Beth Israsel Deaconess Hospital - Plymouth

          

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Cardiac Catheterization

What is Cardiac Catheterization?
Cardiac catheterization is a procedure used to diagnose and determine the best treatment for patients with various forms of heart disease. A catheterization lab has specialized equipment that allows instant moving images of the heart. During the procedure, the patient is mildly sedated. A very thin plastic tube (catheter) is guided through a leg or arm vein and up to the heart. Once the catheter is in place, the physician injects a dye to track blood flow while cameras move around the chest area. The physician takes pictures of the arteries and the main pumping chamber to thoroughly map blood flow through the heart. After the diagnostic catheterization test is complete, the cardiologist reviews the images to determine if there is a narrowing or blockage of vessels requiring further treatment. The cardiologist then discusses the findings with the patient and presents further treatment options, if necessary. No treatment may be necessary, the patient may need a change in medication, or a therapeutic interventional procedure or surgery may be required.

How to Prepare for Cardiac Catheterization
The following are general guidelines for how to prepare for a cardiac catheterization. Please check with your physician or contact the Cardiovascular Center to confirm your individualized preparation plan.

  • Do not eat or drink anything after midnight (sips of water with medication are permissible).
  • Most medications are safe to take before the procedure, however check with your physician to confirm especially if you are taking Coumadin, insulin or oral diabetic medication, or a diuretic.
  • You should receive a phone call from a Cath Lab nurse in the days before the procedure to confirm your appointment, answer any questions you may have and to provide you with additional instructions if necessary.
  • Please arrive and check in at the Cardiovascular Center Reception Area at your designated appointment time. Click here for map/directions.
  • Your personal items will be stored in a locker, however it is recommended to leave valuables at home.
  • Please ensure that you have a reliable ride home, you will not be able to drive for 24 hours because you will be sedated during the procedure.
  • Bring a list of the medications that you take and a list of any allergies to medications you may have.

What to Expect During the Procedure

             Preparing you for the procedure…

  • A registered nurse will greet you when you arrive to the Cardiovascular Services Center
  • You will be checked in and then brought to the Prep/Recovery Area
  • You will be asked to remove your clothing and change into a hospital gown. Your belongings will be stored in a safe locker
  • You will lie on a stretcher and a nurse will take your vital signs, insert an intravenous line in your arm, place you on a heart monitor, and ask you several questions about your medical history.
  • The doctor and/or nurse practitioner will also ask you many questions about your medical history and will explain the risks and benefits of the procedure and ask you to sign your name to consent for the procedure.
  • The radiology technician will shave your groin area if necessary.
  • There may be several staff members involved in your care at one time – we work together as a team to deliver the best care to our patients. Please feel free to ask questions at anytime.

    In the Cath Lab…

  • Nurses will take you into the cath lab when your preparation is complete.
  • Once inside the cath lab you will notice several different staff members in the room – these may include 1-2 registered nurses, 1-2 radiology technicians, and the cardiologist. You will notice that each team member is wearing surgical hats, and masks to keep the room sterile and also lead to protect themselves from repeated x-ray exposure.
  • As you enter the cath lab you will notice a narrow, moveable examination table and several pieces of large equipment including multiple cameras and monitor screens. These pieces are used to take the images of your heart.
  • You will also notice a large window looking into our control room where we monitor the procedure on our computers. You will hear the nurses, technicians and physicians communicating back and forth to each other between the lab and the control room via an overhead microphone/audio system.
  • The nurses will assist you to move onto the narrow table where you will lay on your back for the duration of the procedure.
  • The team will then connect you to the heart monitor, a vital sign monitor, intravenous fluids and oxygen via nasal cannula.
  • The insertion site (generally groin area) will be shaved and prepped with an antiseptic wash and you will be draped with a sterile drape. It is important to remain still during the procedure and to keep your arms by your sides at all times.
  • You will be given medication through your intravenous line that will help to relax you and control your pain. You will be sedated but awake for the entire procedure. You should feel relaxed, pain-free and drowsy but you should be able to answer questions and follow commands if necessary. If you begin to feel anxious or pain you will be given additional medication to make you comfortable.
  • The procedure time varies depending on several different factors, the nurses and doctor will constantly monitor how you are feeling during the procedure.
  • Once you have been medicated the cardiologist will apply a local anesthetic at the insertion site to numb the area, make a small inscision the groin area and insert a catheter up through a vein or artery and into your heart. You may feel some mild pressure or discomfort as the catheter is being inserted.
  • The lights may be dimmed in the room to make it easier to view the images of your heart on the monitor screens. It is very important to stay still during the procedure so that the images and data can be collected accurately.
  • The catheter will be moved to different areas of your heart and dye will be injected via the catheter to measure the pressure in the different chambers of the heart and the blood flow to the heart muscle. It is normal to feel a warm sensation when the dye is injected – this sensation should pass quickly.
  • The cameras will move in different directions to take images of your heart at different angles.

    After the Test

  • You will be brought back to the Prep/Recovery area and will be asked to lay flat on your back for at least 2 hours after the procedure. The reason for this is to prevent any bleeding complications at the insertion site.
  • A nurse will again connect you to the heart monitor and monitor your vital signs frequently. Your pain will be controlled with medication if necessary.
  • You may eat and drink shortly after the procedure although you may have to do so laying flat.
  • At the appropriate time the nurse will slowly assist you to sit up and eventually walk around the prep/recovery area.
  • You will be discharged when the physician and nurse feel that you have recovered sufficiently. The nurse will review your Cardiac Catheterization Discharge Instructions with you and will be available to answer any questions you may have.
  • The physician will discuss the findings with you and present options for further treatment if necessary which may or may not include: no treatment, changing your medication, another cardiac interventional procedure or cardiac surgery.
  • At the end of the procedure the catheter will be removed. The physician may use a vascular closure device to prevent bleeding or may hold firm manual pressure at the insertion site for several minutes.

 

BID-Plymouth
275 Sandwich Street
Plymouth, MA 02360
(508) 746-2000

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