Cardiac Catheterization

Not all heart problems require open-heart surgery. Minimally invasive procedures like cardiac catheterization may be more appropriate for your condition. At East Cooper Medical Center, our catheterization lab offers a range of services to diagnose and treat conditions and diseases that affect the heart.

Our team of cardiac care experts perform the following procedures:

• Coronary and left ventricular digital angiography
• Right and left heart catheterization
• Pacemaker implantation
• Defibrillator and bi-ventricular defibrillator implantation
• Loop recorder implantation

What Is Cardiac Catheterization?

Cardiac catheterization, also known as cardiac cath and heart catheterization, lets doctors take a close look at the heart to find out if you have a disease of the heart muscle, valves or coronary arteries. This medical procedure helps doctors find the cause of symptoms such as chest pain or irregular heartbeat or diagnose conditions such as pulmonary hypertension, cardiomyopathy, ischemic heart disease and heart valve diseases, including aortic stenosis and mitral regurgitation.

How Serious Is A Cardiac Catheterization?

The chances for complications during a cardiac catheterization are low. A small number of people may experience minor problems, such as bleeding and blood clots or bruises where the catheter had been inserted. When a catheter is used to inject contrast dye that can be seen on X-rays, some people may feel sick to their stomachs, get itchy or develop hives. Your doctor will monitor your condition and may recommend medicines to treat these symptoms. In general, this procedure is relatively safe for most people.

In simplest terms, a tube will be inserted into your heart through a vein to take images and measure pressures of the blood vessel. It is relatively safe and simple. In most cases, you may not need general anesthesia or an overnight stay at the hospital.

Is Cardiac Catheterization A Major Surgery?

A doctor with special training performs cardiac catheterization with a team of nurses and technicians in a catheterization laboratory or cath lab that is similar to a small operating room in a hospital. Before the procedure, you will be given a sedative through an intravenous line (IV) which is placed in a vein in your arm to help you relax or make you sleep during the procedure.

A local anesthetic or numbing medicine is usually applied at the site where the doctor will insert a long, thin tube called a catheter. This site may be in the upper thigh, arm, neck or under the collarbone. Your doctor will then place a small straw-sized tube (a sheath) into the vessel and will gently guide a catheter into your vessel through the sheath. A video screen will show the position of the catheter as it is threaded through the major blood vessels and to the heart.

Once the catheter is in place, your doctor may perform tests or treatments on your heart to help with the following:

• Better understand the results from other tests and procedures, such as echocardiography, cardiac magnetic resonance imaging (MRI) and cardiac computerized tomography (CT) scan.
• Diagnose the cause of your chest pain, arrhythmia, or other signs and symptoms of a heart problem or evaluate you during an emergency such as a heart attack.
• Evaluate you before a possible heart transplant.
• Look at the pulmonary arteries for conditions, including pulmonary embolism that can occur because of venous thromboembolism.
• Measure oxygen levels and pressures of the blood in your heart, such as in your ventricles, atria and pulmonary arteries.

Other procedures may also be performed during a cardiac catheterization such as biopsies, coronary angiography, minor heart surgery and percutaneous coronary intervention to diagnose or treat your condition. Cardiac catheterization can be either diagnostic or therapeutic. Interventional cardiologists can perform a variety of interventions depending on the needs of the patient.

Why Might I Need to Visit the Cath Lab?

Only your doctor and cardiologist can determine if you need a cardiac catheterization procedure. But common reasons for a visit to the cath lab are symptoms of chest pain, dizziness, fatigue or shortness of breath. These are the same symptoms that warn of a potential heart attack.

How Do I Prepare for A Visit to A Cath Lab?

Your doctor and cardiologist will provide more detailed instructions. You may be asked to provide blood and urine samples in preparation for the following procedures:

• Electrocardiogram (ECG or EKG) – a test that measures the heart's rhythm and other electrical activity of your heartbeat. It can help your doctor diagnose heart problems, such as arrhythmias and heart attacks.
  
• Chest X-ray – this test can help diagnose diseases in the lungs, heart, major blood vessels and other structures in the chest, such as pneumonia, heart failure, lung cancer, tuberculosis, sarcoidosis and lung tissue scarring, called fibrosis.
  
• Echocardiogram (echo) – a test that allows doctors to look at the structure and function of the heart using high frequency sound waves (ultrasound) to take pictures of your heart.
  
• Stress test – a test that measures how well your heart works during physical stress. Stress tests may be done using a treadmill or it may be given in a form of medicine to achieve the same effect.
  
• Cardiac CT scan - an imaging test that uses X-rays to take detailed pictures of the heart and blood vessels to look for disorders in the arteries, larger blood vessels and valves. 
  
• Cardiac MRI - another imaging test that uses radio waves, magnets and a computer to create detailed pictures of the structure and function of the heart, as well as the type and severity of heart disease.
  
• Blood tests, including a complete blood count (CBC), to check your hemoglobin and platelet levels; blood chemistry tests to check how well your liver and kidneys are working; and tests to check your blood’s ability to clot.

The following activities are recommended in preparation for the procedure:

• Have a friend or family member provide transportation to and from the hospital.
• Do not eat, drink or chew gum after midnight on the day before the procedure.
• Make a list of all medications you are currently taking.
• Follow your doctor’s instructions on changing your medication dosage.

How Long Does It Take to Recover from A Cardiac Catheterization?

When you get home from the hospital, be sure to follow the treatment plan that your doctor recommends for your condition. Schedule follow-up appointments before leaving the hospital and know about the possible complications that may occur after the procedure.

Most people can return to their normal activities the day after the procedure depending on your health before the cardiac catheterization and whether any additional interventions were done during the procedure.

When to Contact a Medical Professional

• There is bleeding at the puncture site that does not stop when you press on it firmly.
• Your arm or leg below where the catheter was inserted changes color, is cool to the touch or is numb.
• The small incision for your catheter becomes red or painful, or yellow or green discharge is draining from it.
• The catheter insertion site swells up very fast.
• You have chest pain or shortness of breath that does not go away with rest.
• Your pulse feels irregular (fewer than 60 beats a minute or over 100 to 120 beats a minute).
• You have dizziness, fainting or you are very tired.
• You are coughing up blood or yellow or green mucus.
• You have problems taking any of your heart medicines.
• You have chills or a fever over 101°F (38.3°C).

Take charge of your heart health. Speak with one of our cardiac providers at East Cooper Medical Center in Mt. Pleasant to learn more about your condition and the treatment suited for your unique needs.