| This will guide you when your doctor
has recommended that you have a cardiac catheterization,
coronary angiogram, and/or possible percutaneous coronary
intervention (angioplasty or stent placement) as part of
your continuing medical care. Your procedure is performed
in a specialized room, the Cardiac Cath Lab. Here, a team
of cardiologists, registered nurses, and technologists
work closely together to provide you care. It is their
goal to make your experience as comfortable as possible. |
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| Note:
Each person is unique and therefore each person’s
condition will vary. This is general information about
these procedures. If you have additional questions or concerns,
please ask the staff. |
|
• What is a
Cardiac Catheterization and Coronary
 Angiogram?
• What is a Percutaneous
Coronary Intervention (PCI)?
• What Can I Expect Before the
Procedure?
• What Can I Expect on the Day of
the Procedure?
• What Can I Expect During the
Procedure?
• What Can I Expect After the Procedure?
• When Do I Get My Results?
•
More Ways to Learn |
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| What is a Cardiac Catheterization and Coronary Angiogram? |
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| A cardiac catheterization is an invasive, non-surgical
procedure done to study the arteries that bring blood to
the heart muscle and to check the function of the main
pumping chamber of your heart. During a cardiac catheterization,
the cardiologist inserts a small, hollow tube (catheter),
into an artery or vein, and then guides it into the heart
using x-ray. The cardiologist injects contrast (x-ray dye)
through the catheter to outline the arteries and to show
any blockages or narrowings that may exist. The results
of these tests will assist your doctor in making the diagnosis
of Coronary Artery Disease (CAD). Most patients have little
or no discomfort during a cardiac catheterization. However,
you may feel a hot, flushing sensation for several seconds
when the contrast is injected into the main pumping chamber
of the heart. The nursing and medical staff will give you
medication and reassurance throughout the procedure to
ensure your comfort. |
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| What is a Percutaneous Coronary Intervention
(PCI)? |
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| PCI is a treatment procedure that unblocks narrowed coronary
arteries without performing surgery. During this procedure,
your cardiologist determines the best treatment for your
condition. Treatment will vary from patient to patient. |
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PCI may include one or
more of the following treatments:
Balloon catheter angioplasty: During
this procedure, the cardiologist inserts a cardiac catheter
with a small
balloon around it into the coronary artery. The cardiologist
then places the balloon in the narrowed area of the artery
and expands it with liquid. This pushes the plaque (blockage)
to the sides of the artery where it remains. This technique
reduces the narrowing in the artery and restores the
normal size of the artery. The cardiologist removes the
balloon catheter at the end of the procedure.
Stent: The
cardiologist places a small, hollow metal (mesh) tube called
a "stent" in
the artery to keep it open following a balloon angioplasty.
The
stent prevents constriction or closing of the artery
during and after the procedure. Drug-eluding stents are
now used. These stents are coated with medication that
helps prevent narrowing of the artery. |
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| Rotational Atherectomy: During this procedure, the cardiologist
uses a specialized instrument to break up rock-hard plaque
with calcium build-up from the blood vessel wall into tiny
pieces. You may experience some discomfort such as chest
pain, pressure or tightness in your chest during this procedure.
Medications may be given to ease the discomfort. This procedure
may last for 30 seconds to one minute. |
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| What Can I Expect Before
the Procedure? |
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| Consultation with your doctor about your medications: |
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• Bring a list of all your
current medications with you to your appointment,
including strength (dose) and frequency (time taken).
This includes any over-the-counter medications, herbal
preparations or vitamins.
• Ask your doctor about whether or not to take your routine medications
with a sip of water before coming to the hospital.
• Usually, aspirin should be taken prior to cardiac catheterization
and PCI.
• If you are taking blood-thinning medications such as Coumadin
(Warfarin), check with your doctor about when to stop
taking these medications prior to the procedure.
• If you
are taking medications for diabetes, e.g., Glucophage
(Metformin) or Glucovance (Glyburide and Metformin),
you may be advised
to stop these medications before the procedure
and re-start these medications after the procedure,
as directed by your doctor.
• Be sure to tell your doctor if you have had an allergic
reaction to x-ray dye (contrast), iodine or seafood,
or have a history
of bleeding problems.
