Cardiac catheterization & bull; hello healthy

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Definition

What is cardiac catheterization?

Cardiac catheterization is a test to examine your heart. This test uses a thin, flexible tube called a catheter that is inserted into the heart through a vein. This test can include coronary angiography, which examines the coronary arteries. Cardiac catheterization can check blood flow in the coronary arteries, check blood flow and pressure in the cavity of the heart, find out how well the heart valves are working, and check for damage to the movement of the heart walls. In children, this test is used to check for heart problems that have been present from birth (congenital heart damage). A coronary angiogram is used to find out if you have disease in your coronary arteries (atherosclerosis). If you have atherosclerosis, this test can show the size and location of the fat and calcium deposits (plaque) that are narrowed in your coronary arteries.

Percutaneous coronary intervention (PCI) is similar to a coronary angiogram, but it is used to open narrowed coronary arteries with special tools. PCI includes:

• angioplasty with or without coronary stents
• atherectomy

The results of a coronary angiogram help determine whether medication decisions, bypass surgery, or Percutaneous coronary intervention (PCI), such as angioplasty, may be effective.

When should I undergo cardiac catheterization?

Cardiac catheterization is done to see if there are any problems with the heart, or as part of a procedure to check for heart problems that your doctor is already aware of.

If you have a cardiac catheterization as a test for heart disease, your doctor can:

• knowing the location of narrowing or blockage of blood vessels in you that is causing chest pain (angiogram)
• measuring pressure and oxygen levels in different parts of your heart (hemodynamic assessment)
• check your heart's pump function (right or left ventriculogram)
• take a tissue sample from your heart (biopsy)
• diagnosing heart defects from birth (congenital heart defects)
• check for problems with your heart valves

Cardiac catheterization is also used as part of several procedures to treat heart disease. This procedure includes:

• angioplasty with or without stent placement
• closing the hole in the heart and correcting other congenital defects
• repair or replace heart valves
• balloon valvuloplasty
• heart arrhythmia treatment (ablation)
• closing parts of your heart to prevent blood clots

Precautions & warnings

What should I know before undergoing cardiac catheterization?

This test is not usually done on people who have a severe allergic reaction to contrast material, heart failure, life-threatening heart rate disorders, or severe kidney disease.

Cardiac catheterization is not performed during pregnancy because radiation rays can harm the developing fetus. But in critical situations, this procedure may be necessary to save the life of a pregnant woman. In this case, the fetus will be protected as best as possible from exposure to radiation rays.

Process

What should I do before undergoing cardiac catheterization?

You should ask your local hospital for instructions on what you need to do. These instructions may include:

• if you are taking warfarin or a "blood thinning" drug (anticoagulant) you will be asked to stop taking it for 2-3 days before the test. (This is to prevent excessive bleeding as long as the catheter is inserted)
• if you are taking insulin or medications for diabetes, you may need to change the time you take this medication. Some drugs need to be discontinued for 48 hours. Your doctor will clarify this to you
• if you are pregnant, tell the doctor who will perform this examination
• You may be asked to stop eating and drinking for several hours before the test
• You may be asked to shave your groin before the exam.

How is the cardiac catheterization process?

During the procedure, you will be on your back and awake. This allows you to follow the doctor's instructions during the procedure. You will be given medication to help you calm down, which can make you feel sleepy.

Your doctor will anesthetize the area of ​​the arm, groin (upper thigh), or neck where the catheter will enter through the blood vessels. Then, a syringe will be needed to make a small hole in the blood vessel. Your doctor will place a pointed tube called a sheath through the hole.

Next, your doctor will thread a thin, flexible wire through the sheath into your vein. The doctor will thread a cord through a blood vessel to your heart. Your doctor will use a cable guide to position the catheter precisely. The doctor will insert the catheter through the sheath and let it pass through the cable guide and into the coronary arteries.

A special X-ray video is taken of the guide cable and the catheter as they travel into the heart. This video will help the doctor to know where to place the catheter. When the catheter is in the right place, your doctor will use it to perform tests or medications on your heart. For example, your doctor may perform an angioplasty or stenting.

The cater will be removed from the place where he was originally entered. To prevent bleeding, the area needs to be closed using pressure, sutures, or other special closures. For example, if a catheter is inserted through the wrist or groin, firm pressure will be applied to the area for 10 minutes to stop the bleeding. Then it will be replaced by pressure dressing in that section. If the catheter is inserted through the elbow, a few stitches will be required to close the wound.

This test lasts 30 minutes. But you need to prepare and heal. The total time for this test can be up to 6 hours. The length of time the examination will take does not indicate the seriousness of your condition.

What should I do after undergoing cardiac catheterization?

After the test is complete, you will be escorted to an observation room, where at regular intervals the medical personnel will check your heart rate, blood pressure, and temperature and check if there is any bleeding from the injection site. The pulse, color, and temperature of the arms and legs where the catheter is inserted will also be checked periodically. You may be given medication to relieve pain.

If the catheter is inserted through the groin, you may have to lie stretched out with your legs for several hours (for example, 1 to 4 hours), depending on the procedure used and your medical condition. After that, you can move freely. If the catheter is inserted through your arm, you can sit up and get out of bed immediately. But your arms need to be rested and sedentary for several hours.

A child who has recently had a heart catheterization may need to be held or supervised by the parent after the test to prevent the child from moving their legs or arms. You will need to drink plenty of water for several hours after the test. This prevents dehydration and helps flush the contrast material out of your body.

Depending on the test results obtained, you may be allowed to go home after a brief observation (for example, 6 hours) or the following day. If the stitches are on your arm, they can be removed in 5 to 7 days. Do not do sports and lift heavy objects until the doctor allows it. This may only last for a day or two.

If you are breastfeeding and have an angiogram test where dye is injected into your body, then do not breastfeed the baby for 2 days after this test. During this period of time, you can give your baby breast milk that you have stored previously, or you can give your baby formula milk. Discard the breast milk that you have pumped for 2 days after the test.

If you have questions related to this test process, please consult your doctor for a better understanding.

Explanation of the Test Results

What do my test results mean?

The test results will be reviewed by the cardiologist and will be available upon completion of the procedure. Your doctor will talk to you about some of the test results immediately after the test is done.

Results will include whether:

• coronary arteries are normal or have narrowing or blockage
• heart pump action (ejection fraction) and pressure in the heart cavity and normal blood vessels
• heart valve working normally

Many conditions can affect the outcome of cardiac catheterization. Your doctor will discuss with you any abnormal results related to your symptoms or medical history.