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Patient Instructions Cardiac Catheterization

A cardiac catheterization is one of the most reliable procedures for determining the anatomy and condition of the heart and its blood vessels. The study includes the observation of the heart's pumping function and the visualization of the coronary arteries, which supply the heart muscle with blood.

PREPARATION

You may be asked to come in for lab work, a chest x-ray, or an EKG so that your physician can review the results before your catheterization.

• Please fast the day of the test (nothing to eat or drink except sips of water and your usual medication).
• Consult your primary care physician to determine which medications you should take on the morning of your procedure. 
• Bring a list of your medications, including dosages and time taken.
• Leave your valuables at home.
• Please remove any nail polish before your arrival at the hospital.
• If you are a Diabetics: If you are taking Coumadin, Prednisone, or Glucophage, please notify your doctor at least four days prior to your procedure. The doctor may want to adjust your dosage temporarily.
  

  NOTE: Please have someone available to drive you home after you have been discharged.

PROCEDURE

You will be awake during the entire procedure, which usually takes 1 to 2 hours and is performed as an outpatient visit. Your cardiologist  and a nurse will be nearby at all time. They will explain the study as it progresses and answer any questions. If an unexpected or unexplained discomfort concerns you, tell them immediately.

• Your groin area or the elbow area of your arm will be cleansed and shaved. An IV will be started to provide fluids and to administer medications ordered during your catheterization. You will receive an oral sedative prior to going to the catheterization lab.
• When you arrive in the Catheterization Lab, you will be positioned on a x-ray table.
• Adhesive electrodardiogram patches or leads will be applied to your body so that your heart rate and rhythm can be continuously monitored.
• The catheter site shaved earlier will be recleansed and covered with sterile drapes. After numbing the area with a local anesthetic, your cardilogistr will make a small incision to allow access to an artery or vein, depending on the type of study planned.
•  As the catheter (a thin, flexible tube) is inserted, you may experience a sensation of pressure. Oxygen may be given to you at this point. The lights will be switched on and off to enable your physician to see the x-ray monitor.
• As the procedure continues, your cardiologist or nurse may ask you to take a gentle, deep breath and hold it, or to cough deeply several times. Listen carefully for these instructions to ensure high-quality x-ray films without prolonging the procedure.
• Radiopaque dye will be injected into the catheter, enabling the cardiologist to visualize your coronary arteries and chambers of the heart. The camera will be tilted at several angles as the doctor observes your heart.
• Cinefluorograms or 35mm movies will be taken during the procedure so your doctor may more carefully interpret the results later.
• When the pumping chamber (ventricle) of your heart is being studied, you will have a very warm sensation throughout much of your body. This is a common experience for most patients, and you should not be alarmed by it. It may occur several times but should last for only 20-25 seconds.
• When the catheter is removed, your cardiologist will apply pressure or suture the incision and apply a snug dressing to prevent bleeding. The procedure is then complete, and you will be transported back to the ambulatory care area.
  

The cardiologist will visit you later that day to discuss the results of your catheterization.

AFTER THE PROCEDURE

In the recovery area:

When you return to the ambulatory recovery area, the medications administered during the procedure may make you feel drowsy. Oral fluids are encouraged to eliminate dye from your system. Your IV will be discontinued 2 to 3 hours after the procedure. Eating may also be permitted. Your catheterization site and vital signs will be checked frequently by the nursing staff. For your safety, ring for assistance the first time you get out of bed. If the incision site becomes uncomfortable, medication is available from the nurse.

The incision site should not be disturbed for several hours. With an arm incision, exercise of your shoulder without bending the elbow is recommended to prevent stiffness. With a groin incision, you must remain in bed for approximately six hours, keeping your leg straight at the hip. You will be told when you can resume normal activities.  If your physician sutures your groin incision, you will lie flat for approximately 2 hours. 

At home:

Please call our offices if you note any of the following:

• excessive drainage
• numbness or tingling
• excessive pain at the incision site
• change in the hand/leg
• red streaks running above or below the incision

You may expect some bruising and tenderness around the incision and a small almond-sized lump under the incision site. Do not participate in activity that requires heavy lifting or bending at the incision site (such as bowling or golf) until your physician allows you to do so.

For arm incisions, keep the incision clean and dry. Wrap it with plastic wrap when bathing or showering, and cover the incision with a band-aid or small dressing when your clothing is rubbing or when you are in dusty areas or outside.Let the incision be open to the air as much as possible.

For groin incisions, keep the incision clean. Cover the incision with a band-aid or small dressing for 24 hours after discharge, and check it occasionally to keep it dry.