Cardiac Catheterization Booklet

What is Cardiac Catheterization?

Cardiac catheterization is a test whereby a thin plastic tube called a catheter is inserted into an artery, and gently guided to the heart. Once the catheter reaches the heart, a small amount of contrast agent (“dye”) is injected into the coronary arteries (arteries that supply the heart muscle) or a chamber of the heart. As the contrast agent is injected, a series of x-rays are taken. A cardiac catheterization can also be called a “coronary angio”, “angiogram”, or “heart cath.”

Why is this test necessary?

It allows your cardiologist (a heart doctor) to see how well your heart is working and if any of your coronary arteries are narrowing or blocked.

The test results may find:

• the cause of your chest pain
• that you need to be treated with cardiac drugs
• that you need balloon angioplasty or surgery

What do I need to tell my doctor?

Your cardiologist must know if you:

• have allergies to any medications, x-ray dyes, or food (especially seafood)
• cannot lie flat or be on your back for extended periods of time
• have been taking “blood thinners” such as coumadin/warfarin
• have any history of excessive bleeding
• have recently been treated for an infection in any part of your body
• you are pregnant
• are diabetic, especially if taking insulin or metformin (glucophage)

NOTE: METFORMIN MUST BE STOPPED THE DAY OF YOUR TEST

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What happens next?

A few days before your cardiac catheterization, your cardiologist will arrange for you to have the following:

• blood tests
• electrocardiogram (ECG)
• chest x-ray
• echocardiogram (ECHO)

The night before your cardiac catheterization…

• remove all makeup, nail polish and jewellery
• shave groin areas (the crease of both legs). The area shaved on each side should be approximately 3 inches by 3 inches. This provides a clean, clear and smooth area for the catheter to be inserted into your artery.
• shower or bathe the night before or the morning of your test
• pack a robe, slippers and personal care items
• arrange for a responsible adult to drive you home from the hospital after your test
• locate your health card and remember to bring it with you the next day
• nothing to eat or drink after midnight. If your test is booked for the afternoon, you may eat a light breakfast before 7:00 a.m. then nothing further to eat or drink.

The morning of your cardiac catheterization…

• don’t forget to bring your health card
• bring all medications with you
• take all medications except metformin, glucophage or coumadin
• leave all valuables at home

If you have dentures or eye glasses, you may wear them during the test.

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Your Cardiac Catheterization …

You and a nurse will walk to the room where your test will take place. The room is called a cardiac catheterization laboratory.

You will be asked to lie down on an x-ray table and remain flat. The x-ray table moves back and forth, and a camera will rotate around you in order to take several series of x-rays during your test. The camera will come very close to you, but it will not touch you.

The nurse in the room will check your blood pressure and pulse, and attach you to a cardiac monitor so that your heart beat can be checked throughout the test.

There is also a video monitor (television screen) in the room that allows the cardiologist and other staff to see the catheter as it moves through your blood vessels and into your heart.

To reduce the risk of infection, it is important that everything that touches you during the test is sterilized (germ free). Therefore, your cardiologist and the assisting nurse will wear masks, gloves and sterilized gowns.

You will be given a small pill under your tongue to help you relax, but you will be awake throughout your test.

The top of your legs will be washed with a brown antiseptic and your chest covered with some sterile green sheets.

Your cardiologist will then inject some freezing into one side of your groin area. You will feel some pressure in this area as the doctor finds the artery and makes a small incision. Once the incision is made, a sheath is inserted into the artery and acts as a guideline or tunnel for the catheter to follow to the heart. You will not feel the catheter as it moves through your artery and into the heart.

At different times during the test, small amounts of contrast agent are injected into the coronary arteries or chambers of the heart. As the dye is injected, you will be asked to take a deep breath and to hold it while a series of x-rays are taken and recorded onto film. The dye makes it possible for better x-ray pictures to be taken.

When the contrast agent is injected into your heart chambers, you may feel warmth, heat or a burning feeling throughout your body for about 10 to 20 seconds. This feeling is not usually felt when dye is injected into your arteries. Please report any unusual feelings or sensations to the cardiologist during the test.

If you feel any chest pain during the test, you must tell your cardiologist right away. You will either be given oxygen or nitroglycerin to relieve the pain.

When your cardiac catheterization has been completed, the doctor will remove the catheter and apply firm pressure to the puncture site in your leg for a full ten to fifteen minutes.

You will be transferred to a stretcher and taken to the recovery area for close observation and routine care. You might have a small weight applied to the puncture site, which will remain in place for about one hour. You will be asked to rest quietly and to avoid bending the leg with the puncture site, in order to prevent bleeding. The nurse will observe the dressing for signs of bleeding and will check your blood pressure frequently during the first few hours following the test. The warmth, colour, sensation, movement and pulses in your foot will also be checked.

In the recovery area, it is important that you drink plenty of fluids. If you are hungry, you may eat a small amount of food. A large meal may make you feel sick to your stomach.

You will be required to remain in bed for three hours, so you will have to use a bedpan or urinal if you need to go to the washroom during this time period. After that time, you will be allowed to use the bathroom with assistance. You will be reminded to pay special attention to the puncture site in your groin, to ensure that there is no bleeding.

Your doctor will come to see you in the recovery area to discuss the results of your test.

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When you are discharged…

• you must have someone drive you home after the test
• do not drive a car for 12 hours following the test
• be sure to have someone stay with you at home on the night following your test
• do not drink alcoholic beverages (this includes wine & beer) the night following your cardiac catheterization
• take your medications and eat as you normally would
• avoid any strenuous activities for the next 48 hours:
• no heavy lifting
• no housework/vacuuming
• no vigorous exercise
• after 24 hours, you can have a shower or a bath
• if your bandage becomes soiled or wet, clean the puncture site and apply a clean dry bandage
• if bleeding occurs, lie down and apply pressure to the puncture site for at least 10 minutes. Apply pressure by placing a piece of gauze or cotton ball on the bleeding area and press directly on it with the tips of 2 or 3 fingers.
• NOTE: Some bruising of the groin to knee area is normal.

If any of the following occur, please seek medical treatment immediately or dial 911:

• excessive or sudden bleeding, or severe pain at the incision site
• numbness, coolness and/or weakness in your legs or feet

For information on resources available to you during your hospital visit or stay (for example: parking, what to bring, discharge times and other helpful information) please click on Patients and Visitors.