Cardiac catheterization - what is it?
Lancaster Regional Medical Center recently renovated our cardiac catheterization laboratory to include some of the most advanced technology available to more clearly visualize each patient. Cardiac catheterization is a procedure to examine blood flow to the heart and test how well the heart is pumping. A physician inserts a thin plastic tube (catheter) into an artery or vein in the arm or leg. From there it can be advanced into the chambers of the heart or into the coronary arteries. This test can measure blood pressure within the heart and how much oxygen is in the blood. It's also used to get information about the pumping ability of the heart muscle. Catheters are also used to inject dye into the coronary arteries, a test called coronary angiography or coronary arteriography. Catheters with a balloon on the tip are used in the procedure called coronary angioplasty (commonly referred to as percutaneous coronary intervention [PCI]).
Cardiac catheterization - what to expect at Lancaster Regional
There are many reasons for why a cardiac catheterization is performed and your cardiologist will take time to explain your specific situation. Many times this procedure is performed because your doctor has noticed something abnormal on a diagnostic test. After the doctor explains the procedure to you the office staff (or the nurse if you are already at LRMC) will schedule the procedure with LRMC’s catheterization laboratory (cath lab.)
Where to go if you are not already at Lancaster Regional:
- Please report to Lancaster Regional two hours prior to your procedure time.
- Park in the Day Hospital parking garage on College Avenue.
- Go to Patient Registration, and report directly to Admissions Desk.
- If possible, and if you are not on Coumadin or Lovenox (blood thinners), please have your physician schedule your pre-procedure testing (blood tests and chest x-ray) completed in Lancaster Regional’s Outpatient Laboratory one or two days before your cardiac catheterization.
- Do not eat or drink anything after midnight the night before your procedure. Take only a sip of water with prescribed medications as directed by your physician the day of your procedure. If you are taking medications for diabetes, your physician may give you special instructions on how to take these medicines the day of the procedure.
If you have any questions please call the Lancaster Regional cath lab at (717) 291-6733 or your physician's office.
Please allow for a whole day for any cath lab procedure:
- 2 hour prep time
- 1-2 hours for the procedure
- 2-6 hours for recovery
If you are already in the hospital, the nursing staff will prepare you for the cardiac catheterization and make sure that all of the pre-procedure tests are completed.
The cath lab staff will explain the procedure and answer any questions you might have. Preparations include:
- Changing your clothes into a hospital gown.
- Performing a complete nursing assessment (vital signs, weight, temperature, listening to your heart and lungs and checking your medical chart etc.)
- Placing you on a heart, and blood pressure monitor.
- Starting an intravenous line.
- Shaving your groin for the procedure.
- Placing sterile drapes over your lower body.
- Administering any medications that have been ordered by your doctor for the day of your procedure.
What does cardiac catheterization feel like?
The only pain you should feel is at the very beginning when the doctor injects the local anesthetic into your groin. This will feel like a sting and burn for a few seconds until the anesthetic medicine starts to work. You may also feel some pressure while the doctor inserts the catheter into the blood vessel in your groin (sheath). Once the sheath is inserted the team will measure pressures and take pictures of your heart under the x-ray camera. Taking pictures includes inserting a longer catheter through the sheath in your groin, which will then be advanced through your blood vessels to your heart. You will not feel the catheters moving inside of your body. You can watch the pictures if you wish.
What is the Cardiologist looking for during a cardiac catheterization?
During the procedure the doctor will take measurements of certain pressures in your heart using the catheters. Some procedures require more measurements than others and you will need to lie still and quiet so that accurate measurements can be obtained. After the measurements are complete, the cardiologist will take x-ray pictures of your heart arteries (coronary arteries) and the important pumping chamber of your heart (left ventricle). X-ray dye will be injected into your heart arteries, which will momentarily take the place of the blood and outline the heart arteries under the x-ray camera. The cardiologist will take several pictures of each of the four major arteries. All of these arteries also have smaller branches associated with them. If you have had bypass surgery in the past the doctor will also take pictures of your bypass grafts. The doctor is looking for segments on these arteries that are pinched and might be restricting the flow of blood to your heart.
After or just before the arteries are imaged. the doctor will take a picture of the left ventricle. The left ventricle is the major pumping chamber of your heart and is responsible for pushing blood through your entire body. During this picture you may feel a warm sensation travel through your body that will subside within about 30 seconds. The cardiologist uses this picture to assess the strength of your heart and how well it pumps blood to your body.
What to expect after cardiac catheterization
After all of the diagnostic information is obtained, the cardiologist will determine if any interventions need to be performed and discuss all of your treatment options. Sometimes these procedures can be done immediately. If not, you will then be moved into the recovery area where we will remove the tubes from your groin, which takes approximately 15 – 20 minutes. A small patch is also used to aid in sealing the artery. A nurse or cath lab technologist will be nearby at all times while you are in the recovery area or in the hospital. If you have any questions or concerns please feel free to ask one of the staff at any time.
If you will be discharged the day of your procedure you will finish out your recovery in the Day Hospital. The Day Hospital nurses will go over your discharge instructions and make sure you are set up for any medication changes or follow up doctor appointments.