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| Prepare the night before: |
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• Drink plenty of fluids the evening
before the test, unless otherwise directed by your doctor.
•
Do not eat or drink anything after midnight, the night
before your procedure, unless otherwise
directed by your doctor.
•
You must arrange for a relative or friend to drive you
home. You may not drive for 24 hours following the procedure. |
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| What Can I Expect on
the Day of the Procedure? |
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• Take medications that your doctor
has specifically instructed you to take on the day of your
procedure with a sip of
water.
•
Arrive at least 2 hours before your scheduled procedure.
Note: If you are scheduled for a 7 a.m. procedure, please
arrive
at 6 a.m.
•
Most scheduled procedures are performed on time. However,
your scheduled procedure time may be delayed if there are
emergency cases.
•
Family members and friends are invited to wait in a designated
waiting area. The cardiologist will contact them
there after the procedure. |
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| While you are in the Ambulatory Care Unit (ACU) and Cath
Lab holding area: |
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• Your nurse places a small intravenous
(IV) catheter (tube) in
your arm. The IV is needed to give you medications to help
you relax and make sure that you are comfortable
throughout the procedure.
•
You will be asked to sign several consent forms stating
that you understand the procedure. These forms may include
consent for cardiac catheterization, coronary angiogram,
PCI, emergency
coronary bypass surgery, and blood product
transfusion, if needed.
•
The nurse shaves either your groin and/or arm area (the
insertion site for the cardiac catheter) to remove hair
and prevent
infection.
•
Then, the nurse may insert a small tube (urinary catheter)
into your bladder to drain your urine. The catheter will
be
removed after your procedure. |
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| What Can I Expect During
the Procedure? |
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• The nurse or technologist brings
you into the Cardiac Cath Lab procedure room.
•
The nurse gives you medication through your IV to help
you relax and to ensure your comfort throughout the procedure.
•
The nurse cleans your groin/arm area with a special anti-bacterial
soap, and covers you with sterile drapes to prevent
infection.
•
The cardiologist injects a numbing medication (local anesthesia)
into the groin/arm area. This may feel like a mild sting
which lasts only a few seconds and will keep the area pain
free.
•
Next, the cardiologist places a small plastic tube called
a sheath through the skin and into
the artery. You may feel a slight
pressure at that moment.
•
Immediately report any chest pain or discomfort during
the procedure.
•
Once the sheath is in place, the cardiologist inserts a
catheter into the sheath and advances it toward the heart.
Then, x-ray pictures are taken as the contrast is injected.
You may feel a "hot flash" or a flushing sensation
during contrast injection. |
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| What Can I Expect After
the Procedure? |
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| After the procedure, you will return to the holding area
for a recovery period before you go home. |
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• The sheath will be removed. The timing of the
sheath removal depends
upon the results of your blood tests
(bleeding time) and other considerations.
•
Manual pressure, a compression device, or a "closure
device" may be used to seal the artery puncture site.
•
If the insertion site was in your arm, you will have a
compression band placed around the puncture site. The nurse
will slowly release the compression band and place a dressing
over the puncture site.
•
If you have had a PCI, you will be transferred to a special
cardiac care unit for an overnight stay. There, nurses
will continue
to monitor your condition closely. Most patients go home
the following day after a PCI.
•
After the procedure, you will remain flat in bed for 6
or more hours to prevent bleeding from the
catheter/sheath
insertion site. You may not sit up
until several
hours after the sheath is removed and the blood vessel
is sealed
by manual pressure or a
closure device has been placed. Your
nurse may raise the head of your bed slightly to allow
you to eat and drink
beginning one hour or more after your
procedure.
•
You may experience a backache after the procedure. Report
any backache to your nurse. Your nurse will give you medication
if needed.
• Call your nurse immediately if you are
experiencing any
chest pain, lightheadedness, bleeding, or severe back pain.
•
The nursing staff will give you detailed instructions about
what to expect when you go home. This will include symptoms
to watch for and when to call your doctor.
•
If you experience pain, moisture or any unusual sensation
at the cath site, call your nurse.
•
If you have to cough or sneeze, apply gentle pressure at
the site with your hand. |
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| When Do I Get My Results? |
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| Your cardiologist will notify you, your family member(s)
or friend(s) of the test results after the procedure. |
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