Understanding Cardiac Catheterization

Cardiac catheterization is not a surgery. Instead, it is a special x-ray test that provides your doctor with information about the blood flow through your heart and helps doctors diagnose heart conditions such as coronary artery disease, defective heart valves, or congenital heart defects. The procedure, sometimes referred to as a coronary angiogram or coronary arteriography, generally takes about one to two hours to complete.

If you have a cardiac catheterization scheduled, and wish to pre-register online, click here.

Are tests performed before cardiac catheterization?

Yes. In addition to an examination of your medical history, several routine tests are typically performed before a cardiac catheterization:

Blood tests
EKG
Chest x-ray

Can I eat or drink before the test?

Generally, you may not have anything to eat or drink for the six to eight hours before the procedure. You will receive specific instructions about the food you may have.

When your cardiac catheterization is completed, you will receive a snack and be asked to drink a lot of fluids. Since you will be lying flat for several hours, you will not be able to eat much.

How do I prepare?

Pack a small bag of overnight clothing in case your doctor decides you need to stay overnight.
Do not bring any valuables, but please wear your hearing aids.
Bring a list of medications (with the exact names, frequency, and dosages) that you are currently taking, include any over-the-counter medications or herbs.
Your doctor will tell you which medications you may take on the day of the procedure.
Arrange for someone to drive you home.
Be sure to tell the doctor or technician if you are allergic to x-ray contrasts, iodine, or shellfish.
Let the doctor or technician know if you have any kidney disease.

What type of equipment is used?

There are video monitors around the room that show the catheter’s movement to and through the heart. After the catheter is removed, we may use one of several types of devices to close the femoral artery at the insertion (or “puncture”) site:

A collagen closure device delivers a “collagen plug” directly over the insertion site after your procedure. Collagen is an abundant natural protein in your body and aids in the healing process of the tissues and blood vessels at the insertion site.
A suture medicated closure (SMC) device allows your physician to close with a stitch the insertion site following your diagnostic or interventional procedure. The benefit of using one of the above devices to close the artery is that direct pressure does not usually have to be applied to the insertion site once the catheter is removed. This means more comfort for the patient, as well as the potential for him or her to get up much sooner.

How is this test done?

This procedure is done in one of our two catheterization laboratories at EIRMC (also called cath labs). You may receive a mild sedative, but you will be awake during the procedure, which usually takes less than an hour for the catheterization only. If you have a balloon angioplasty or other procedures, more time will be required.

A local anesthetic is injected at the incision site and a small tube, or sheath, is inserted into the artery in your groin. You may feel a little pressure at the incision site with the insertion. If you feel nervous or uncomfortable a medication can be given to you to help you relax. The procedure begins when the doctor inserts a thin, flexible tube (called a catheter) through the sheath into the artery. The catheter is then threaded gently through the artery toward your heart. As this is done, doctors, nurses, and technicians check the TV monitors to follow the catheter’s movement to the heart.

Next, a contrast solution is injected through the catheter. This helps the doctor to pinpoint where the problem with your coronary arteries might be. The doctor will take several x-ray pictures of the coronary arteries to determine where blockage or narrowing may be. When the procedure is finished, the doctor will remove the catheter. A nurse or technician will apply pressure unless a closure device is used. If the catheter was inserted in the groin, you’ll remain lying down for several hours and be asked not to move your leg. If a closure device is used, you’ll lie down for a shorter time.

The nurses will watch you carefully, take your blood pressure, and check the site frequently to make sure there is no bleeding. You will be asked to drink a lot of fluids to flush the contrast out of your system.

The procedure usually takes 30 minutes to an hour. Your doctor will return to explain the results of the procedure to you. Sometimes a cardiac catheterization will show that your heart is just fine. If there is a problem, your doctor will discuss the possible treatment options.

Can I wear my hearing aid?

Definitely. It will be very important for you to hear the instructions given by your doctor and other staff members.

When will the doctor talk to my family?

The doctor will talk to your family when the procedure has been completed and the films have been reviewed.

How soon can I go home?

You may be able to go home later that same day. In some cases, your doctor may request that you stay overnight.

What can I do when I return home?

Be sure to make arrangements to have a friend or family member drive you home. Avoid lifting anything over 5–10 pounds and keep your activity light for about five days.

How do I take care of the insertion site?

You may have a small bruise or lump the size of an olive under the skin at the insertion site. This should go away in four to six weeks.

If you have a collagen plug or a stitch in the insertion site, the hospital staff will review the instructions for care according to the doctor’s orders. Some general guidelines are as follows:

The collagen plug is absorbed into your body in about a six-week period.
You may see slight redness and swelling at the site. If it worsens, call your doctor.
You may feel a knot under the skin at the groin site for approximately a week.
Follow your doctor’s instructions about returning to your normal activity level and showering.
Your doctor will tell you if you need to have a dressing over the insertion site. Otherwise, you may leave it open to air.
No tub baths or hot tubs for one week; showers are acceptable.
If you do not have a collagen plug, follow your doctor’s orders on taking care of the insertion site. Keep it clean and dry.

Are there any potential complications?

Yes. This is an invasive procedure because a catheter is inserted into the body. As with any procedure of this type, there can be some risk involved. Please ask your doctor to discuss the risks and benefits so that you are fully informed. Call your doctor or 911, or seek immediate medical treatment if: