Cardiac Catheterization

What Is a Cardiac Catheterization?

Coronary artery disease is the narrowing or blockage of the coronary (heart) arteries. After an interventional procedure, the coronary artery is opened, increasing blood flow to the heart. Cardiac catheterization is an invasive imaging procedure that is used to:

Evaluate or confirm the presence of coronary artery disease, valve disease, disease of the aorta, or heart disease
Evaluate heart muscle function
Determine the need for further treatment, such as an interventional procedure or coronary artery bypass graft

What Is Atherosclerosis?

Atherosclerosis, sometimes called hardening or clogging of the arteries, is the buildup of cholesterol and fatty deposits (plaque) on the inner walls of the arteries that restrict blood flow to the heart.

Coronary artery disease (atherosclerotic heart disease) is the narrowing or blockage of the coronary arteries. Without adequate blood, the heart becomes starved of oxygen and the vital nutrients it needs to work properly. This can cause chest pain called angina. When one or more of the coronary arteries are completely blocked, a heart attack (injury to the heart muscle) may occur.

Description

During a cardiac catheterization, a long, narrow tube called a catheter is inserted through a plastic introducer sheath (a short, hollow tube that is inserted into a blood vessel in your arm or leg). The catheter is guided through the blood vessel to the coronary arteries with the aid of a special X-ray machine.

Contrast material is injected through the catheter, and X-ray movies are created as the contrast material moves through the heart’s chambers, valves, and major vessels. This part of the procedure is called a coronary angiogram (coronary angiography). The digital photographs of the contrast material are used to identify the site of the narrowing or blockage in the coronary artery.

Additional imaging procedures, called intravascular ultrasound (IVUS) and fractional flow reserve (FFR), may be performed along with cardiac catheterization in some cases to obtain detailed images of the walls of the blood vessels.

Risks

What Are the Possible Risks of the Procedure?

Cardiac catheterization is usually very safe. A small number of people have minor problems. Some develop bruises where the catheter was inserted. The dye that makes the arteries show up on X-rays causes some people to feel sick to their stomachs, get itchy, or develop hives.

Before the Procedure

How to Prepare for Cardiac Catheterization

Preprocedure tests that are necessary before your cardiac catheterization procedure include blood work, EKG, and chest X-ray
Do not drink or eat anything for 8 hours before the procedure
Tell your doctor if you are allergic to anything, especially iodine, shellfish, latex, rubber products, medicines, or X-ray dye
Arrange to have someone drive you home after your procedure
Discuss your medications with your physician, especially those listed below:
- Anticoagulant medications
- Diabetes medications

Here is our article discussing preparation for cardiac catheterization.

What to Bring

A family member to wait with you before the procedure
Comfortable, easy-to-fold clothing
Toiletries and any other items you would like to make your stay more comfortable

After the Procedure

Activities Guideline

Your doctor will tell you when you can resume activities. In general, you will need to take it easy for the first two days after you get home. You can expect to feel tired and weak the day after the procedure. Take walks around your house and plan to rest during the day.

For femoral cardiac catheterization (groin):

To prevent bleeding, do not strain during bowel movements for the first 3 to 4 days after the procedure
Avoid lifting, pushing, or pulling heavy objects for the first 5 to 7 days after the procedure.
Do not participate in strenuous activities (jogging, golfing, tennis, etc.) for 5 days after the procedure
Walk up and down stairs more slowly than usual
Within one week after the procedure, gradually increase your activities until you reach your normal activity level

For radial cardiac catheterization (wrist):

Do not participate in strenuous activities (jogging, golfing, tennis, etc.) for 2 days after the procedure
Within 2 days after the procedure, gradually increase your activities until you reach your normal activity level

Ask your doctor when it is safe to:

Return to work
Resume sexual activity
Resume driving

Medication

Please review your medications with your doctor before you go home and ask if you should continue taking the medications you were taking before the procedure.

If you have diabetes, your doctor may adjust your diabetes medication(s) for 1 to 2 days after your procedure. Please be sure to ask for specific directions about taking your diabetes medication after the procedure.

Depending on the results of your procedure, your doctor may prescribe new medication. Please make sure you understand what medications you should be taking after the procedure and how often to take them.

Fluids Guideline

Be sure to drink eight to ten glasses of clear fluids (water is preferred) to flush the contrast material from your system.

Importance of a Heart-Healthy Lifestyle

It is important for you to be committed to living a heart-healthy lifestyle.

Our heart specialists can help you achieve your goals, but it is up to you to take your medications as prescribed, make dietary changes, quit smoking, exercise regularly, keep your follow-up appointments, and be an active member of the treatment team.

Follow-Up

Please call the office the day you are discharged to schedule a follow-up appointment within two to three weeks of your procedure with your cardiologist.

FAQS

Are These Procedures Considered Surgical?

No. Cardiac catheterization and interventional procedures are not considered to be surgical procedures because there is no large incision used to open the chest, and the recovery time from catheterization is much shorter than that of surgery.

In some cases, surgery may be recommended afterward, depending on the results of the procedure.

Will I Be Awake During The Procedure?

Yes. You will be given a mild sedative to relax you, but you will be awake and conscious during the entire procedure. The doctor will use a local anesthetic to numb the catheter insertion site.

Who Performs The Procedures?

Cardiac catheterization and interventional procedures are performed by a specially trained cardiologist and a cardiovascular team of nurses and technicians.

How Long Do The Procedures Take To Perform?

The cardiac catheterization procedure itself generally takes 30 minutes, but the preparation and recovery time add several hours to your appointment time (4-6 hours).