• Heart Cath
• Angiogram

What Is Cardiac Catheterization?

• This procedure is nonsurgical and is performed under X-ray guidance in the Cardiac Catheterization Lab.
   
• A catheter (a long, thin, flexible tube) is inserted through an artery (blood vessel) in the thigh up into the heart. Occasionally an artery in the arm is used.
   
• X-rays (pictures) are taken of the heart and coronary arteries.
  
  
• The patient is given a mild sedative to help him relax but remains awake during the procedure to allow him to answer questions regarding his comfort level, any chest pain or shortness of breath.
   
• A small area of the groin or arm is shaved and cleansed where the catheter will be inserted.
  
  
• Medication will be used to anesthetize (numb) this area so a small incision can be made where the catheter will be inserted.
  
  
• The catheter is inserted through the femoral artery in the groin (or an artery in the arm at the crease of the elbow). X-ray is used to guide the catheter up into the heart.

• A colorless dye is injected through the catheter, and X-ray pictures are taken of the heart and coronary arteries.
  
  
• The patient can watch the procedure on the monitor if he wants to.
  
  
• The test takes about an hour.

• This test will help the doctor to evaluate the patient's cardiac condition related to:
  • How well the heart muscle and valves are working
  • The extent of damage to the heart after a heart attack
  • Which coronary arteries are narrowed
  • The extent and degree of the narrowing
  • What treatment is required: medical management, an angioplasty (PTCA) or surgery

• Slight burning or stinging from the medicine used to numb the catheter insertion site.
• Slight discomfort or pressure as the catheter is being inserted.
• Slight nausea, extra heartbeats, and/or a warm flushing throughout the body (10-20 seconds) as the dye is being injected.

• After X-rays are taken, the catheter is removed.
• A bandaid or pressure dressing will be placed over the area where the catheter was inserted.
• Firm pressure is applied for 15-30 minutes until the bleeding stops.
• If an artery in the arm is used, pressure will be applied.
• The patient will be observed for 6-8 hours before discharged home.
• The insertion site will be checked frequently for signs of bleeding.
• Blood pressure and the pulse in the leg (or arm) used will be checked frequently.
• A knot under the skin where the catheter was inserted may occur. This is only temporary.
• Bruising to the leg/groin area where the catheter was inserted may occur. The bruising may spread down the leg and is only temporary.
• Most patients are discharged in 8 hours with minimal activity restrictions.

• Avoid bending the leg at the hip (groin area) for 6 to 8 hours.
• Hold the bandaid firmly, if need to cough or sneeze.
• Avoid bending or using the arm for several hours, if it was used for the insertion of the catheter.

• Discomfort or sudden pain at the insertion site.
• A warm, moist and sticky feeling, or bleeding.
• Any discomfort in chest, neck, jaw, arms or upper back, shortness of breath, weakness or dizziness.

• Nothing to eat or drink after midnight.
• It is important for the patient to ask his doctor:
  • How to adjust insulin and food intake prior to the test if he is a diabetic
  • If he should take his regular medications the morning of the test
  • If taking blood thinners (ie. Coumadin), should they be withheld and, if so, how long prior to the procedure
• Leave all valuables at home.
• Make arrangements to be driven home