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Why did my doctor order a cardiac catheterization?
What is a cardiac catheterization?
What preparations will I need to make?
How is the test administered?
What will I experience during the test?
How long will the procedure last?
What will the recovery be like?
What happens after the test?
What risks are involved?
Will my insurance cover this?
Who should I contact with questions about this test?

1. Why did my doctor order a cardiac catheterization?

Following one or a series of tests (electrocardiogram or EKG, a treadmill or stress test, a chest x-ray or blood test), your physician may have noticed that your heart is not working properly. One or more of your arteries may have narrowed or become blocked with deposits known as atherosclerotic plaque. When this occurs, the heart does not receive enough oxygen to do its work properly. If the artery becomes totally blocked, a heart attack (myocardial infarction or MI) can occur.

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2. What is a cardiac catheterization?

A cardiac catheterization is a non-surgical test your doctor will perform by inserting a very narrow, soft, flexible plastic tube called a catheter through a blood vessel and into your heart. It is the most thorough test you can have to determine how well your heart is working. The catheter will allow x-ray pictures of your heart to be taken to show if there are any narrowings and/or blockages of the coronary arteries and, if so, where they are located. Your doctor can observe how the heart valves are opening and closing, and study the overall pumping efficiency of the heart muscle itself.

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3. What preparations will I need to make?

Your nurse or physician will provide you with specific directions prior to the test. You may not be able to eat or drink anything after midnight the night prior to the test. They will advise you. As for the actual test, the catheter will be inserted into either your wrist or the groin area (upper leg). Prior to the procedure, this area will be shaved and cleaned with antiseptic to prevent infection. Adhesive electrocardiogram (EKG) wires will be placed on your shoulders and hips so your heart can be continuously monitored. You will be awake during this procedure, since the physician will need you to take deep breaths and cough. Prior to the test, you may be given a mild sedative to help you relax and an intravenous (IV) line that will provide you with fluids.

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4. How is the test administered?

You will receive a local anesthetic through a needle to numb the area before the catheter is inserted. The two common approaches to inserting catheters into the body are through the wrist or through the groin. While both methods are equally safe, the doctor will choose which site he/she prefers. A needle will be used to make a small puncture through the skin into the blood vessel.

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5. What will I experience during the test?

Once the catheter is inserted into your heart, you may feel your heart skip a beat or possibly beat faster. This feeling is normal and is caused by the catheter in your heart. Your heart rhythm will be monitored by the medical team. If at any time during the procedure you feel any discomfort or chest pain, notify the medical team working with you immediately.

Once the catheter reaches the left ventricle or main pumping chamber, a dye or contrast medium will be injected through the catheter, and the doctor will begin taking pictures of your heart. You may feel a warm sensation when the dye is injected. This is normal and will only last 15 to 30 seconds. The dye makes it easier for the doctor to see the overall function of your heart. So a clearer picture of your heart may be taken, the doctor may ask you to take a deep breath and hold it for a few seconds.

Different catheters may be inserted and removed through the insertion site in the arm or groin during the test to study each main coronary artery. Several pictures will be taken from different angles. Again the doctor may ask for your help by asking you to cough. This clears the dye from your coronary arteries. When the necessary pictures have been taken, the catheter is removed.

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6. How long will the procedure last?

The procedure itself will last one to two hours.

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7. What will the recovery be like?

Your recovery will be monitored for four to eight hours. If the catheter was inserted through a puncture through the skin in the groin area, pressure will be applied by hand or with a specially designed clamp. Once a dressing has been applied at the catheter insertion site, you will be returned to your hospital room. If the procedure was done on an outpatient basis, you will be monitored by the medical team in a recovery room for a few hours before returning home with specific instructions on what to do once you get there.

For the first few hours following the procedure, nurses will check your blood pressure, pulse and catheter insertion site frequently. They will give you specific instructions as to how long you will need to remain in bed and the limitations on movement of the arm or leg used during the test. You may be encouraged to drink fluids that will make you urinate more frequently. This will assist your body in eliminating through your kidneys the dye used during the test. Your nurse will assist you with a bedpan or urinal until you are allowed to get out of bed. Should you experience any discomfort at the catheter insertion site as the local anesthesia wears off, your nurse will be able to give you pain medication.

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8. What happens after the test?

Many x-ray pictures will be taken during your catheterization. Once all these pictures have been developed and your doctor has been able to review them, he/she will discuss the final results with you, and if necessary, recommend any further treatment.

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9. What risks are involved?

The benefits of cardiac catheterization outweigh the risks of the procedure. There are, however, a few risks that you should be aware of before you sign the consent form. These risks include: bleeding; blood clots; perforation of the heart muscle, blood vessel or lung; heart block; damage to a heart valve; stroke or heart attack (rare); or death (extremely rare).

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10. Will my insurance cover this?

Depending on the type of coverage, most commercial insurance carriers will pay the major share of the cost. You should always consult your insurance company to determine proper coverage.

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11. Who should I contact with questions about this test?

Feel free to consult your doctor.

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Back to Cardiac Catheterization

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