A Cardiac Catheterization is a common test used by the cardiologist to learn about the patient's heart and how it is functioning. The test does not treat any form of heart disease, but allows the viewing of the chambers valves, and arteries surrounding the heart. There are two different types of Cardiac Catheterization: a Left and a Right.
A Left Heart Catheterization views the arteries around the heart to diagnose any blockages, narrowing, or defects.
A Right Heart Catheterization gives specific information about fluid pressures within the heart, lung pressures, cardiac output (the amount of blood delivered with every heart beat), and oxygen saturation. At the time of the Cardiac Catheterization, images are saved so that the results can be studied or evaluated by other members of the patient's health care team. The test itself can be finished in approximately 1 to 1 1/2 hours.
The Cardiac Catheterization is done in Botsford Hospital's Cardiac Catheterization (or Cath) Lab located on the first floor. In the procedure room, there is a large camera, a heart monitor, a blood pressure monitor, an oxygen saturation sensor, a movable table, and many different types of supplies. There is also equipment used in case of an emergency. The staff is certified in Advance Cardiac Life Support and remain with the patient throughout the entire test. Map Floorplan
On the day of the test, the patient is usually kept without food or drink for approximately 6 hours prior to the test. They are prepared for the test in the Holding Room of the Cath Lab. There a Nurse will ask the patient to undress completely and wear a hospital gown. A heart monitor will be applied, and vital signs will be taken. The Nurse will gather a brief history of the patient, and insert an IV. Next the Nurse will prep the patient's groin area by shaving any hair in the area. This helps to ensure cleanliness and reduce the potential for infection. Both sides will be prepped, however, only one site will be used for the procedure. After the patient is completely prepped, all questions have been answered, and an informed consent has been obtained, the patient is then taken to the Procedure Room.
In the Procedure Room, the patient will be asked to slide onto a table, and attached to the heart monitor, blood pressure cuff, and oxygen sensor. Again, to help ensure cleanliness and the reduction of potential infection, the patient will be covered by sterile sheets. A mild sedative can be administered to help the patient relax, but not go to sleep. The patient will have to perform certain tasks during the test such as coughing, deep breathing, and turning his/her head to either side.
The test involves passing a long flexible catheter from the access site up into the coronary arteries. Before inserting the catheter, the physician will numb the skin area which will cause a momentary burning sensation. Even though the skin has been numbed, the patient may still feel the Physician touching or applying pressure on the area of the catheter insertion. Arteries, veins, and the inside of the Heart do not have nerve endings so the patient will not feel the catheter traveling through and in these structures. Also, the presence of the catheter inside the heart chambers does not change the heart's functions. Occasionally, the patient may feel a 'fluttering' caused by an extra or early heart beat; this is a common, but not serious occurrence.
During the entire test, fluoroscopy pictures (similar to x-rays) are taken. They are displayed on monitors so that the Physician, Nurses, and other staff members can watch the procedure at all times. When the catheter is moved to specific areas of the heart, pressure readings can be obtained, and dye can be injected to help the Physician assess the size and functioning of the heart chambers, values, and the status of the patient's coronary arteries. During the injection of the contrast dye, the patient usually feels a 'hot flash' that lasts for about 30 seconds. It is caused by the dilation of the blood vessels in the skin. Infrequently, nausea and headache can accompany the hot flash, but these symptoms are also temporary. The cardiologist may instruct the patient to take a deep breath, hold it, and cough which will improve the pictures, and help minimize the symptoms. The pictures taken during the procedure are saved, stored on CD, and may be printed.
At the end of the procedure, the catheter is withdrawn, but the sheath (the special item used to guide the catheter) may be left in if the patient requires an interventional procedure (i.e. angioplasty). If the sheath is removed, pressure is held over the site for approximately 20 minutes, to ensure that all bleeding has stopped.
Results of the test are known immediately, and the cardiologist can discuss them with the patient and the patient's family, if requested. Many times, the physician will confer with another physician if an Angioplasty or Bypass surgery seems to be indicated.
Any invasive procedure has potential complications associated with it. The risk of any major complication from a Heart Catheterization is 1 in 1,000. The most common complication is a disturbance in heart rhythm which is why the patient's heart rhythm is monitored continuously before, during, and after the procedure. Other possible complications include blood clots, heart attack, damage to the accessed artery, or hematoma (collection of blood under the skin). Every effort is made to minimize the risk of any complication, and the staff is fully prepared to treat any complication should it occur.
After the procedure, the patient will be given instructions to help minimize the potential for bleeding or any other complication. A patient is usually monitored in a room for approximately 4-6 hours, and then will receive instructions upon discharge. Fluids are encouraged to help dilute and flush out the contrast dye used during the Heart Catheterization. A follow-up visit with the Cardiologist will be made at the time of the patient's discharge.
If, at any time, the patient has questions or concerns regarding the procedure, he/she is welcome to call the Cardiac Catheterization Lab and speak to one of the staff.