Cardiac catheterization is a diagnostic procedure that assesses how well a patient’s heart is functioning. Doctors order cardiac catheterization if they suspect heart problems or to see how an existing problem is progressing. The procedure involves inserting a tube into one of the large blood vessels in the heart. Though often solely diagnostic, sometimes the surgeon will perform an angioplasty, as well.
Cardiac catheterization as a diagnostic tool
There are various reasons a person may require cardiac catheterization. When used diagnostically, the surgeon can inject dye into the heart to examine the condition of the arteries with an x-ray, looking for any narrowing or blockages. This procedure is known as coronary angiography. Cardiac catheterization can also be used to assess the blood pressure inside the heart and to see how effectively the organ is pumping. The surgeon may examine the inside of the heart for defects. Blood samples can show blood oxygenation, and tissue samples indicate signs of disease.
Sometimes, cardiac catheterization enables surgery on the arteries of the heart. For example, if one of the arteries of the heart is too narrow, cardiac catheterization can widen the narrowed artery using a special balloon. Afterward, the surgeon can place a stent to keep the artery open and blood flowing freely. Cardiac catheterization may also be used to replace blocked or diseased vessels with healthy tissue.
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Fortunately, cardiac catheterization is unlikely to cause serious complications. However, some people may develop bruising where the medical practitioner inserted the needle. This will usually heal quickly. If dye is being injected into the heart to take x-rays, people may occasionally experience adverse reactions. The dye can make the patient feel sick or develop an itchy skin reaction.
In most cases, patients are awake during their cardiac catheterization. However, it’s likely that they will be offered sedative medication to help keep them calm, especially if they are feeling nervous. The practitioner injects a local anesthetic at the catheter insertion site, which is usually the arm, but may also be the groin. This should relieve any pain from the insertion.
Inserting the catheter
First, the surgeon shaves and thoroughly cleans the area and administers the local anesthetic. He or she then inserts a needle into a blood vessel, and a thin tube called a catheter through this needle. The physician will guide the catheter through the large blood vessels into the heart. Most patients do not find this procedure painful, though they may feel some pressure. Often, the patient can watch the procedure unfolding on a screen.
After the procedure
After the procedure is complete, the patient stays in a recovery room in the hospital for a few hours. During this time, medical practitioners place pressure on the insertion site to stem any bleeding. The patient needs to remain flat on their back and avoid moving the limb into which the doctor inserted the catheter. The hospital staff will check that the patient is recovering well by regularly checking their vital signs. They will also check there is no undue pain or swelling at the puncture site.
Going home after cardiac catheterization
Once the patient feels well enough, they can recover at home. This will usually happen on the same day as the test unless there are any complications. However, the patient should arrange a pickup and should not drive him or herself, due to the sedating drugs. The patient should feel better quite quickly, although it is normal to feel tired for a few days. Any pain or bruising should clear up within a week.
When patients leave the hospital, they will receive instructions on how to care for themselves at home. Normally, the patient can go back to work the next day. The doctor will probably recommend the wound be kept dry for a couple of days while it heals, so avoiding baths is ideal. It is also best to avoid any vigorous physical activity for a couple of days. The doctor may prescribe medication the patient will take following the procedure.
When to seek help
Most people will recover well after cardiac catheterization. However, the patient should consult a doctor promptly if the condition of the wound site worsens. This includes any swelling, discoloration, discharge or redness that gets worse instead of better. Other indications of trouble include increasing pain levels or bleeding that does not stop when pressure is applied. If the affected limb begins to tingle, feels numb, or turns blue or gray, see a doctor.
Results and treatment
The doctor will share the results of the cardiac catheterization tests with the patient. Depending on the findings, he or she may recommend further treatment or investigation. If a heart condition is detected, the doctor can prescribe medications. If there is an issue with the blood flow around the heart, such as clogged arteries, the patient may require a further procedure to widen or replace the damaged pathways. Occasionally, cardiac catheterization may identify the need for heart surgery such as a bypass.