What happens on the day of the procedure?
Before the catheterization, a heart doctor (cardiologist), will
examine you and review your medical history and diagnostic tests.
He will explain the procedure and its risks and benefits, and
will ask you to sign a consent form. Do not hesitate to ask questions
and voice your concerns. Tell the doctor if you are pregnant or
think you may be.
During your discussion with the doctor, he will ask you if you
have any allergies, particularly to certain food or dyes. If you
have allergic reactions to shellfish, and/or iodine-containing
x-ray contrast liquid, you may be given medication to prevent
an allergic reaction during the procedure.
You will also discuss your current medications. It is always
a good idea to bring all your medicines with you whenever you
visit a doctor or have a procedure performed. This enables the
doctor to learn the exact dosages you are taking. Make sure to
tell this doctor if you are taking nitroglycerin medicine.
Usually, you will have blood tests, an electrocardiogram, and
a chest x-ray taken prior to the procedure.
Will I be given local or general anesthesia?
You may be given a mild sedative about 1/2 hour before the procedure
to help you relax. You will stay awake throughout the procedure
and will be asked to perform some simple tasks. At times you will
be asked to take a deep breath, cough, turn your head to one side,
or refrain from speaking for a few minutes while pressures are
You will be given a local anesthetic during the catheterization.
What happens during the procedure?
In most cases, the procedure takes place in the catheterization
laboratory which is usually cold and dimly lit. The dimmed lights
will make the TV screens that monitor the procedure appear brighter
to the catheterization team. In addition to the television screens,
you will see heart monitors, a blood pressure machine and other
various instruments and devices in the laboratory.. You will lie
on a bed near an x-ray camera. The camera will move across you
on an arm over the bed.
Electrodes will be applied to your chest and back to monitor
your heart rhythm at all times. A blood pressure cuff will be
placed on your arm to monitor your blood pressure. You will be
shaved and cleansed with antiseptic solution in the area of your
groin where the catheter will be inserted. These steps are taken
to prevent infection..
An intravenous line will be started in your arm to allow for
the administration of medication during the procedure.
A local anesthetic will be injected into the skin to numb the
insertion site. This stings a little bit. Then a small incision
will be made in the skin. The doctors will use a special needle
to puncture the blood vessel (vein or artery), into which the
catheter. will be introduced. A radiologist or cardiologist will
insert the catheter through a small incision in an artery or vein
in your arm or groin. You will feel some pressure but no pain,
If you do feel pain, let the doctor know, so more numbing medication
can be given to you.
If the doctors want to view your left ventricle, the catheter
will then be carefully threaded into your heart using X-ray ../images
called fluoroscopy, to guide the insertion. When the catheter
is in place, dye is injected to visualize the structures and vessels
within the heart. The structures, vessels and blood flow are recorded
immediately on the televisions screens. A permanent record is
If the doctors want to view your coronary arteries, the catheter
is guided into each of the coronary artery openings. Dye is pumped
into the arteries a few times. . This flow of dye. is also recorded
on the television screens.
While the dye is moving through your blood vessels, you may feel
hot or flushed for up to 30 seconds. Some people experience slight
nausea or extra heartbeats.
How long does the procedure last?
The procedure takes from 20 to 40 minutes from the time of catheter
insertion. The total procedure lasts about an hour to an hour
and a half.
What will happen after the tests?
When the tests are finished, the catheter will be removed. If
the femoral artery in the groin was used, firm pressure will be
applied to the site for 10 to 20 minutes. Then bandages will be
applied.. Sometimes a 5 pound sandbag will be placed on top of
the bandages for 4 to 6 hours. This additional pressure helps
to stop bleeding.
You will leave the catheterization laboratory and go to another
room where you will have bed rest for up to six hours.. You must
lie straight, with your head slightly raised. Depending on the
insertion site, you should not bend your knee or arm. You may
wiggle your foot and toes to prevent stiffness.
A nurse will check your insertion site. and vital signs. If you
are in pain, ask her for medicine to relieve it. You may feel
drowsy. Notify the nurse if you experience a sudden pain at the
insertion site or if you have a warm, sticky or wet feeling around
It's a good idea to drink a lot of fluids. This will hasten the
removal of dye from your body.
You will be able to go home after the period of bed rest.
What happens when I get home?
Your doctor will tell you when you will be able to shower. It's
usually after 24 to 36 hours. The bruise at the insertion site
may take up to 2 weeks to heal. Call your doctor if pain or the
size of the bruise increases.
What happens next?
The tests will provide your doctor with valuable information regarding
your coronary arteries, the heart valves, your heart's electrical
function, blood flow, and the presence of any blockages of blood
flow. Based on this information your doctor will be better able
to diagnose your heart problem and advise you.