Patient education: Cardiac catheterization (The Basics)

What is cardiac catheterization? — Cardiac catheterization, or "cardiac cath," is a procedure doctors can do to look for certain heart problems. Doctors usually do a cardiac cath to understand how your heart is working or why you have symptoms such as chest pain.

Most people who have a cardiac cath have a test called "coronary angiography" done as part of the procedure. Doctors do coronary angiography to look at the arteries in the heart. That way, they can see if there are any blockages in the arteries and how serious the blockages are.

Some people have a cardiac cath without having coronary angiography. Doctors can do a cardiac cath to look for problems in the heart chambers or valves (figure 1). To get information about the heart chambers or valves, they can measure the pressures or amounts of oxygen in the blood in different parts of the heart.

How do I prepare for a cardiac cath? — The doctor or nurse will tell you if you need to do anything special to prepare.

Before your procedure, your doctor will do an exam. They might send you to get tests, such as:

●Blood tests – These include tests to check kidney function and red and white blood cell counts.

●Electrocardiogram ("ECG") – This test measures the electrical activity in your heart.

Your doctor will also ask you about your "health history." This involves asking you questions about any health problems you have or had in the past, past surgeries, and any medicines you take. Tell them about:

●Any medicines you are taking – This includes any prescription or "over-the-counter" medicines you use, plus any herbal supplements you take. It helps to write down and bring a list of any medicines you take, or bring a bag with all of your medicines with you.

●Any allergies you have – This is especially important if you have an allergy to shellfish.

●Any bleeding problems you have – Certain medicines, including some herbs and supplements, can increase the risk of bleeding. Some health conditions also increase this risk.

You will also get information about:

●Eating and drinking before your procedure – You need to "fast" before surgery. This means not eating or drinking anything for a period of time. In some cases, you might be allowed to have liquids until a short time before the procedure.

●Lowering the risk of infection – Body hair might need to be trimmed or shaved, and the area cleaned with a special soap.

●What help you will need when you go home – For example, you might need to have someone else bring you home or stay with you for some time while you recover.

Ask the doctor or nurse if you have questions or if there is anything you do not understand.

What happens during a cardiac cath? — When it is time for the procedure:

●You will get an "IV," which is a thin tube that goes into a vein. This can be used to give you fluids and medicines.

●You will be awake during the procedure, but your doctor will give you medicine to help you feel relaxed. They will also use "local anesthesia." This is medicine to numb a small part of your body so you don't feel pain.

●The doctors and nurses will monitor your breathing, blood pressure, and heart rate during the procedure.

●Your doctor will make a very small cut in the top, inner part of your leg, or at your wrist.

●The doctor will put a thin plastic tube, called a "catheter," in a blood vessel that is just below the cut. Then, they will gently push the tube through your blood vessels to your heart (figure 2). You will not be able to feel this.

●While this is happening, an X-ray will take pictures of the tube in your body. This helps your doctor know when the tube has reached the correct place in your heart.

●When the tube is in place, your doctor will do tests. If you are having coronary angiography, your doctor will inject a dye into the tube that shows up on an X-ray. This dye can show if any of the arteries in your heart are clogged. Your body might feel warm during this part of the test.

●If your arteries are clogged, your doctor might do a procedure to open them during the catheterization. This is called "stenting." If you might have this procedure, your doctor will talk with you about it in their office before your cardiac cath.

●The doctor will remove the tube from your body and put pressure on the cut to prevent bleeding. They will cover the cut with a bandage.

●The procedure usually takes about 2 to 4 hours.

What happens after a cardiac cath? — After your procedure, you will be taken to a recovery room. The staff will watch you closely as your anesthesia wears off.

As you recover:

●You will need to rest in the hospital for a few hours. You will probably be able to go home after that, but someone else will need to bring you. If your doctor fixed any of your arteries, you might need to stay in the hospital overnight.

●Before you leave, your doctor will tell you when you can drive and do your usual activities again.

●Someone on the medical staff will discuss your medicines with you and set up a follow-up appointment to see you in about a week. At the follow-up, you will learn about the results of your cardiac cath.

What are the risks of cardiac cath? — Your doctor will talk to you about all of the possible risks, and answer your questions. The most common problems are:

●Bleeding

●Bruising

●Soreness in the area where the tube was put in

These problems can last for a few days, especially if the tube was put in the leg.

Other problems can happen during or after a cardiac cath, but they are uncommon. They include:

●Heart attack

●Stroke (when a part of the brain is damaged because of a problem with blood flow)

●Injury to blood vessels

●Blood clots to toes

●Kidney damage

●Allergic reaction to the dye

●Death

A cardiac cath does involve some radiation. Too much radiation can cause serious health problems, such as cancer. The small amount of radiation from 1 cardiac cath will not cause any long-term problems in many people. But your doctor will talk with you about the possible long-term side effects of radiation.

When should I call my doctor or nurse? — Call your doctor or nurse if any of the following happen after your cardiac cath:

●The area where the tube went in bleeds a lot.

●You get a fever or have pain, swelling, or redness where the tube went in.

●Your leg or hand is weak or numb.

●You have chest pain.

●You feel dizzy or lightheaded.

More on this topic

Patient education: Heart attack (The Basics)
Patient education: Chest pain (The Basics)
Patient education: Coronary artery disease (The Basics)
Patient education: Heart failure (The Basics)
Patient education: Heart murmurs (The Basics)
Patient education: Stenting for the heart (The Basics)
Patient education: Cardiac catheterization – Discharge instructions (The Basics)

Patient education: Heart attack (Beyond the Basics)
Patient education: Chest pain (Beyond the Basics)
Patient education: Heart failure (Beyond the Basics)
Patient education: Stenting for the heart (Beyond the Basics)
Patient education: Angina treatment — medical versus interventional therapy (Beyond the Basics)