(Coronary Angiography; Coronary Arteriography; Coronary Angiogram)
Cardiac catheterization is a procedure to see how well the heart is working. A wire is passed through blood vessels to the heart. Images of the heart and blood vessels are taken with a type of x-ray. Other steps may also be done to treat problems found during the test.
Reasons for Procedure
This test is done when heart problems are suspected. A doctor may use cardiac catheterization to:
- Find any narrowed or clogged arteries of the heart
- Measure pressures within the heart
- See how well the heart valves and chambers are working
- Check for heart defects
- Look at an enlarged heart
- Decide on a treatment plan
Problems are rare, but all procedures have some risk. The doctor will go over some problems that may happen, such as:
- Bleeding where the catheter goes in
- Damage to an artery wall
- Heart attack or abnormal heart beats known as arrhythmias
- Allergic reaction to the x-ray dye
- Blood clot formation
Some things that may raise the risk of problems include:
What to Expect
Prior to Procedure
Other tests may have been done before cardiac catheterization. The doctor may review these tests before the procedure.
Talk to your doctor about your medicines. You may be asked to stop taking or change the doses of some medicine before the procedure.
A cardiac catherization may be done as an emergency. If this is a scheduled procedure:
- Arrange for a ride to and from the procedure.
- Do not eat or drink anything after midnight the night before.
A local anesthesia will be used at the insertion site. It will numb the area and block pain.
A mild sedative may be given 1 hour before the procedure. It may also be given through an IV during the procedure. This will help you relax.
Description of the Procedure
Fluids and medicines will be given through IV. An EKG will track the heart’s activity. You will be awake but medicine will help you stay relaxed. The care team may ask you to do some tasks like cough, breathe out, and hold your breath. You will also need to tell the care team about problems like chest pain, nausea, or tingling.
An area in the groin or arm will be 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. It is then passed until it reaches your heart. A soft, flexible tube will then be slipped over the wire and passed up to your heart.
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An x-ray tool will show where the wire and catheter are. Dye will be passed into the arteries of the heart. This will highlight the arteries and heart on the x-ray images. You may feel a warm flush when the dye is injected. The catheter will take measurements like pressure in the heart. Blood samples may also be taken. Many images will be taken to look for any problems in the blood vessels. The catheter is removed once all the tests and images are done. A bandage will be placed over the area when it is all done.
Other procedures may need to be done. A balloon angioplasty and stenting can help to prop open clogged arteries.
How Long Will It Take?
The procedure itself takes about 30 to 90 minutes. Total time will be several hours with recovery and preparation.
Will It Hurt?
The procedure is generally not painful. It can cause some discomfort, including:
- A burning feeling when the insertion site is numbed
- Pressure when the catheter is moved around or replaced
- A flushing feeling or nausea when the dye is injected
- Heart palpitations
Pain medicines will be given when needed.
Average Hospital Stay
The stay will depend on why the procedure is being done. An overnight stay may be needed or you may go home the same day.
At the Care Center
- ECG and blood tests may be done.
- If the catheter was inserted in the groin area, you will lie still in bed. You will need to be flat on your back for a period of time. If the catheter was in your arm, you will be out of bed sooner.
- A pressure dressing may be placed over the area where the catheter was inserted. It will help stop bleeding. Be sure to follow the care team's instructions.
There will be some limits in the first few days. You will need to avoid heavy lifting and intense activity for 5 to 7 days.
Problems To Look Out For
Call your doctor if you are not feeling better or you have:
- Signs of infection, including fever or chills
- Redness, swelling, more pain, a lot of bleeding, or any discharge from the catheter insertion site
Call for medical help right away if you have:
- Drooping face muscles
- Changes in vision or speech
- Problems walking or using your arms
- Change in feeling to the leg or arm where the catheter was put in:
- Feeling cold
- Change in color
- Extreme sweating, nausea, or vomiting
- Chest pain
- Rapid or irregular heartbeat
- Cough, shortness of breath, or trouble breathing
- Weakness, fainting, or lightheadedness
If you think you have an emergency, call for medical help right away.
- Cardiac catheterization. Cleveland Clinic website. Available at: https://my.clevelandclinic.org/health/diagnostics/16832-cardiac-catheterization.
- Diagnostic cardiac catheterization and coronary angiography. EBSCO DynaMed website. Available at: https://www.dynamed.com/evaluation/diagnostic-cardiac-catheterization-and-coronary-angiography.
- Preparing for a heart test, study, or procedure. Cedars-Sinai website. Available at: https://www.cedars-sinai.org/programs/heart/preparing.html.
- What is cardiac catheterization? National Heart, Lung, and Blood Institute website. Available at: https://www.nhlbi.nih.gov/health/cardiac-catheterization.
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