A cardiac catheterization (coronary angiogram) is a special test done by a cardiologist to show if the arteries that feed your heart muscle have any blockages. (See “Understanding Your Heart” for a description of coronary arteries.) A soft, hollow tube is threaded up to the heart through an artery in your leg or arm. The catheter carries dye that is released in a coronary artery so X-ray pictures can be taken to reveal areas that are clogged or narrowed. The doctor can see, on an X-ray screen, the exact spot where the artery is blocked.
The doctor also will be able to measure:
- Pressures inside the heart.
- How well the valves of your heart are working.
- How well the muscle of your heart contracts and pumps. This is called an ejection fraction. A normal ejection fraction is 50 percent to 70 percent.
Before your cardiac catheterization procedure, you will:
- Need to notify your physician or nurse if you are
- Allergic to shellfish or iodine.
- Not eat or drink anything after midnight, except
- For your medications with a small sip of water.
- Empty your bladder before you leave your room or holding area.
- Be asked to sign a consent form that lets us know that you understand the procedure and the risks and benefits.
- Have blood work drawn and your medical history checked by the staff admitting you.
- Be given an aspirin if you have not already taken one.
- Be taken to the procedure room, where two to three staff members will be working for you.
During your procedure, you will:
- Be placed on a heart monitor, have a clip placed on your finger or toe to read the level of oxygen in your blood and a blood-pressure cuff placed on your arm that will inflate automatically.
- Have the hair shaved at the area where the doctor will be working. This area could be the groin or arm.
- Have this area cleaned with a special soap and covered with a sterile sheet.
- Be asked to keep your arms under the sheet and not to bend or move your legs.
- Be given medicine through your IV to help you relax. You may become very sleepy.
- Be given a local anesthetic (numbing medicine) by the doctor to numb the area where he or she will be putting catheters into the artery. Once the medicine takes effect, you should not feel any pain. You may feel dull pressure where the doctor is working with the catheters. The doctor will inject dye into the coronary arteries, once the catheters are in place. The doctor will be able to see any blockages on the X-ray screen.
- Feel warm all over from the dye. This feeling will only last for 10 seconds.
- Not feel the catheter because you do not have nerve endings in the coronary arteries.
If your coronary arteries are normal, you will not need further treatment. If blockages are found, your doctor may recommend that you have an angioplasty or a stent procedure to open the blockages. These procedures often can be performed at the time of the angiogram. The doctor also may recommend coronary artery bypass surgery and/or medical treatment for blockages found.
After your cardiac catheterization procedure, you will:
- Be moved to a recovery area.
- Be placed on a heart monitor, automatic bloodpressure cuff and oxygen monitor (a finger clip).
- Be asked to empty your bladder.
- Have the catheter removed from the artery and have firm pressure applied for 10 to 20 minutes. This is to prevent bleeding.
- Have your blood pressure and pulses in your feet checked by a nurse every 15 minutes for the first hour.
- Have a bandage applied to the insertion site. You may have a closure device at the site where the doctor did the procedure if the artery is big enough and the doctor thinks it is appropriate.You will be given written information on this.
- Need to tell the staff right away if you feel a warm, wet feeling at the catheter site; you could be bleeding.
- Be on bed rest for four to six hours. If a closure device is used, bed rest will be only one to two hours.
- Need to drink a lot of fluids to help flush the dye out of your body.
- Need to put your hand over the bandage and press
- Firmly if you need to cough or sneeze.
- Possibly have a bruise at the site; this is normal.
- Possibly feel a lump at the site. If the lump is walnut size or bigger, let the nurse know.
- Have pain medicine available.
- Go back to your room. At the time of discharge, you will be given instructions for what to do when you go home: eating, activities, care of the catheter site, medications, etc.