Cardiac catheterization is a diagnostic procedure
that allows doctors to examine the blood vessels of your heart (coronary
arteries) to see if there are any blockages. It also checks the function
of your heart valves and how well your heart pumps blood to the body.
It is performed at Newark Beth Israel Medical Center and Saint Barnabas
Medical Center on a daily basis, and is an important test used to diagnose
heart disease. Cardiac catheterization is not a surgical procedure.
Your catheterization will be performed in the cardiac
catheterization laboratory by a cardiologist and a specialized team
of nurses and technicians. You will be placed on a table that has
a large x-ray camera above it. Pictures of the procedure are viewed
by the team on television screens close by. Your doctor will decide
whether the procedure will be performed through your leg or arm. The
procedure will begin by inserting a long, thin plastic tube (catheter)
into an artery in the groin or arm.
You will be awake during the catheterization,
but you will be given medication to relax. The catheterization usually
lasts one to two hours. Your cardiologist will meet with you afterward
to review the results of the procedure. For routine cardiac caths,
you can expect to be discharged within 24 hours.
- Let your doctor know if you are allergic
to any medications or foods.
- Eat nothing after midnight if your procedure
is scheduled early in the morning. You may
have clear liquids if your procedure is late
in the day. Clear liquids include apple juice,
tea, water, Seven-Up, ginger ale, gelatin and
chicken broth. Clear liquids do not include
orange juice, milk, coffee and cola.
- You should take your medications (except
Digoxin and "water pills") with a few sips
of water. If you are taking Coumadin (Warfarin),
you must inform your doctor.
- Do not smoke because this may affect the
test.
- An electrocardiogram (EKG), chest x-ray,
and blood studies will all be done before your
catheterization.
- You will be wearing a hospital gown. Do not
wear jewelry into the lab, but you may wear
your dentures, hearing aid and glasses.
- As you enter the catheterization lab you
will be greeted by a team of doctors, nurses
and technicians in surgical scrub clothes.
The temperature in the cath lab is kept cool
to protect the computer and x-ray equipment.
- The preparation for the catheterization takes
about 30 minutes.
- The staff will prepare you by shaving your
arm or groin, then cleansing the area with
an antiseptic, and covering it with sterile
sheets.
- Your heart rhythm and blood pressure will
be continually monitored. An intravenous (IV)
line will be started.
- You will receive an injection of a local
anesthetic to numb the area where your doctor
will insert the catheter. You will feel pressure
at the insertion site. If the procedure becomes
uncomfortable, however, please tell the staff.
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- A catheter will be placed into your artery
and another one into your vein. The catheters
are guided through the blood vessels and into
your heart. During this time it's normal to
experience some heart palpitations.
- Once the catheter is in place, dye is injected.
Pictures of your heart will be taken at various
angles. You may feel a warm flush, or become
nauseated. These feelings are normal and should
pass.
- The dye highlights the coronary arteries,
the chambers of the heart, and the heart valves.
If there is a blockage in the coronary arteries,
or if there is a problem with your valves,
the doctor can see this on the monitor at the
time of the procedure.
- This procedure is recorded on film. Once
the film is developed, your doctor will discuss
the results with you.
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- After your procedure you will be taken to
the Cardiac Catheterization Recovery Room where
the catheters will be removed, and you will
be monitored by the cath lab nurse. You will
stay in the recovery area for approximately
30 minutes.
- When you return to your room, you will be
given fluids to drink which will help your
kidneys "flush" the dye from your body. You
will also receive fluids through an IV.
- About three hours later, the head of the
bed will be raised and you will be offered
solid foods.
- The dye and all the fluid that you drink
may cause an increase in urination. Sometimes
patients have difficulty urinating while lying
flat. If you need assistance with a bedpan,
call your nurse.
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- You may shower after the dressing is removed,
and the puncture site has been examined by
your nurse or doctor.
- If you stay overnight, you will have blood
drawn the morning following your catheterization.
This is done to check the creatinine level,
which reflects how your kidneys are functioning.
This is important because the dye you received
during the catheterization can cause your kidney
function to slow down.
- Notify the nurse immediately if you should
experience the following symptoms after your
catheterization:
- Discomfort in the face, jaws, arms,
chest, or upper back
- Shortness of breath
- Dizziness
- Weakness
- Leg pain/numbness
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Follow-up care will vary from patient to patient
according to the diagnosis your doctor has made.
If a blockage has been found, the treatment may
include medication, balloon angioplasty, atherectomy,
stent or bypass surgery.
If your procedure was uncomplicated, your doctor
may allow you to return to normal activities
within 48 hours.
The following may be used as a guideline once
you leave the hospital:
- Most patients can resume all activities and
return to work within 48 hours. There may be
some restrictions, depending on your diagnosis.
- Follow-up care will be determined by your
cardiologist. You may need to call his/her
office to schedule an appointment
- You are permitted to shower within 24 hours
after the procedure. If your arm was used,
you should avoid wetting this area (cover with
a plastic bag) until your doctor has observed
the site.
- Continue to drink plenty of fluids for two
days after the test. If you have a condition
that restricts the liberal use of fluids, you
will be given specific instructions before
you leave the hospital.
- All sutures must be removed in four to five
days.
- Driving should be avoided for 24 hours after
your procedure if the groin was the catheterization
site, or 72 hours if your arm was used.
- Avoid lifting (five pounds or more), stretching,
or straining for the first 48 hours after your
procedure.
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PLEASE NOTIFY YOUR DOCTOR IMMEDIATELY...
if the puncture site changes in any of the following
ways:
- increase in bruising/color
- increase in hardness
- bleeding
- hot/swollen
or if you develop:
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Early
Heart Attack Care (EHAC)
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