Cardiac Catheterization
(Coronary Angiography; Coronary Arteriography; Coronary Angiogram)
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Definition
Cardiac catheterization is a test for the heart and its blood supply. A wire is passed through blood vessels to the heart and images are taken with type of x-ray.
Reasons for Procedure
This test is used to find the cause of symptoms that may be due to heart problems. Cardiac catheterization can help a doctor:
- Locate any narrowed or clogged arteries of the heart
- Measure pressures within the heart
- See how well the heart valves and heart chambers are working
- Check for heart defects
- Evaluate an enlarged heart
- Decide on a treatment plan
Possible Complications
If you are planning to have cardiac catheterization, your doctor will review a list of possible complications. Complications may include:
- Bleeding where the catheter goes in
- Damage to an artery wall
- Heart attack or abnormal heart beats known as arrhythmias
- Allergic reaction to the x-ray dye
- Blood clot formation
- Infection
Some factors that may increase the risk of complications include:
- Allergies to medications or x-ray dye
- Obesity
- Smoking
- Bleeding problems
- Increased age
- Recent pneumonia
- Recent heart attack
- Diabetes
- Kidney disease
What to Expect
Prior to Procedure
Other tests may have been done before cardiac catheterization. The doctor may review these tests before the procedure.
Talk to your doctor about your medicines. You may be asked to stop taking or change the doses of some medicine before the procedure.
A cardiac catherization may be done as an emergency. If this is a scheduled procedure:
- Arrange for a ride to and from the procedure.
- The night before, don't eat or drink anything after midnight.
Anesthesia
A local anesthesia will be used at the insertion site. It will numb the area and block pain.
A mild sedative may be given 1 hour before the procedure. It may also be given through an IV during the procedure. This will help you relax.
Description of the Procedure
Fluids and medicines will be given through IV. An EKG will monitor the heart’s activity.
You will be awake. Medicine will help you stay relaxed. The care team may ask you to do some tasks. This may include coughing, breathing out, and holding your breath. You will also need to tell the care team if you have problems. This may include chest pain, lightheadedness, nausea, tingling, or other discomfort.
An area in the groin or arm will be cleaned and numbed. A needle will be inserted into a blood vessel. A wire will be passed through the needle and into the blood vessel. It is then passed until it reaches your heart. A soft, flexible tube will then be slipped over the wire and passed up to your heart.
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An x-ray tool will show where the wire and catheter are. Dye will be passed into the arteries of the heart. This will highlight the arteries and heart on the x-ray images. You may feel a warm flush when the dye is injected. The catheter can then take measurements. Pressure can be measured in the heart's different chambers. Blood samples may also be taken. Many images will be taken to look for any disease in the blood vessels. After all the tests and images are complete, the catheter will be removed.
Other procedures may be done if there is an artery that is narrow or clogged. This may include a balloon angioplasty and stenting. They will help to open the arteries up. A bandage will be placed over the area when it is all done.
How Long Will It Take?
The procedure itself takes about 30 to 90 minutes. Total time will be several hours with recovery and preparation.
How Much Will It Hurt?
Although the procedure is generally not painful, it can cause some discomfort, including:
- A burning feeling when the insertion site is numbed
- Pressure when the catheter is moved around or replaced
- A flushing feeling or nausea when the dye is injected
- Headache
- Heart palpitations
Pain medicines will be given when needed.
Average Hospital Stay
The stay will depend on reason for the procedure. An overnight stay may be needed or you may go home the same day.
Postoperative Care
At the Care Center
- ECG and blood tests may be done.
- If the catheter was inserted in the groin area, you will lie still in bed. You will need to be flat on your back for a period of time. If the catheter was in your arm, you will be out of bed sooner.
- A pressure dressing may be placed over the area where the catheter was inserted. It will help to stop bleeding. It is important to follow instructions.
At Home
There will be some limits in the first few days. You will need to avoid heavy lifting and intense activity for 5 to 7 days.
Call Your Doctor If Any of the Following Occur
Contact your doctor if your recovery is not going as you expect or you have problems such as:
- Signs of infection, including fever and chills
- Redness, swelling, increasing pain, excessive bleeding, or any discharge from the catheter insertion site
Call for Medical Help Right Away If Any of the Following Occur
Call for medical help right away if you have symptoms including:
- Drooping facial muscles
- Changes in vision or speech
- Difficulty walking or using your arms
- Change in sensation to affected leg or arm, including numbness, feeling cold, or change in color
- Extreme sweating, nausea or vomiting
- Lightheadedness
- Chest pain
- Rapid or irregular heartbeat
- Cough, shortness of breath, or difficulty breathing
- Weakness or fainting
If you think you have an emergency, call for emergency medical services right away.
RESOURCES:
American Heart Association
http://www.heart.org
National Heart, Lung, and Blood Institute
https://www.nhlbi.nih.gov
CANADIAN RESOURCES:
Canadian Cardiovascular Society
http://www.ccs.ca
Heart and Stroke Foundation
http://www.heartandstroke.ca
REFERENCES:
Cardiac catheterization. Cleveland Clinic website. Available at: https://my.clevelandclinic.org/health/diagnostics/16832-cardiac-catheterization. Accessed December, 3, 2020.
Cardiac catheterization. National Heart Lung and Blood Institute website. Available at: https://www.nhlbi.nih.gov/health-topics/cardiac-catheterization. Accessed December, 3, 2020.
Preparing for cardiac catheterization. Cedars-Sinai website. Available at: https://www.cedars-sinai.org/programs/heart/resources/preparing-for-cardiac-procedures-and-studies/cardiac-catheterization.html. Accessed December, 3, 2020.
Last reviewed December 2020 by EBSCO Medical Review Board Michael J. Fucci, DO, FACC Last Updated: 12/3/2020