With our state-of-the-art facility and highly trained personnel, Southern California Heart Centers commits to provide excellence in cardiac catheterization and an enhanced overall patient experience.


CARDIAC CATHETERIZATION (CATH)

Cardiac catheterization is a procedure used to diagnose and treat cardiovascular conditions. The most common reason for performing a cardiac catheterization is to detect the presence of coronary artery disease (a blockage of the arteries that supply oxygen and nutrients to the heart muscle). Cardiac catheterization is an invasive procedure that consists of inserting a long thin tube called a catheter into a blood vessel in the arm or leg, and threading it up to your heart. Using this catheter, doctors can then do diagnostic tests as part of a cardiac catheterization. Using a technique known as fluoroscopy, the doctor can inject a contrast agent into the heart and coronary arteries and view real-time X-ray images to measure the valves, the coronary arteries, and the chambers of the heart. Some heart disease treatments, such as coronary angioplasty, also are done using cardiac catheterization.


PREPARING FOR A CARDIAC CATHETERIZATION

Medications:

Your doctor will tell you which medications you should take on the day of your examination. Don't stop any of your medications without first talking to your doctor. He will tell you which medications you should stop taking and when to stop taking them. Usually you will be instructed to stop taking aspirin or Coumadin (warfarin) a few days before the procedure. If you have diabetes, ask the nurse how to adjust your diabetes medications or insulin.

Food and drink

Eat a normal meal the evening before your procedure. However, DO NOT eat, drink or chew anything after midnight before your procedure. This includes gum, mints, and water. Try to take all your medications before midnight. If you must take medications after midnight, only take them with small sips of water. When brushing your teeth, do not swallow any water.


BEFORE A CARDIAC CATHETERIZATION

The patient should wear comfortable clothing and leave all jewelry and valuables at home. You will change into a hospital gown for the procedure. Remove all makeup and nail polish.

Please bring the followings items with you:

  • Prescription or referral from your physician
  • Insurance cards and identity cards issued by government
  • A one-day supply of medications. Do not take the medications without first talking with the doctor or nurse.

When you arrive, you may have to complete additional medical information. You must know the name of all the medications you take and whether you are allergic to anything. Do not forget to remind the doctor or male nurse if you suffer from any allergy. This is especially important if you are allergic to iodine, shellfish or radiographic dye. It is also important to report an allergy to latex. Some medications could increase the risk of suffering complications due to the catheterization. These include aspirin and related medications, Coumadin (warfarin), Plavix (clopidogrel), diuretics and insulin. Take a list of your medications (including over-the-counter ones) and the doses.


DURING A CARDIAC CATHETERIZATION

WHERE IS THE PROCEDURE PERFORMED

Cardiac catheterizations are performed on an outpatient basis at the local hospital affiliated with our clinic doctors.

The cardiac catheterization room will be cool and not very well lit. The air must be kept cool not to damage the equipment that is used in the procedure.

WHAT WILL HAPPEN DURING THE PROCEDURE?

  • A nurse will place an intravenous path in your arm so that liquids and medications can be administered to you during the procedure.
  • You will have to lie down on a special table that is hard. You will see a large camera and several television monitors. You will be able to see the cardiac catheterization on the monitors.
  • The nurse will clean your skin on the site (arm or groin) where the catheter (a thin plastic tube) is inserted. The site where the catheter is inserted may be shaved.
  • Sterile cloths will be used to cover the insertion site and prevent it from becoming infected. It is important for you to keep your arms and hands on the sides, under the sterile cloths.
  • Electrodes (small flat adhesive patches) will be placed on your chest. The electrodes are connected to an electrocardiography (electrocardiogram) monitor, which will monitor the heart rate and rhythm during the procedure.
  • A mild sedative will be applied intravenously for you to relax, but you will be awake throughout the procedure.
  • The doctor will use a local anesthetic to numb the site where the catheter will be inserted. A plastic introducer (a short and hollow tube that is used to guide the catheter up to the blood vessel) will be inserted in a blood vessel in the arm or groin. It may be necessary to make a small incision to insert the introducer through the skin. A catheter will be introduced through the introducer and will be threaded up to the heart. Y ou may feel pressure when the introducer or catheter is inserted, but you should not feel pain. Tell the nurse or the doctor if it hurts.
  • Once the catheter is in place, the lights will be dimmed and a small amount of contrast material (an intravenous dye that allows the heart and the blood vessels to be seen on the X-rays) will be injected into the arteries and the chambers of the heart through the catheters. The contrast material delineates the vessels, valves and chambers.
  • When the contrast material is injected into the heart, you may feel heat for several seconds. This is normal and will disappear in a few seconds. The symptoms of an allergic reaction may include itching or a feeling of tightness in the throat. You must inform the doctor immediately if this happens. Symptoms of nausea and chest discomfort may also appear. Inform the doctor or the male nurses if you perceive these symptoms or any other.
  • The X-ray camera will be used to take photographs of the arteries and the chambers of the heart. You may be asked to hold your breath while the X-rays are taken. Once all the X-rays are taken, the catheter will be removed and the lights will be turned on.
  • An interventionist procedure may be combined with the cardiac catheterization. These procedures are used to treat problems that are found during the catheterization. Your doctor will tell you if he plans any interventionist procedure as part of your cardiac catheterization.
  • Although you'll be sedated, you'll be awake during the procedure so that you can follow instructions. Throughout the procedure you may be asked to take deep breaths, hold your breath, cough or place your arms in various positions. Your table may be tilted at times.

AFTER A CARDIAC CATHETERIZATION

Following the procedure, the catheters and the introducer will be removed.

If the catheter was inserted into the arm:

  • The incision will be bandaged. You will have to keep your arm straight for at least an hour. You will be able to walk. You will remain under observation for a few hours to check whether any symptom or side effect from the procedure appears. You will be given instructions about how to care for your arm when you return home. Tell the male nurse if you think you are bleeding (if the site feels warm and moist) or if you feel tingling or numbness in the fingers.

If the catheter was inserted in the groin:

  • The incision will be closed applying pressure directly to the site where the catheter was inserted, or with a plug. The plug is out of a material that helps the body's natural scarring process to form a clot in the site punctured the artery. A suture may also be used to close the small incision on the skin in the catheter insertion site. You must lie flat and keep your leg straight for two to six hours to keep the catheter insertion site from bleeding (you will stay less time if a plug is used). You will not be able to raise your head more than 30 degrees (2 pillows). Do not try to sit up or stand up.
  • A sterile bandage will be placed on your groin to protect it against infections. The nurse will examine the bandage periodically, but contact him if you think that you are bleeding (you feel the site warm and moist) or if you feel tingling, numbness or coldness in the fingers.

You will need to drink lots of liquids to eliminate the contrast material from the body. You may feel the need to urinate more frequently. While you are in bed, you will have to use a commode or urinal.

The doctor will tell you if you can return home or have to spend the night admitted. You will be monitored for several hours after the procedure.

The treatment, including medications, diet and future procedures, will be explained to you before you return home. How to care for the wound, what activities you can do and what the subsequent treatment will be will also be explained to you.

The cardiac catheterization procedure generally takes only 30 minutes, but plan on 5 to 10 hours from the time you arrive until you are ready to go home.