Cardiac Catheterization (Angiogram)

Cardiac Catheterization (Angiogram)

 Cardiac Catheterization (Angiogram)

A cardiac catheterization (an angiogram) is a diagnostic test that will give your doctor detailed information about your heart and coronary arteries. Your doctor will be able to evaluate any blockages in your coronary arteries, the overall health of your heart and valves, and abnormal blood flow and pressures in your heart. Based on this information, your doctor will make a diagnosis and recommend a plan of care. The doctor will usually discuss the results of your test with you the same day.

Words you should know

• Anesthetic: a medicine applied to an area to numb it
• Catheter: a small, thin, flexible tube

Before the test:

Do not eat or drink after midnight the day of the test until the test is over. Take all medications as prescribed with a small sip of water unless directed otherwise by your doctor. Bring your medications with you, along with a list of your daily dosages. Be sure to tell your doctor if:

• You have an allergy to seafood, x-ray dye or iodine.
• You know or suspect that you are pregnant.
• You are taking blood thinners.
• If you take Coumadin, please obtain instructions from your physician 5-7 days before the procedure regarding when to stop and restart the medicine
• You have a history of bleeding problems.
• You are diabetic.

During the procedure family members will be taken to a waiting room where the doctor will speak with them after your procedure. You should make arrangements to have someone drive you home after the procedure.

The cardiac catheterization procedure

The procedure is performed by a physician who is specially trained in performing cardiac catheterization. You will be moderately sedated during the procedure and your doctor and nurses will explain each step as it occurs. An intravenous needle (IV) will be started and a nurse will give you a sedative to help you relax. Your blood pressure and heart rhythm will be monitored constantly throughout the test.

The procedure will begin by administration of an anesthetic to the site where the catheter will be inserted – usually in the groin or arm. You may feel a slight “stinging” sensation during the injection. A special catheter is then inserted into your groin artery. The catheter will then be advanced through a blood vessel into your heart. You should experience no pain while the catheter is threaded into your heart.

Once the catheter is in place, several injections of dye will be made into the arteries and chambers of your heart. You may experience some discomfort (“hot flash”) for 20-30 seconds as dye is injected into your heart. An x-ray camera will be moved around the table to take pictures of your heart from a number of different angles. The procedure usually takes 30-60 minutes.

It is unusual to experience any pain during the procedure. If you do, report it to your doctor immediately. After the procedure, the catheter will be withdrawn and a nurse may apply pressure to the site for about 20 minutes. You may receive a collagen “plug” at the puncture site to speed up your recovery.

Complications

Complications during or after cardiac catheterization are rare. The most common complication is bleeding at the site of the blood vessel where the catheter is inserted. If this occurs, it is usually results in minor bruising. Sometimes a small lump occurs at the site, but this will go away in a week or so. The possibility of a heart attack, stroke, sudden closure of a blood vessel or death is very rare.

Following the procedure

Your doctor will decide when you will be able eat and drink after the test. You will remain in bed for about 2-5 hours, with the head of the bed either flat or slightly raised. Movement of your leg may be restricted for several hours. Your vital signs will be closely monitored.

It is not uncommon to have swelling, bruising and a small lump at the catheter insertion site. Please tell your nurse if you experience any pain or discomfort including warmth, wetness, numbness or tingling, or if you develop a fever over 100ºF.

Discharge usually takes place within 2-6 hours of the procedure. Mild exercise and driving may usually resume after 1-2 days with the permission of your doctor.

Home Instructions

• Avoid heavy activity for 7 days, including pushing or pulling heavy objects or lifting more than 5-6 pounds.
• Stop exercising before you become tired or short of breath.
• Avoid soaking of the catheter insertion site, shower is OK.
• Avoid rubbing the lump at the catheter insertion site.

Call your doctor if:

• Your arm or leg becomes numb or painful, or if there is redness or a yellow discharge at or below the catheter insertion site. It is normal to have soreness at the catheter insertion site.
• The catheter insertion site swells or bleeds. If this happens, lie down immediately on a firm surface and have someone apply pressure to the catheter insertion site for 10 minutes by pressing the heels of both hands over the lump and pushing down. If the swelling and/or bleeding don’t stop, call your doctor or go to the emergency room while continuing to hold pressure to the site.
• Call your doctor or seek emergency medical care immediately if you have chest pain like the pain before or during your catheterization with or without exercise.

Medications

You may be placed on medications following your catheterization to prevent blood clots from forming. Report all side effects from medications to your doctor. Do not stop taking any medication unless directed by your doctor.

Follow-up

Be sure to contact your cardiologist for a follow-up evaluation and final discussion of the results of your catheterization within 7-10 days of the procedure.