Cardiac Catheterization

Minutes matter when it comes to responding to 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 heart muscle, valves or coronary arteries.

We use a cardiac cath to examine how well your heart is functioning. It lets us take a closer look at your heart to identify issues and perform other tests to assess your cardiac health further.

Our cardiac cath lab in Framingham, MA 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:

  • Percutaneous coronary interventions: Percutaneous coronary interventions (PCI)are minimally invasive procedures that rebuild and unblock clogged blood vessels. During the procedure, a catheter is inserted into a large blood vessel. Your physician can then repair clogged blood vessels using balloon angioplasty, stent insertion or other mechanical devices or specialized lasers.
  • Angiography (Coronary arteriography): During coronary angiography, X-rays are used to examine the blood vessels or chambers of the heart. These images are used to diagnose blockages and other problems in arteries and veins.
  • Fractional flow reserve: Fractional flow reserve (FFR) is a procedure performed during cardiac catheterization to measure blood pressure and flow through an artery. The procedure can help assess whether angioplasty or stenting is appropriate.
  • Intravascular ultrasound: Intravascular ultrasound is a procedure performed during heart catheterization that uses sound waves to inspect blood vessels, which is helpful in examining coronary arteries and may be used to help physicians place stents correctly

What Is Cardiac Catheterization?

The heart catheterization procedure aims to diagnose any disease related to your heart and its muscles, valves and arteries. A thin, long flexible tube (catheter) will be inserted into a blood vessel in your groin, arm or neck during this procedure. Your heart doctor will thread the catheter through the blood vessels leading to your heart.

Upon reaching the heart, your doctor may perform coronary arteriography or coronary angiography by injecting a contrast dye into your coronary arteries to check your heart for blockage or narrowing. Some patients may qualify for a catheterization procedure instead of other more invasive surgeries to replace heart valves or repair cardiac defects.

Here are different tests your doctor may perform in a cath lab:

  • Assess the pumping ability of your cardiac chambers 
  • Check the pressure in your heart’s four chambers 
  • Do minor heart surgery to treat narrowed heart valves or congenital cardiac defects
  • Evaluate the hemodynamics in the heart’s right and left side
  • Look for defects in the heart valves or chambers 
  • Perform PCI
  • Take blood samples to measure the oxygen content in your heart’s chambers
  • Treat arrhythmias using catheter ablation

Specifically, cardiac catheterization aims to evaluate and treat the following conditions:

  • Cardiac arrhythmias 
  • Congenital heart diseases 
  • Heart failure 
  • Left ventricular malfunction
  • Pericardial and myocardial diseases
  • Valvular heart disease

How Serious Is Heart Catheterization?

Cardiac catheterization is generally safe. It is normal to develop bruises in the catheter’s puncture site. Problems following this procedure are rare but may include blood clots and bleeding. Our cardiac doctors thoroughly monitor our patients' conditions and may recommend medicine to prevent blood clots. If you have any of the following conditions, your doctor may wait or advise against cardiac catheterization for you:

  • Abnormal blood electrolyte levels
  • Acute gastrointestinal bleeding 
  • Acute or severe kidney failure
  • Acute stroke 
  • Blood that is too thin due to any causes
  • High levels of digoxin, a medicine for treating arrhythmia or heart failure, in blood
  • Allergic reaction to the dye used for heart cath 
  • Severe anemia
  • Unexplained fever 
  • Untreated infection

How Long Does a Heart Cath Take?

If your doctor only uses a cardiac catheter to examine your heart, a heart cath test may last up to 60 minutes. But if you need other heart procedures during cardiac catheterization, it may take longer. If the catheter passes through your groin, your doctor may ask you to lie flat on your back for several hours after catheterization to avoid bleeding.

Preparation for the Cardiac Catheterization Procedure

At MetroWest Medical Center, we will thoroughly evaluate you to assess your qualification for heart catheterization. If your doctor recommends cardiac cath after the initial assessment, you will undergo a physical examination to determine how right cardiac catheterization will be for you. We pay special attention to reviewing a patient’s possible drug allergies.

A basic patient diagnostic exam for cardiac cath includes:

  • Basic metabolic panel (BMP)
  • Chest X-ray
  • Complete blood count (CTC)
  • Electrocardiogram
  • Prothrombin time

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 food or drink for six to eight hours before your procedure. Tell your doctor about any supplements and medicines you take, as your doctor might tell you not to take them before your heart cath.

Disclose to your doctor if you are allergic to anything, especially shellfish, X-ray dye, iodine, rubber or latex products, etc. Patients with documented previous allergies to contrast dye will need to take antihistamines and corticosteroids. On the other hand, patients with kidney disease will need adequate planning with their doctors and pre-hydration to reduce the risk of worsening kidney function.

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. Have someone drive you home after your heart cath procedure.

What Happens During a Cardiac Catheterization?

A team of medical technicians and nurses assists a doctor with special training who will perform the heart cath procedure in a hospital cath lab. A nurse will put an IV line into a vein in your arm where a sedative will pass through to help you relax. Even so, you will stay awake and able to follow your doctor’s instructions.

