Cardiac catheterization or “cardiac cath” is a diagnostic procedure that provides a picture of the blood vessels of the heart by using an x-ray dye and fluoroscopy, a type of x-ray movie. These blood vessels called coronary arteries, supply the heart with oxygen and nutrients. Coronary arteries are often the main focus of a cardiac cath, but aren’t the only part of the heart that can be examined. The function of the heart muscle and the valves can also be evaluated. Coronary artery disease, heart valve disease, heart failure, and congenital heart conditions are some of the problems that can be diagnosed with a cardiac catheterization. There may be other reasons for your doctor to recommend this procedure. Since coronary artery disease is the most common type of heart disease, let’s look at how the heart works and the vital role of the coronary arteries.
The heart’s main function is to pump blood to the rest of the body. To do this, it needs oxygen and nutrients for energy just like other muscles. So, it’s important that the coronary arteries that bring blood to the heart muscle are not blocked. There are 2 main arteries of the heart: the left and right coronary arteries. Normally, the inside walls of these arteries are smooth and flexible, allowing blood to flow freely to the heart muscle without obstruction. But in coronary artery disease or atherosclerosis, there’s a build-up of plaque in the inner lining of an artery. Plaque is made up of fatty material, calcium, and other substances. The gradual build-up of plaque narrows and stiffens the artery. This can decrease the blood flow through the artery to the heart and cause chest pain or other symptoms. Also, a plaque can break open or rupture. When this occurs in a coronary artery, a clot may be formed, cutting off vital blood flow to a portion of the heart muscle. This causes a heart attack. Depending on the location and degree of blockages in the coronary arteries, symptoms can range from;
- mild tightening in the chest
- shortness of breath
- nausea or vomiting
- severe jaw pain
- arm pain
- crushing chest pain that will not subside.
Specific symptoms vary by individual and can mimic other conditions. Also, remember men and women may experience symptoms differently. Based on your symptoms and other tests, your doctor may recommend a cardiac catheterization. This is an important diagnostic procedure used to determine the amount and the location of blockages in the coronary arteries of the heart.
Before your procedure, make a complete list of your medications and supplements. Be sure to discuss with your doctor if you’re taking a blood thinner such as Coumadin or aspirin. You may be asked to skip certain medications prior to the procedure. Also, tell your doctor if you’re allergic to contrast dyes, latex, tape or any medications. You’ll be asked to fast several hours prior to your procedure. Your doctor will describe the risks associated with a cardiac catheterization. Possible risks may include bleeding, infection and damage to the blood vessel at the catheter insertion site. Heart rhythm disturbances, chest pain and stroke may also occur, but are uncommon. There may be other risks depending on your specific medical condition. Be sure to discuss any concerns with your doctor. Now, let’s look more closely at the procedure itself. Before the cardiac cath begins, you’ll be given a gown to wear, blood will be drawn for lab tests, your blood pressure will be taken, and your groin area will be shaved. An I-V will be inserted so that fluids and medications can be given as needed. A cardiac cath takes place in an area that looks like an operating room. It’s called a cath lab. Once you’re in the cath lab, you’ll lie flat on a table. You’ll receive a sedative to help you relax. A numbing medication will be given before the catheter is inserted in the groin area. The usual catheter insertion site is the femoral artery in the groin, but sometimes an artery in the arm may be used instead. The catheter will be guided to the heart. Once it’s in place, dye will be injected into the coronary arteries. Your doctor can see any blockages as the dye moves through these arteries. A series of x-ray images will be made using a circular x-ray tube that rotates, called a C-arm. It shows the images of the arteries and heart from different angles. The doctor will view these images on a TV-like monitor. Some people feel a flushing sensation, metallic taste, or headache from the dye, but this only lasts for a few moments. If you experience breathing difficulties, sweating, numbness, or nausea, let your doctor know.
During your cath, your doctor may also evaluate your heart valves function and the overall performance of your heart, in addition to assessing the coronary arteries. Once all the x-ray images have been made, the catheter will be removed. Pressure or a closure device may be used to seal the artery to prevent bleeding. After the procedure, you may remain flat in bed for several hours. A nurse will check your blood pressure and heart rate, the insertion site, and the pulses in your feet. If the groin was used for the insertion site, it will be important not to sit up in bed or bend the leg during your bed rest. In order to remind you of this, a sheet may be placed across your leg. You may be given pain medication as requested. Let your nurse know immediately if you feel any chest pain or tightness, or any other pain. You’ll be encouraged to drink water and other fluids to help flush the dye from your body. You can generally resume your usual diet after the procedure. After your bed rest has been completed, you may get out of bed with assistance. You’ll be given discharge instructions prior to going home. Be sure to ask when to re-start any medications that were stopped for the procedure. Discharge instructions may vary depending on your situation. However, typical instructions may include:
- Keep the catheter insertion site clean and dry. Report any redness, swelling, drainage or bleeding. A small bruise at the catheter insertion site is common and isn’t a problem unless it’s raised or gets bigger.
- Notify your doctor if you have any fever, chills or any changes in your leg or arm that was used during the cath.
Your doctor will discuss your results with you and will recommend what steps to take next. Many heart problems can be treated when caught early. A cardiac catheterization can provide valuable information that may save your life.
