Cardiac Catheterization
(Angiogram, Coronary Arteriography)
Definition |
Body Parts Involved |
Reasons for Procedure |
Complications |
What to Expect |
Outcome |
Call Doctor If
Definition
Diagnostic procedure performed to detect problems with the heart and its blood supply.
Parts of the Body Involved
Reasons for Procedure
This procedure is generally performed as a diagnostic test after a patient experiences chest pains or other symptoms that could point to a problem with the heart.
Cardiac catheterization helps doctors to:
- Identify narrowed or clogged arteries leading to or within the heart
- Measure blood pressure within the heart
- Evaluate the heart valves' functioning
- Ascertain how well the four chambers of the heart are functioning
- Check for congenital heart defects
- Evaluate an enlarged heart
- Decide on an appropriate treatment
Risk Factors for Complications during the Procedure
- Allergies to medications, shellfish, or x-ray dye
- Pre-existing heart or lung conditions
- Obesity
- Serious recent or chronic illness
- Bleeding disorder
- Kidney Disease
- Debilitation
What to Expect
Prior to Procedure
Your doctor will likely do the following:
- Blood and urine studies
- Electrocardiogram (ECG, EKG) – a test that records the heart's activity by measuring electrical currents through the heart muscle
- Chest x-ray
- Stress test
In the days 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 (except for liquids taken with medication)
During Procedure – IV fluids and medications, fluoroscopy, EKG, anesthesia, possibly a sedative
Anesthesia - Local anesthesia applied to the insertion site, and possibly a mild sedative given one hour before the procedure or via IV during procedure
Description of the Procedure - You'll be awake, but given sedation so that you'll be more relaxed and less anxious. Your doctor asks you to perform basic functions such as coughing, exhaling, and holding your breath. A clear plastic hood may be placed briefly over your head to measure the air you exhale and determine your heart's pumping efficiency. If you feel any chest pain, dizziness, nausea, tingling, or other discomfort, tell your doctor.
The catheter is threaded over a guide wire, inserted into an artery in your arm or leg, and fed up and into the heart. Your doctor watches the threading and placement of the catheter via a fluoroscope, which is a type of x-ray that takes pictures of moving organs.
Once in the heart, the guide wire is removed. The catheter is then used to measure blood pressure within the heart's different chambers and to take blood samples.
Dye is injected though the catheter and into the coronary arteries. Multiple x-ray images are taken to allow identification of any disease in the coronary arteries. An aortogram, which gives a clear image of the aorta, is also performed at this time. The catheter is then removed.
After Procedure:
- EKG and blood studies are done
- If catheter was inserted in your groin you will be required to lie flat on your back for at least six hours. During this time a catheter may be inserted in your bladder to assist with urination.
- A sandbag may be placed over your groin to exert pressure on the artery used for catheterization and prevent bleeding
- If catheter was inserted in your arm, you will be required to keep your arm perfectly straight using a stiff arm board, but you will be allowed out of bed within 2 hours
- You will be encouraged to drink lots of fluids to flush the x-ray dye from your system
How Long Will It Take? The actual procedure takes 1-2 hours and pre-procedure tests take 1-2 hours.
Will It Hurt? Although the procedure is generally not painful, it can cause some discomfort, including:
- Burning sensation (when skin at catheter insertion site is anesthetized)
- Pressure when catheter is inserted or replaced with other catheters
- A flushing feeling or nausea when the dye is injected
- Headache
- Heart palpitations
Pain medication will be given when necessary.
Possible Complications - Complications are rare, but can include:
- Blood clots, possibly resulting in heart attack, stroke, kidney damage, lung injury, or damage to arms or legs
- Allergic reaction to x-ray dye
- Arrhythmias (abnormal heart beats)
- Bleeding at point of catheter insertion
- Perforation or other damage to arteries
- Infection
- Heart attack
- Accumulation of fluid in the heart sac that can interfere with the heart pumping and adequately circulating blood, called pericardial tamponade
Average Hospital Stay: 0-1 days
Postoperative Care:
- If you are diagnosed with heart valve disease, you may be given antibiotics to avoid valve infection or endocarditis; take all of the antibiotic prescribed, even if you do not feel ill
- Do not lift heavy objects or engage in any strenuous exercise or sexual activity for a minimum of 24 hours
- Change the dressing around catheter incision area as instructed
- Take medications as instructed
- Use acetaminophen for pain relief, not aspirin or ibuprofen
- Use an electric heating pad or warm compress to relieve pain at the catheter insertion site
- Bathe and shower as usual, but keep the wound dry and covered with a bandage for the first 2-3 days after surgery
Outcome
The test results are generally available within 24 hours of the procedure. At that point, your doctor will discuss the findings and suggest appropriate treatment options. In some cases, the results can indicate an immediate need for surgery.
Call Your Doctor If Any of the Following Occurs
- Signs of infection, including fever and chills
- Extreme sweating or nausea
- Leg feels cold, turns white or blue, or becomes numb or tingly
- Redness, swelling, increasing pain, excessive bleeding, or discharge at point of catheter insertion
- Extreme pain, including chest pain
- Difficulty breathing
- Cough, shortness of breath, chest pain, or severe nausea or vomiting
SOURCES:
American College of Cardiology
Center for Cardiovascular Education
Last reviewed March 2001 by Medical Review Board
