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Cardiac catheterization involves threading a long, thin tube (a catheter) through an artery or vein in your leg or arm into the heart. Once this has been done, different procedures may be done to diagnose or treat coronary artery disease. The catheter may be used to inject dye into the heart and its arteries, and send electrical impulses to study irregular heartbeats.
Before Cardiac Catheterization
- Don't eat or drink anything for six to eight hours before the test. If you have diabetes, discuss this with your doctor. Not eating can affect your blood sugar and adjustments may need to be made to your insulin dosage.
- Discuss any medicines you are taking with your doctor. He or she may want you to stop taking them before the test, especially if you are taking a blood-thinner such as Coumadin® (warfarin) or anti-platelet medicines such as aspirin or Plavix®. It is important helpful to bring a list of your allergies, medicines and dosages to the procedure, so the healthcare team knows exactly what you are taking and how much.
- Wear a hospital gown and empty your bladder before your procedure.
- Your nurse will ask you to sign the consent form for the procedure.
Before the procedure, you may have blood tests and a chest X-ray. In addition, a needle with a tube attached (an intravenous or IV line) will be inserted in your arm. This allows drugs to be given, if needed, during the test. It may also be used to give you a relaxing drug before and during your procedure.
The catheter will be inserted into a small area on one or both legs. This area will be clipped of hair and cleaned with an antiseptic solution to prevent infection.
Once you are in the Cardiovascular Intervention Center, you will see television monitors, heart monitors and blood pressure machines. You will be connected to an electrocardiogram to monitor your heart during the test.
You will be given an anesthetic shot to numb the area around where the catheter will be inserted. This may be mildly uncomfortable. Afterward, tubes will be inserted to gain access to the artery and vein. A catheter is gently threaded through the artery and, guided by X-rays, into your heart. There should be no pain.
Your family can wait in the sixth floor lobby, where your doctor can meet with them after the procedure.
After Cardiac Catheterization, Angiography and Electrophysiological Studies
If you only have a diagnostic heart catheterization, angiography or an electrophysiological study, you will most likely be able to go home the same day. If an intervention is also going to be done, you will probably need to stay overnight.
- After the test, the catheters are removed.
- Firm pressure will be applied where the catheter was removed to stop any bleeding. In some cases, a device is used to seal the incision site to help stop the bleeding and to decrease the amount of time you will have to lie still to recover.
- For a few hours, you will need to rest in your room. You may feel sleepy until the sedative has worn off.
- It is important to try to lie still and not bend your knee too much for about four to six hours. You should keep your head relatively flat. Your doctor or nurse will discuss with you how long you need to lie flat. You don't need to keep your affected leg stiff - you can move your foot and arms and wiggle your toes.
- You must use the urinal or bedpan for elimination.
- If you have to sneeze or cough, press your fingers over the area where the catheter was inserted.
- The nursing team will continue to monitor your heart rate and blood pressure and regularly check the place where the catheter was put in.
- After you have rested and considered stable for discharge, you will be able to go home.
Caution - Call the nurse immediately if you feel:
- Sudden pain at the site
- Warm, sticky sensations or fluid or blood on the affected leg. Pressure will be reapplied for as long as needed to stop the bleeding.
Discharge Instructions for Outpatients (Same-day Discharge)
- Arrange for someone to drive you home after you are released from the hospital.
- Arrange for a responsible adult to be with you for 12 hours at home.
- If bleeding occurs, lie down immediately and use your hand to apply firm pressure continuously over the insertion site until no blood can be seen. Notify your doctor immediately.
- Do not lift any heavy objects or do any strenuous activities for two weeks following your procedure.
- You may resume your normal diet and previous drugs after your procedure, unless your doctor tells you otherwise.
- You may shower the next day. Remove the bandage and replace it with a bandage. Do not take a tub bath or submerge in water for one week.