Heart catheterizations are used to both diagnose and treat heart and blood vessel conditions. Angiography is the most common cardiac catheter procedure.
Using a catheter to distribute contrast agents, heart cath procedures diagnose problems in the heart valves, chambers or main blood vessels (the aorta or pulmonary artery). They also look for fatty buildup (atherosclerosis) and/or a blood clot (coronary thrombosis) within the arteries.
Patients are asked to have no food or drink (NPO) for a number of hours before the procedure to lower the chance of nausea or vomiting. Once in the cardiac catheterization lab, an IV is started to administer medications and fluids. Before the procedure, electrodes are placed on the chest to monitor the heartbeat and medications are given through the IV to relax the patient.
The catheter will be inserted in an artery or vein in the groin or arm after the skin over the site is numbed with medicine. Once the tip of the needle is in the blood vessel, a guide wire is moved through the needle into the artery or vein. There should be no pain when the catheter passes over the guide wire to the heart because blood vessels have no pain receptors.
The catheter is first placed in the left pumping chamber (the ventricle) of the heart and X-ray dye is injected. Moving pictures are made as the heart squeezes the dye into the main blood vessel (the aorta).
Some patients have a warm or hot feeling throughout their body for about 30 seconds. Patients may also have slight nausea or extra heartbeats, but these should pass quickly and not come back.
After pictures of the ventricle are made, the catheter is placed in each of the coronary artery openings. Smaller amounts of dye are pumped into the arteries a number of times and moving pictures then record the flow of dye into the smaller branches.
The total heart cath lasts about an hour, during which the patient is awake. The patient may talk during most of the time and at times will be asked to take a deep breath, cough, turn to one side or not speak for a few moments while pressures are being measured.
If your cath is done through the groin, the hole from the cath in the artery is sealed by firm hand pressure for 10-20 minutes followed by a tight bandage and 3-4 hours of bed rest with the hip and knee of the cath leg straight.
If your cath is done through the arm, you might be allowed to walk to the bathroom and around the room right away, but the arm may not be used in any way for the rest of the day after the cath.
If the artery near the thumb (radial) is used, a small compression strap is needed to keep pressure over the site for several hours. Sometimes the artery or vein near the elbow (brachial) is used instead. In some cases a few stitches may be needed in the blood vessel and skin after the catheter is removed and an arm board may be placed on the arm to restrict movement for several hours.
After the procedure, a nurse will check vital signs frequently. Patients may also feel drowsy as the medicine given during the cath continues to work. Soreness at the puncture site is also normal as the "numbing" given on the skin wears off.
Your body gets rid of the dye used for the cath through the kidneys, making extra urine so patients are asked to drink more fluids after their cath.
For more information, contact the Catheterization Laboratory at 706-475-3984.
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