All About Cardiac Catheterisation
Dr. Fawaz Akhras Dr.
Hassan Chamsi Pasha
What is Cardiac
Catheterisation?
During this procedure, a long flexible plastic tube (about the width of
a tube inside a ball point pen) is inserted into the main artery in your groin
or arm with the help of an x-ray machine. The tube is slowly fed through the
blood vessel until it is positioned in the heart. A dye that can be detected by x-ray can be
injected into the heart through the catheter and the x-ray image of the pumping chambers is called
'angiogram'. The entire test takes about 1 hour.
What is
Coronary Angiogram?
The catheter is then positioned at the entrance
of the main coronary artery on the heart's surface and a dye is
injected into each of them. Any severely narrowed sections or blockages will show up clearly on the x-ray. This
is called 'coronary angiogram'.
Are there
any tests which need to be done
before Cardiac Catheterisation?
Yes. There are routine tests which include blood tests, chest X-ray and one electrocardiogram
(ECG).
Shall I fast
before Cardiac Catheterisation?
If the procedure is scheduled before noon, you will not be allowed to
eat or drink after midnight the night before.
If it is going to be done in
late afternoon, then you will be given a light breakfast after which you will not be permitted to eat
or drink.
Drugs may be given,
if ordered by the doctor.
What is in
the Cardiac Catheterisation room?
You will be taken to the cardiac catheterisation room by a nurse. You
will be moved from a wheelchair to a flat narrow hard table. This special table
will allow for a video tape to be taken during the procedure. You may be
interested in watching the television monitor that will be displaying your
heart during the procedure. There will be a minimum of three people in the room
with you, a doctor and 2 nurses.
Do I have to
do anything during the procedure?
You may be asked to cough, breathe deeply and hold your breath whilst
the camera is filming your heart. Other than that, all you have to do during
the procedure is to lie completely still and try to relax.
Will I be
awake during the procedure?
Yes. Although you will probably be sedated during the 30 minutes of the
procedure, you will still be awake.
Will I feel
anything during the procedure?
During the procedure you should feel very little or no pain. If you do feel
any pain, please let the doctor know so that he can treat your discomfort as
quickly as possible. You should expect to feel certain sensations during the
procedure. You will feel a cool sensation when the nurse is cleaning the area
where the doctor will be inserting the soft narrow tube. You will feel a slight
needle pinch when the doctor is freezing the area with a local anaesthetic. You
may also feel some pressure as the doctor inserts the tube. Another sensation
may be a 'hot flush' all over your body which is from the x-ray dye. This is
normal and will pass in a few seconds.You may also have a headache and a nasty
taste in your mouth for a while afterwards.
What would
the doctor do during the procedure?
Once the soft tube is introduced, it is advanced up the artery into the
aorta where it is kept under visual control by x-ray screening.
In coronary angiograpy, the coronary arteries and left ventricle can be
outlined one after the other
by selective injection of x-ray dye. In a cardiac catheterisation for a
rheumatic valvular disease,
another soft tube is inserted in the vein of the same area and measurement of
pressures of the right side of the
heart will be obtained.
When the soft tube is withdrawn, it is necessary to compress the artery
in the groin for about 10 minutes,
or to put in some stitches if it was inserted in the arm.
Will I be
able to move my legs or arms
following the procedure?
If your doctor inserted the tube into your leg, you will have a small
puncture wound which should heal itself easily if you lie flat and keep your leg completely
still for at least 6 - 8 hours.
The nurse will assist you in changing your position in bed so that you
do not move your leg. Please call the nurse when you need to pass water, eat or
change position in bed.
If the tube was inserted into your arm, do not bend your arm sharply
for four hours and do not lift anything heavy until the soreness is completely
relieved. The stitches will be removed within one week.
Will I
return to my room following the procedure?
You will be taken back to your room. Frequent checks of your pulse,
blood pressure and the area around
the insertion site will be made.
Notify the nurse if you notice any of the following:
1. Red blood on your dressing.
2. Feeling
coldness, numbness or pain in your arm or leg.
3. Discomfort
in your chest, neck, jaw, arms or upper back.
Your doctor may
order a light meal and/or something to drink.
Will I get
any pain after the procedure?
It is normal to feel some pain following the procedure. Notify the nurse
of any discomfort, so you will be given some pain killer tablets.
When will I know the results?
Your doctor will inform you as soon as possible when the results of your heart catheterization are available. Your doctor will show you on the diagram where your problem is.
By : Dr. Hassan
Chamsi Pasha & Dr. Fawaz Akhras