The Results?
The ultrasound images of your heart are reviewed and interpreted by one of our physicians, and the results are compiled into a written report which is sent to your referring physician. Information gained from this test helps your doctor make an accurate diagnosis and develop a treatment plan that is best for you.
Cardiac Catheterization
Why Is Catheterization Important?
Cardiac catheterization provides more the most accurate and detailed information about how your heart is working than any other diagnostic test. It helps doctors diagnose any problems accurately, and it helps them choose the best treatment for you.
What Is Cardiac Catheterization?
During cardiac catheterization, doctors insert a long, thin, flexible tube, called a catheter, into the body. The catheter is inserted into a blood vessel and is guided toward the heart under x-ray obsrvation.
The procedure allows doctors to study how well your heart pumps blood, and to examine the coronary arteries (the vessels that supply blood to the heart muscle), and the heart valves.
Other terms for cardiac catheterization are: coronary angiography, angiogram, cardiac cath, and heart cath.
Why Do Cardiac Catheterization
This test provides the most accurate and detailed information possible about the heart.
In general, cardiac catheterization is done for one or more of the following reasons:
- to evaluate or confirm coronary heart disease (for example, in patients with chest pain and/or an abnormal stress test
- to determine whether treatment (with balloon angioplasty or bypass surgery) can help a patient diagnosed with coronary heart disease
- to see how well blood flows through the coronary arteries after angioplasty or bypass surgery
- after a heart attack, to find out how severely the coronary arteries are narrowed or blocked
- during a heart attack to open the blocked artery as quickly and effectively as possible
- to evaluate the cause of heart failure
- to determine if there is significant heart valve disease that might require surgery
- to determine whether there is a congenital heart defect and evaluate how severe it is
Preparing For Catheterization
We generally refer our patients to the Hartford Hospital Cardiac Cath Lab for catheterization and possible angioplasty.
Patients usually have a consultation with one of the Cardiac Cath Lab doctors in the office the 1-2 days before the procedure.
Unless you are already in the hospital, you will arrive in the morning on the day of your catheterization.
You will have several routine tests, such as an ECG, x-rays, and blood tests. (These tests may be done a few days before the procedure.)
The doctor will review your medical history and examine you.
The doctor or nurse will talk with you about the procedure and its purpose, benefits, and risks. This is a good time to ask questions and to share any concerns you may have. You will then be asked to sign a consent form.
A nurse will shave and cleanse the area where the catheters will be inserted. This is usually at the groin (the fold between the thigh and abdomen). In some cases it may be in the wrist or arm. Shaving and cleansing make it easier to insert the catheters and help prevent infection.
An intravenous (IV) line will be inserted into a vein in your arm. This line allows drugs to be injected directly into the vein, if needed. To help you relax, you will be given a sedative.
If you wear dentures, hearing aids, or glasses, you can usually keep them on.
Before Your Catheterization
You will be asked not to eat or drink anything for 6-8 hours before the procedure. This helps prevent nausea.
You may have small sips of water to take your medications. Check with your doctor several days before the procedure about medications. You may be asked to stop some medications, such as aspirin or anticoagulants, for a few days before your catheterization.
Make arrangements with a friend or family member to drive you to and from the hospital. You will not be permitted to drive home after the procedure, since you may be drowsy.
Pack a small overnight bag in case your doctor decides to keep you in the hospital overnight. You may want to include a robe, slippers, pajamas or nightgown, and toiletries.
Bring a list of the names and dosages of all the medications you are taking.
Tell the doctor or nurse if you have had any allergic reactions to medications or x-ray contrast dye, iodine or seafood, or if you have a history of bleeding problems.
For your comfort, empty your bladder as much as possible before the procedure begins. There will also be a bedpan or a urinal, should you need it during the procedure.
During Cardiac Catheterization
Cardiac catheterization is performed in a specially equipped x-ray room called a cardiac catheterization laboratory, or cath lab.
You will be taken to the cath lab in a wheelchair, and be helped onto the x-ray table. The table has a large x-ray camera above and TV screens close by. There also are heart monitors and other instruments.
The cath lab team generally includes a cardiologist, an assistant, nurses, and technologists.
Once you are positioned on the x-ray table, you will be connected to several monitors and then covered with sterile sheets. The staff will be wearing sterile gowns, gloves, and masks.
What Happens During The Procedure
The site where the catheters will be inserted is usually in the groin. Sometimes it is in the wrist or arm. The site is cleansed thoroughly. A local anesthetic is injected into the skin with a tiny needle to numb the area. This may cause a stinging sensation.
A small incision is made in the skin, and a needle is used to puncture the blood vessel, usually an artery. A guidewire, a soft and flexible wire, is threaded into the artery. A short plastic tube, called a sheath, is then slipped over the guidewire and into the artery, and then the guidewire is removed.
Once the sheath is in place, doctors can insert and remove different catheters without having to use a needle each time.
The catheter is inserted into the artery and guided toward the heart, while the staff watches its progress on a TV screen. The catheter may be removed and replaced several times. This is done to reach each of the heart chambers or coronary arteries.
Once the catheter is inside the heart, the doctors measure the pressures in the left ventricle, the main pumping chamber, and take pictures of the coronary arteries and left ventricle.
If you are having a right-heart catheterization, a special catheter is inserted into a vein and is guided to the right side of the heart. This is done to measure pressures inside the right heart chambers and in the lungs, especially in people who have a weakened heart.
What You Can Expect
You will be given medication to help you relax and make you drowsy. You may be awake, or you may sleep through part or all of the procedure. The staff will be monitoring you at all times.
You may be asked to take a deep breath and hold it, to keep the pictures from blurring. You may be asked to cough forcefully several times, to help move the dye through the heart.
The procedure generally is not painful, although you may feel some pressure as the catheters are inserted. You will not feel the catheters as they move through the blood vessels and into your heart. For many, the most difficult part of the procedure is having to lie still for a long time on a hard table.
As x-ray contrast is injected into the heart, you may feel a warm sensation ("hot flash") through your body, lasting for 20-30 seconds. You may also feel nausea, chest discomfort, or a mild headache.
A complete cardiac catheterization procedure usually takes from 1-2 hours. If you feel pain or discomfort at any time during the procedure, let the staff know.
What Does Catheterization Show?
Cardiac catheterization allows doctors to measure the pressures inside the heart, see how well the heart is pumping blood, and take pictures of the coronary arteries and the heart chambers. Your doctors will discuss the results with you soon after the procedure is completed.
