Cardiac Catheterization

Your doctor may order:

• Blood and urine tests
• Chest x-ray
• Electrocardiogram (ECG, EKG)—a test that records the heart's activity by measuring electrical currents through the heart muscle
• Stress test

Talk to your doctor about your medicines. You may be asked to stop taking some medicines before the procedure, like:

• Anti-inflammatory drugs (eg, ibuprofen)
• Blood thinners, like warfarin (Coumadin)
• Clopidogrel (Plavix)
• Metformin (Glucophage) or glyburide and metformin (Glucovance)

Leading up to your procedure:

• Arrange for a ride to and from the procedure.
• The night before, do not eat or drink anything after midnight.

Local anesthesia will be used at the insertion site. A mild sedative may be given one hour before the procedure or through an IV (needle in your arm) during the procedure. This will help you relax.

During the procedure, you will receive IV fluids and medicines. An EKG will be monitoring your heart's activity.

You will be awake but sedated so that you will be more relaxed. Your doctor will ask you to do basic functions such as coughing, breathing out, and holding your breath. If you feel any chest pain, dizziness, nausea, tingling, or other discomfort, tell your doctor.

The catheter will be inserted into an artery in either the groin or arm (usually at the crease opposite the elbow or at the wrist). The insertion area will be shaved, cleaned, and numbed. A needle will be inserted into a blood vessel. A wire will be passed through the needle and into the blood vessel. The wire will then be guided through until it reaches your heart. A soft, flexible catheter tube will then be slipped over the wire and threaded up to your heart.

The doctor will be taking x-ray pictures during the procedure to know where the wire and catheter are. Dye will be injected into the arteries of the heart. This will make the arteries and heart show up on the x-ray images. You may feel warm during the dye injection.

Once in place, the catheter can be used to take measurements. Blood pressure can be taken within the heart's different chambers. Blood samples may also be taken. Multiple x-ray images will be taken to look for any disease in the arteries. An aortogram may also be done at this time. This step will give a clear image of the aorta (large artery leaving the heart). Once all the tests and images are complete, the catheter will be removed.

Sometimes, the doctor will do a balloon angioplasty and stenting if he finds an area in your arteries that is narrow or clogged. These procedures help to open narrowed arteries.

Finally, a bandage will be placed over the groin or arm area.

The procedure takes about 1-2 hours. Preparation before the test will take another 1-2 hours.

Although the procedure is generally not painful, it can cause some discomfort, including:

• A flushing feeling or nausea when the dye is injected
• Burning sensation (when skin at catheter insertion site is anesthetized)
• Headache
• Heart palpitations
• Pressure when catheter is inserted or replaced with other catheters

Pain medicine will be given when needed.

0-1 days