort when the catheter is being moved through your heart's chambers and vessels. The procedure typically lasts from 30 minutes to a few hours, depending on whether any additional interventions are performed.

Pre-op Instructions

• Fasting: You will be asked to fast for 8 hours before the procedure to ensure your stomach is empty.
• Medication: Inform your physician about all the medications and supplements you are taking. You might need to adjust or temporarily stop certain medications, especially if they could affect blood clotting or interact with the procedure.
• Preparation at Home: Shower using antibacterial soap the night before or the morning of your procedure to reduce the risk of infection.

Medications to Avoid Before the Procedure

• Blood Thinners: Your physician may advise you to stop taking blood thinners a few days before the procedure to reduce the risk of excessive bleeding.
• Diabetes Medications: If you take medication for diabetes, especially insulin, you may need to adjust your dose since you will be fasting before the procedure.
• Herbal Supplements: Inform your physician about any herbal supplements you take, as some can affect blood clotting and should be avoided.

What to Bring to the Surgery Center

• A List of Current Medications: Include dosages and how often you take them.
• Personal Identification and Medical Insurance Information: Bring your ID, medical insurance card, and any necessary medical documentation.
• Comfort Items: Consider bringing a book, magazine, or music player with headphones for relaxation before the procedure.

What to Expect After the Procedure

• Immediate Recovery: You will be moved to a recovery area where your heart rate, blood pressure, and oxygen levels will be monitored. The staff will also check the catheter insertion site for bleeding or swelling.

Post-op Instructions

Follow these post-procedure guidelines to plan your recovery:

• Driving Restriction: Do not drive for at least 24 hours after the procedure. Arrange for someone to drive you home from the procedure center.
• Activity Restrictions: Avoid strenuous activities and lifting heavy objects for a specified period determined by your physician.
• Catheter Site Care: Keep the insertion site clean and dry. Follow your physician's instructions on how to care for the site to prevent infection.
• Medication: You may be prescribed new medications or continue with your existing regimen. Adherence to medication instructions is crucial for your recovery.

Recovery Tips

• Hydration: Drink plenty of fluids to help flush the contrast dye from your body, unless otherwise directed by your physician.
• Healthy Diet: Eat a balanced diet to support your heart health.
• Monitor for Symptoms: Keep an eye on the catheter insertion site for signs of infection or unusual bleeding.

When to Seek Medical Attention

• Emergency Symptoms: If you experience chest pain, difficulty breathing, excessive bleeding or swelling at the insertion site, fever, or signs of infection (redness, warmth, or drainage), seek medical attention immediately.
• Unusual Discomfort: Contact your physician if you feel persistent pain or discomfort after the procedure, especially if it is related to the catheter insertion site or your heart.

By understanding what to expect and how to prepare for and recover from Cardiac Catheterization, you can help ensure a smoother procedure and recovery process. Always follow your healthcare provider's instructions and communicate openly about any concerns or symptoms you experience before and after the procedure.