Cardiac Catheterization

What is cardiac catheterization?

Cardiac catheterization, also known as coronary angiography or cardiac cath, is used to diagnose and treat heart conditions. It involves inserting a thin, flexible tube called a catheter into a blood vessel and guiding it to the heart. This procedure allows doctors to directly visualize and assess the heart’s blood vessels, chambers, and valves using special X-ray imaging equipment.

Who conducts cardiac catheterization?

Cardiac catheterization is generally performed in a specialized cardiac catheterization laboratory (cath lab) by a team of doctors, including specially trained cardiologists, nurses, and technicians.

Cardiac Catheterization Procedure

Before the procedure

Before the procedure, specific instructions are given to the patient. These may include fasting for six to eight hours and avoiding certain medications (blood thinners, aspirin, etc.). The patient should inform the doctor about any allergies or medical conditions they are suffering from. The patient is also requested to remove dentures and any jewelry, particularly necklaces, that could obstruct heart images.

During the procedure

A nurse will place an IV line in the arm to deliver a sedative. This helps the patient feel calm and relaxed during the procedure, while still remaining awake and capable of following instructions.

During the procedure, the catheter is typically inserted through a blood vessel in the groin area, although it can also be inserted in the arm or neck. The insertion site is numbed with a local anesthetic to minimize discomfort.

The catheter is then carefully guided through the blood vessels under X-ray guidance until it reaches the heart.

A contrast dye is injected through the catheter into blood vessels. This dye helps highlight the heart’s chambers, valves, and major blood vessels, allowing the cardiologist to identify any blockages or narrowing in the arteries, check the size and shape of the heart’s chambers and blood vessels, and detect any abnormal leaks or holes.

If blockages are discovered during the procedure, the cardiologist may address the blockage either by inserting a stent (also called angioplasty) or by employing an alternative treatment method after discussing it with the patient and relatives.

Throughout the procedure, the patient is closely monitored by a healthcare team. They will check vitals, i.e., blood pressure, heart rate, and oxygen levels. The procedure usually takes 30 minutes to an hour, but the preparation and recovery time can add several hours.

The procedure is typically considered safe, but like any medical intervention, there are risks involved, such as bleeding, infection, allergic reactions to the contrast dye, damage to blood vessels or the heart, blood clots, or irregular heart rhythms. However, serious complications are rare.

After the procedure

After the procedure, the patient will be moved to a recovery room. After removing the catheter, a technician or nurse will apply pressure to the puncture site. If the catheter was inserted through the groin, the patient will be asked to lie flat for a few hours and keep the leg straight for two to six hours to prevent bleeding. If the catheter is inserted through the wrist or neck, the patient can sit up. A nurse will monitor vital signs and check for chest pain, swelling, or bleeding at the puncture site.

A minor bruise at the puncture site is expected, but if the patient observes substantial bruising, swelling, fluid buildup, or numbness/tingling, it is important to inform the doctor. If the patient experiences symptoms like fever, chest pain, difficulty breathing, or irregular heartbeats, it is crucial to seek immediate medical help.

Most people can resume normal activities the day after the procedure, with restrictions on strenuous exercise and heavy lifting for about a week or until the wound heals. The doctor will provide guidance based on the patient’s specific situation.

The results obtained from cardiac catheterization can help guide further treatment decisions, such as medication therapy, lifestyle changes, or the need for additional procedures like bypass surgery or angioplasty.


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