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McKesson Clinical Reference Systems: Women's Health Advisor 2002.2
Spanish version
Illustration
Heart Catheterization
What is heart catheterization?
Heart (cardiac) catheterization is a procedure in which a
narrow, flexible tube is inserted through a blood vessel
into the veins, arteries, and chambers of your heart. The
tube is called a catheter. It is usually inserted through a
blood vessel in the arm, groin, or neck.
Heart catheterization can:
- Record the blood pressure in the blood vessels in the
lungs and the heart and in the chambers of the heart.
- Measure blood flow and oxygen content of blood in
different parts of the heart.
- Allow x-ray pictures (angiograms) outlining the heart
chambers or coronary arteries to be taken with use of a
special dye.
- Take a tissue sample (biopsy) of the heart muscle using
an instrument passed through the catheter.
Usually you do not need to stay in the hospital overnight
for this procedure.
When is it used?
Some of the reasons heart catheterization may be done are:
- Coronary artery disease: If your coronary arteries are
partly or completely blocked, you have an increased risk
of a heart attack, especially if your symptoms have
gotten worse recently. Cardiac catheterization and the
injection of dye into the arteries is the best way to
study the coronary arteries. The dye study shows the
location and the amount of the blockage. The procedure
may be done to see if you need coronary bypass surgery or
coronary angioplasty.
- Open-heart surgery: Sometimes catheterization is needed
before open-heart surgery. The surgeon needs to check
for any conditions that may increase the risk of problems
during surgery.
- Artificial heart valves: If you have an artificial heart
valve, you may need catheterization so the health care
provider can see how the valve and the rest of the heart
are working.
- Biopsy: The tissue sample of heart muscle can be checked
for inflammation or other problems.
- Angioplasty: Catheters can be used to open a narrowed
heart valve or artery. Balloon angioplasty, for example,
uses pressure from a balloon to widen an artery.
- Stenting: Catheters may also be used to remove plaque
buildup and to place stents that hold open arterial
walls.
How do I prepare for the procedure?
You will be asked not to eat or drink anything for 12 hours
before the procedure. Arrange for someone to drive you home
afterward. Follow any other instructions your health care
provider may give you.
What happens during the procedure?
You are given a sedative, which will make you feel relaxed,
but you will stay awake. You are also given a shot (a local
anesthetic) to numb the area where the catheter is inserted.
The doctor will insert the catheter through a small
incision. The catheter is pushed through the blood vessels
toward the heart. X-rays are used to follow the position of
the catheter. You will not feel the catheter as it passes
through your blood vessels.
The health care provider will direct the tip of the catheter
to precise positions in the heart and its blood vessels.
The catheter is attached to a device that measures blood
flow and blood pressure in various places in the heart and
blood vessels.
If pictures of the heart chambers, valves, or coronary
arteries are needed, a special dye is injected through the
catheter. During this injection, moving x-ray pictures are
recorded. This procedure with dye is called angiography.
When the procedure is finished, the health care provider
will remove the catheter and apply pressure over the area
where the needle was inserted to control any bleeding.
What happens after the procedure?
The procedure may last 30 to 60 minutes. You will spend
several hours in the recovery room. After that, you may go
home. You should avoid strenuous activity for the rest of
the day to prevent bleeding.
Ask your health care provider if you should take any
precautions after the procedure, what symptoms to watch for,
and when you should come back for a checkup.
A swollen bruise may appear near the puncture site and be
uncomfortable for a few days.
What are the benefits?
Heart catheterization is considered the most accurate way to
gather the information your health care provider needs to
diagnose and treat heart problems most effectively. The
health care provider will study the x-ray moving pictures to
see if your heart valves are normal, to check how well the
heart is pumping, and to look for possible blockages in the
coronary arteries. He or she will take note of the
direction and the amount of blood flow through the heart.
With the knowledge gained from the procedure, heart valves
may be repaired or replaced before congestive heart failure
occurs. Heart attacks may be prevented or delayed by
treating coronary artery blockages.
What are the risks?
- You may feel some minor discomfort.
- In rare cases, you may have an allergic reaction to the
drug used in the anesthesia.
- The procedure can cause irregular heart rhythms, which
could require treatment.
- If the catheter is placed in an artery, a blood clot
could form around the catheter. If this happens, your
health care provider may give you a blood thinner and
keep you in the hospital for a few days to dissolve the
clot.
- You may have an allergic reaction to the dye and become
nauseated or flushed. This reaction can be treated with
medicine. The dye could also damage the kidneys.
- The catheter could puncture a blood vessel and cause
internal bleeding.
- While not common, a heart attack or stroke might be
triggered by the procedure.
Complications from this procedure are rare. The risk of
death is very low. People with diabetes or kidney disease
may be at higher risk for kidney damage from the dye. In
general, the more skilled the health care provider, the less
likely you are to have problems.
When should I call my health care provider?
Call your health care provider if you have:
- severe pain where the catheter was placed
- bleeding from the puncture site
- increased swelling and tenderness where the needle was
inserted.
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