If the doctor decides that your catheter will go through the groin, a nurse will clean or shave this area. A local anesthetic may be used to numb the catheter puncture site. Depending on the purpose of catheterization, your doctor may place various instruments at the catheter’s tip.

You may feel painless pressure in your groin as your doctor inserts a sheath (a small, straw-sized tube) and gently guides the catheter through your vessel. A video screen shows the catheter’s position as it goes through the major blood vessels and to the heart. After your procedure, the doctor will remove the sheath and catheter. A nurse will press the puncture site to prevent bleeding. A special device may be used to close the wound.

What Happens After Cardiac Catheterization?

After leaving a cardiac catheterization lab, you will stay in a recovery room for a few hours, lying flat on your back with your legs straight. Medical personnel will apply pressure to the catheter’s puncture site to stop it from bleeding. They will also check your vital signs. If you feel pain in your chest, report it to your doctor. If your puncture site swells, hurts or bleeds, report this also.

Before hospital discharge, your doctor will give you written instructions on what to do as you recover at home. Follow all instructions carefully. Take your prescribed medications as indicated. Attend follow-up appointments. Most patients can go back to their normal activities the next day.

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 heart doctor if:

  • The leg with the puncture site tingles or feels numb, or your foot turns blue or feels cold
  • You observe worsening bruise around the puncture area
  • You feel swelling or see draining fluid from the puncture site
  • You experience shortness of breath or chest pain that does not subside with rest
  • You feel your pulse too slow or too fast
  • You feel dizzy or exhausted
  • You cough up blood with green or yellow mucus
  • 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 angioplasty can walk around within six hours after their cardiac catheterization procedure. A full recovery may take a week. If the catheter has passed through your arm, you may recover faster.

Whether the catheter went through your groin or arm, avoid sexual activity for five days. Keep your puncture area dry for up to 48 hours. Until then, you should not swim or take a bath. Most patients who do not do heavy work may return to work in three days.

Walking short distances on flat surfaces is alright if you underwent a heart cath through your groin. For the first two to three days after your procedure, limit using the stairs. Avoid lifting heavy objects, driving, playing sports or other strenuous activities. If the catheter went through your arm, do not lift anything heavier than 4.5 kilograms. Do not do any heavy pulling, pushing or twisting.

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 says so.

Consult your healthcare provider for when you can go back to doing the activities you used to do.

Caring for Your Heart

At MetroWest Medical Center, you have access to various cardiovascular treatment options, including coronary angioplasty, stenting and permanent pacemaker placement. Our cardio services include:

  • A comprehensive cardiac rehabilitation program
  • Comprehensive Echocardiography Laboratory, which includes transesophageal echocardiography
  • Coronary artery calcium scoring program 
  • Diagnostic and interventional electrophysiology laboratory, including 3D mapping and intracardiac echocardiography for complex ablations
  • Preventive cardiology, wherein our doctors work with you to identify your heart problems and develop a personalized treatment plan
  • State-of-the-art stress testing laboratory including:
    • Exercise treadmill testing
    • Exercise stress echocardiography
    • Myocardial perfusion imaging/nuclear cardiology
  • 3T Cardiac MRI Program for structural heart disease assessment

Our highly skilled cardiologists specialize in:

  • Stroke care
  • Cardiac catheterization
  • Heart attack care
  • Electrophysiology diagnosis and treatment for heart rhythm disorders
  • Cardiovascular disease prevention and rehabilitation

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.

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Price Estimate

If you have an upcoming catheterization procedure, call us at 833-850-5052, and we will connect you with one of our financial counselors to give you an individualized hospital cost estimate. We can also assist you with financial options, such as a flexible no-fee payment plan. Call to see if you qualify for our financial assistance program.

How to Get the Most Accurate Cost Estimate

Step 1: Collect Treatment Plan Details

Request the following information from your doctor’s office:

  • Surgeon’s name (If you do not have a surgeon or doctor, proceed to Step 2)
  • Details about your diagnosis and recommended services
  • Expected length of hospital stay, from pre-op and surgery to in-hospital recovery (how many days or nights?)

Step 2: Collect Insurance Plan Details

Your costs will depend on your insurance plan’s coverage and status. Have your insurance card ready, so we may check the patient’s personal information we need, such as:

  • Name
  • Birth date
  • Social security number of the person who is the primary insurance policy holder

We keep all personal information confidential.

Step 3: Call Our Financial Experts at 833-850-5052

Give us with the information from Steps 1 and 2, so we may provide you with the most accurate cost estimation of your hospital expenses and your expected financial obligation. Learn more about our payment plans.

Call us to see if you qualify for our financial assistance program.

Step 4: Make Your Plans

Once you learn about your hospital cost estimate, ask our financial counselors about setting up a monthly payment plan to make out-of-pocket costs more affordable.

If you have questions about your treatment options, please ask your doctor. As soon as you are ready to proceed with your procedure, contact your doctor’s office to schedule the date and time. Thank you for choosing MetroWest Medical Center.

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