Cardiac Catheterization
Minutes matter when it comes to treatment of acute heart attacks. At MetroWest Medical Center, we invest in new and advanced diagnostic tests and tools to assist our understanding of the complexity of cardiovascular conditions and diseases. Cardiac catheterization
is one of the advanced procedures we offer to diagnose diseases affecting the coronary arteries and heart valves.
We perform a cardiac catheterization to determine whether there are blockages in the coronary arteries supplying the heart muscle
Our cardiac cath lab in Framingham has recently received the American Heart Association Gold Plus award for STEMI care. Our highly trained medical team consistently opens blocked arteries in heart attack patients in under 90 minutes, the gold standard
for care. Our services include:
- Angiography (Coronary arteriography): During coronary angiography, a catheter is inserted most commonly via the wrist artery and advanced to the heart. X-rays are then used to examine the blood vessels for any blockages.
- Pressure wire/Fractional flow reserve (FFR): FFR is a procedure performed during a cardiac catheterization to assess the flow through a stenosed artery. The procedure helps determine whether stenting of a moderate severity blockage
is indicated.
- Percutaneous coronary intervention (PCI): A PCI is a minimally invasive procedure that relieves a narrowed blood vessel. During the procedure, your physician can repair a clogged blood vessel using balloon angioplasty followed by a stent
insertion.
- Intravascular ultrasound: Intravascular ultrasound is a procedure performed during a catheterization that uses sound waves to inspect blood vessel and stent characteristics.
What Is A Cardiac Catheterization?
A heart catheterization procedure aims to diagnose any disease related to your heart’s muscle, valves and arteries. A thin flexible tube (catheter) is inserted into a blood vessel in your wrist or groin. 90% of procedures performed at MWMC are done
via the more comfortable and safer wrist site. Your heart doctor will thread the catheter through the blood vessels up to your heart.
Upon reaching the heart, your doctor may perform coronary angiography by injecting contrast dye into your arteries
to assess for blockages.
Here are different tests your cardiologist may perform in during a catheterization:
- Assess for blockages in your heart’s arteries
- Assess the pumping ability of your heart
- Check the pressures and oxygen levels in your heart’s chambers
- Assess for stenosis or leakage of your heart’s valves
- Perform a PCI to relieve a blockage in your heart’s artery by implanting a stent
Specifically, a cardiac catheterization aims to evaluate and treat the following conditions:
- Coronary artery disease
- Congestive heart failure
- Cardiomyopathies (weakened heart muscle function)
- Valvular heart disease
How Safe Is A Heart Catheterization?
Cardiac catheterization is a minimally invasive and generally safe procedure. It is normal to develop bruises at the catheter’s access site (wrist or groin). Problems following this procedure are rare but may include bleeding and very rarely a heart
attack or stroke. If you have any of the following conditions, your doctor may delay performing a cardiac catheterization:
- Abnormal blood electrolyte (e.g. potassium) levels
- Acute gastrointestinal bleeding
- Acute or chronic kidney failure
- Recent stroke
- Blood that is too thin due to various causes (coagulopathy)
- Allergic reaction to the dye used for heart cath
- Severe anemia
- Unexplained fever
- Active infection
How Long Does a Cardiac Cath Take To Perform?
The diagnostic portion of the cardiac catheterization generally takes no more than 30 minutes. If a PCI is then performed, the procedure will often then last another 30-60 minutes on average. If the catheter passes through your groin, you will need to
lie flat on your back for two hours after the catheterization to reduce the bleeding risk.
Preparation for the Cardiac Catheterization Procedure
If your doctor recommends a cardiac cath after the initial assessment, you will first undergo a thorough history and physical examination. We also will review your current medications, allergies, smoking history and family history of heart conditions.
Further testing prior to a cardiac cath may include:
- Bloodwork including a basic metabolic panel (BMP) and complete blood count (CBC)
- Electrocardiogram
- Echocardiogram and/or Stress Testing
Your doctor will advise on what to eat and drink 24 hours before your cardiac cath procedure. Typically, you will be asked not to consume any large meal six hours before your procedure.
