Heart Catheterization

What is Cardiac Catheterization? Cardiac catheterization is a procedure used to diagnose and treat cardiovascular conditions. During cardiac catheterization, a long thin tube called a catheter is inserted in an artery or vein in your groin, neck or arm and threaded through your blood vessels to your heart. Using this catheter, doctors can then do diagnostic tests as part of a cardiac catheterization. Some heart disease treatments, such as coronary angioplasty, also are done using cardiac catheterization (Mayo Clinic Staff). For example, your doctor may put a special type of dye in the catheter.

The dye will flow through your bloodstream to your heart. Then, your doctor will take x-ray pictures of your heart. The dye will make your coronary (heart) arteries visible on the pictures. This test is called coronary angiography. The dye can show whether a waxy substance called plaque has built up inside your coronary arteries. Plaque can narrow or block the arteries and restrict blood flow to your heart. Doctors also can use ultrasound during cardiac catheterization to see blockages in the coronary arteries. Ultrasound uses sound waves to create detailed pictures of the heart’s blood vessels.

Doctors may take samples of blood and heart muscle during cardiac catheterization or do minor heart surgery (Zieve). Doctors also can treat Coronary Heart Disease during cardiac catheterization using a procedure called angioplasty. During angioplasty, a catheter with a balloon at its tip is threaded to the blocked coronary artery. Once in place, the balloon is inflated, pushing the plaque against the artery wall. This creates a wider path for blood to flow to the heart. Sometimes a stent is placed in the artery during angioplasty. A stent is a small mesh tube that supports the inner artery wall.

Most people who have heart attacks have narrow or blocked coronary arteries. Thus, cardiac catheterization might be used as an emergency procedure to treat a heart attack. When used with angioplasty, the procedure allows your doctor to open up blocked arteries and prevent further heart damage (Zieve). What can I expect during the heart catheterization? Cardiac catheterization is done in a special operating room that has special X-ray and imaging machines that normal operating rooms don’t have. Cardiac catheterization is usually performed while you’re awake, but sedated.

An IV line will be inserted in your hand or arm, and will be used to give you any additional medications you might need during your procedure. You will also have monitors (electrodes) placed on your chest to check your heartbeat during the test. Just before the procedure, a nurse or technician may shave the hair from the site where the catheter will be inserted. Before the catheter is inserted in your artery, you’ll be given a shot of an anesthetic to numb the area. You may feel a quick, stinging pain before the numbness sets in. After you feel numb, the catheter will be inserted.

A small cut is made, usually in your leg, to access an artery. A plastic sheath will be inserted in the cut to allow your doctor to insert the catheter (Mayo Clinic Staff). Common Uses for Cardiac Catheterization Coronary angiogram. If you’re having this test to check for blockages in the arteries leading to your heart, a dye will be injected through the catheter, and X-ray images of your heart arteries will be taken. In a coronary angiogram, the catheter is usually first placed in the artery in your groin or wrist. Right heart catheterization.

This procedure checks the pressure and blood flow in the right side of your heart. For this procedure, the catheter is inserted in the vein in your neck or groin. The catheter has special sensors in it to measure the pressure and blood flow in your heart. Heart biopsy. If your doctor is taking a sample of heart tissue (biopsy), the catheter will usually be placed in the vein in your neck. A catheter with a small, jaw-like tip is used to obtain a small sample of tissue from your heart. You may feel pressure as this catheter is being used, but you likely won’t feel the actual tissue being snipped.

Balloon angioplasty, with or without stenting. This procedure is used to open a narrowed artery in or near your heart. The catheter will likely be inserted in the artery in your groin for this procedure. A long, flexible catheter will be threaded through your arteries to the narrowed artery. Then, a smaller balloon catheter will be led through the flexible catheter and inflated at the narrowed area to open it. In many cases, your doctor will also place a mesh coil called a stent at the narrowed portion to help keep the artery open.

Repair of heart defects. If your doctor is closing a hole in your heart, such as an atrial septal defect or patent foramen ovale, you will probably have catheters inserted in both the arteries and veins of the groin and neck. A device is then inserted into your heart to close the hole. Balloon valvuloplasty. This procedure is done to open up narrowed heart valves. The placement of your catheters will depend on which valve problem you have. A catheter is threaded across the valve. A balloon is then blown up to make the valve open more easily.

You may feel pressure as the catheters are inserted into your body, but you shouldn’t feel discomfort from the balloon treatment itself. Valve replacement. This procedure is similar to ballon valvuloplasty, except that an artificial valve will be implanted in your heart to replace a leaky or narrowed heart valve. Heart ablation. In this procedure, you’ll usually have multiple catheters placed in the arteries and veins of the groin or neck so that radiofrequency energy can be directed to the part of your heart causing abnormal heartbeats. Although you’ll be sedated, you’ll be awake during the procedure so that you can follow instructions.

Throughout the procedure you may be asked to take deep breaths, hold your breath, cough or place your arms in various positions. Your table may be tilted at times, but you’ll have a safety strap on to keep you on the table. Threading the catheter shouldn’t be painful, and you won’t feel it moving through your body. Tell your health care team if you have any discomfort (Zieve). It usually takes several hours to recover from a cardiac catheterization. After your procedure is finished, you’ll be taken to a recovery room while the anesthesia wears off. This usually takes about an hour.

The plastic sheath inserted in your groin, neck or arm will be removed soon after the procedure unless you need to continue on blood-thinning medication. After you leave the recovery room, you’ll go to a regular hospital or outpatient room. After your catheter is removed, the technician or nurse who has removed your sheath will apply pressure to the insertion sites. You’ll need to lie flat for several hours after the procedure to avoid serious bleeding and to allow the artery to heal. You’ll be able to eat and drink after the procedure. The length of your stay in the hospital will depend on your condition.

You may be able to go home the same day as your catheterization, or you may need to stay overnight or longer if you have an additional procedure, such as angioplasty and stent placement (Mayo Clinic Staff). I enjoyed getting to observe in the cath lab at PMC. I there were no procedures for me to actually observe but I was given the opportunity to view all of the equipment used and films from several procedures. I didn’t realize that there was so much involved in a heart catheterization. I was in awe of the images of the coronary artery blockages and getting to see the stent placement and the improved blood flow after the procedure.

I was very grateful for this experience and hope to get another opportunity to view the procedure taking place.

References Mayo Clinic Staff. (n. d. ). Retrieved from http://www. mayoclinic. com/health/cardiac-catheterization/MY00218 MedicineNet. (n. d. ).

Retrieved from http://www. medicinenet. com/cardiac_catheterization/article. htm Thompson, M. (n. d. ). Retrieved from http://www. webmd. com/heart-disease/cardiac-catheterization Zieve, M. (n. d. ). Retrieved from http://www. nlm. nih. gov/medlineplus/ency/article/003419. htm.

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