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The High-Tech Heart: What to Expect from Cardiac Catheterization

separator Your doctor has told you you need to have a test called cardiac catheterization done, and you’re feeling pretty worried about it. Will it hurt? Is it dangerous? How do they do it?

How the procedure works
This procedure takes place in the cardiac catheterization lab. The lab contains special video screens and X-ray machines that can show enlarged images of blocked areas in the arteries of your heart.

You lie on a table, and you’ll have an intravenous line inserted. You’ll have fluids and medications inserted through that line. You’ll generally get medications to relax you and to prevent blood clots from occurring. You’ll be awake enough to communicate with your doctor during the procedure.

During the procedure, the doctor will thread a thin flexible tube, or catheter, through a small incision in your groin area through a blood vessel to the area of the artery that is blocked. Before the tube is inserted, the groin area is shaved and then numbed. The numbing usually stings a bit as it is going in.

A small amount of dye is injected into the catheter. An x-ray is taken so that your doctor will be able to see the coronary arteries, valves and the chambers of your heart.

Once the tube reaches the blockage, your doctor inflates a tiny balloon that’s attached to the end of the tube. The balloon makes the artery wider, so that blood can flow to the heart more easily.

When the procedure is over, the doctor removes the catheter from the heart.

Patients usually describe procedure as “simple and painless”
Gregory Hood, Supervisor of the Cardiac Catheterization Lab at St. Vincent’s Hospital, says that it’s the unknown that concerns patients the most. “The doctor or a technologist talk with patients before the test, but they’re still scared or just plan nervous,” he says. “The thought of sticking a catheter inside their heart makes them nervous. They believe it will make a big incision in their leg or groin to get access to the artery, when in fact it is a needle puncture with an IV or sheath placed into the femoral artery.”

The most common question, says Hood, is, “Is it going to hurt? I answer by saying that they’ll feel a needle prick in the leg area, which is the numbing medicine. As it numbs the skin, you may feel pressure as the sheath is placed into the artery. You have no feeling of the catheter inside your body,” continues Hood. “God gave us no nerve endings inside our artery.”

The last image that’s taken, or the “grand finale,” as Hood describes it, “is an injection into the left ventricle of the heart. You will feel a hot sensation, but some patients describe it as warm, not hot at all.”

The procedure takes between 25 to 40 minutes. “Ten minutes of that is the set-up by the technologist to get the patient ready,” says Hood.

Hood says that after the procedure, the majority of patients experience no discomfort. Some complain of back pain from lying on the table, and some, very few, complain of leg pain.

Patients stay in the hospital from one and half to three hours, explains Hood. “The discharging nurse will go over discharge orders and precautions before you’re released. Possible complications are bleeding at the puncture site or infection. These are seen in about 2 percent of patients after the procedure.”

To prevent complications, you should do no lifting, no deep knee bends and no excessive stair walking for 24 to 48 hours after the procedure. After that, you can go back to your normal routine.

Hood says, “The majority of the patients say the procedure was very simple and painless. Most would recommend it to their friends.”

National Heart, Lung, and Blood Institute; Gregory Hood, Supervisor, St. Vincent’s Cardiac Catheterization Center.
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