Patients with a previous allergy to IV contrast dye will need to take antihistamines and corticosteroids prior to the procedure.
Patients with kidney disease will need adequate planning including pre-hydration to reduce the risk of worsening kidney function after IV contrast exposure.
If you wear eyeglasses, you can bring them to your scheduled appointment. You can also wear a hearing aid during your procedure if you usually wear one.
You should plan to have someone drive you home after your heart cath procedure and anticipate going home later that same afternoon or evening.
What Happens During a Cardiac Catheterization?
A team including your cardiologist, nurses and radiology technicians work together to perform a heart cath procedure in the Catheterization Laboratory. A nurse will put an IV line into a vein in your arm where a sedative will pass through to help
you relax throughout the procedure. Even so, you will remain arousable and able to follow your doctor’s instructions as needed. The access site, most commonly the wrist, will be treated with a local anesthetic.
You will feel a feeling of intense warmth in your arm, lasting around 30 seconds, after the sheath is first inserted into your wrist artery.
A video screen shows the catheter’s position as it goes through the major blood vessels and to the heart. During the procedure, the lights will dim at times and this is when the X ray images are actively being acquired.
After your procedure, the doctor will remove the sheath and catheter from your radial artery. A bandage will then be applied to the wrist site for the next few hours and will feel like you are wearing a tight watch.
What Happens After A Cardiac Catheterization?
After leaving the cardiac catheterization lab, you will stay in a recovery room for a few hours. Your nurse will gradually release the pressure in your wrist bandage and monitor for any bleeding. Your vital signs and heart rhythm will be monitored.
If you feel pain in your chest or shortness of breath, you should report it to your nurse.
Before hospital discharge, your nurse will give you written instructions on what to do and not do as you recover at home. Follow all instructions carefully.
Prescriptions for any new medications, including important blood thinners after a PCI, will be sent to your pharmacy electronically.
Take all of your prescribed medications as indicated.
Make sure to attend your scheduled follow-up appointment with your cardiologist.
Most patients can go back to their normal activities, including driving, within one to two days of the procedure.
A bruised puncture site is normal. If it bleeds, lie flat and press the site firmly for a few minutes before checking if the
bleeding has stopped. Call your cardiologist’s office if:
- The leg with the puncture site tingles/feels numb or your foot turns blue, feels cold or has significant pain
- The hand with the puncture site develops pain, numbness or feels cold
- You observe worsening bruising around the puncture area
- You notice swelling or see drainage from the puncture site
- You experience shortness of breath or chest pain that does not subside with rest
- You feel your heart racing
- You feel dizzy or exhausted
- You have a fever or chills
If puncture site bleeding does not subside even after pressing on it or if it swells up rapidly, call 911.
Self-Care After Cardiac Catheterization
In general, patients who have undergone a catheterization can walk around within a few hours after their procedure (once the sedating meds have cleared from the system).
Most patients who do not do heavy lifting may return to work in two days.
For the first two days after your procedure, avoid lifting heavy objects.
Follow your doctor’s instructions on how often you should change your incision’s
dressing. If your incision wound bleeds, lie down and apply pressure on it for half an hour.
If you have been prescribed medications, take them exactly as your doctor instructed. Do not stop taking them unless your doctor instructs you to do so.
Caring for Your Heart
At MetroWest Medical Center, you have access to various cardiovascular treatment options, including coronary stenting and permanent pacemaker/defibrillator implants. Our cardiology services include:
- Comprehensive Echocardiography Laboratory including transesophageal echocardiography
- Coronary artery calcium scoring program
- Diagnostic and interventional electrophysiology laboratory, including 3D mapping and intracardiac echocardiography for complex ablations
- Preventative cardiology, where our doctors work with you to identify your heart problems and develop a personalized treatment plan before you develop symptoms
- Stress testing laboratory including:
- Exercise treadmill testing
- Exercise stress echocardiography
- Myocardial perfusion imaging/nuclear cardiology
- 3T Cardiac MRI Program for structural heart disease assessment
- Phase 2 cardiac rehabilitation program
Please click below if you are interested in learning more about some of the common diseases and conditions, tests and screenings and treatments and procedures we provide.
