Cardiac Catheterization

What Is a Cardiac Catheterization?

A cardiac catheterization is a procedure in which a catheter (a long, thin tube) is inserted into a blood vessel. Then, a cardiologist guides it to the heart and the blood vessels around it.

Why Are Cardiac Catheterizations Done?

Cardiac catheterizations can help cardiologists diagnose and treat many different heart problems.

The procedure may be done on teens to:

• Look at how the heart and blood vessels are formed and connected.
• Check the pressures and oxygen levels in the heart and blood vessels.
• Treat a congenital heart defect (a heart problem that someone is born with).
• Treat an irregular heartbeat (arrhythmia).
• Open up narrowed blood vessels (called angioplasty ).
• Repair leaky or narrow heart valves.

How Should We Prepare for a Cardiac Catheterization?

Your cardiologist will talk with you and your parents about how to prepare for the procedure and:

• Give you instructions about when you should stop eating and drinking (usually 6-8 hours before the procedure for food and 4 hours for clear liquids such as water, apple juice, and broth).
• Tell you which medicines you should continue taking.
• Discuss the risks and benefits of the procedure.

What Happens During a Cardiac Catheterization?

A cardiac catheterization is done in a type of operating room called a catheterization lab. There will be an area close by where your parents can wait until the procedure is finished.

In a cardiac catheterization:

• An intravenous (IV, into a vein) line is put in to give medicines and contrast material through a vein. This special dye helps the cardiologist see your heart's vessels, valves, and chambers more clearly.
• A sedative is given through the IV. This lets you sleep through the procedure.
• Small sticky patches (electrodes) are placed on your chest. They're attached to an electrocardiograph (ECG) monitor, which checks your heartbeat throughout the procedure.
• The area where the catheter will go in (usually the groin) is shaved (if necessary) and cleaned. The area is sometimes numbed with an injection of medicine.
• A sheath (like a tube about the size of a coffee straw) is inserted into a blood vessel.
• The cardiologist gently guides a catheter through the sheath and blood vessel to the heart. A type of X-ray called fluoroscopy lets the cardiologist guide the catheter to where it needs to be.
• The cardiologist does the test or procedure.
• The catheters and sheath are removed and the site is bandaged.
• You move to the recovery area, where your parents can join you.

What Happens After Cardiac Catheterization?

You'll be watched closely for several hours after the catheterization. You must stay lying down with that leg straight until the doctor says it's OK to get up, usually 4–6 hours.

The doctor will also talk to you and your parents about:

• pain medicines
• when you can eat and drink
• continuing medicines you were on before the procedure or starting new ones
• when to remove the bandage
• if you can get up and move if you have a long trip home
• when you can bathe
• when you can return regular activities, school, and sports

What Should I Do at Home?

Take the bandage off as instructed by the cardiologist, usually the day after the catheterization. Wetting the sticky parts of the bandage will help it come off. Then, dry the area and put a small adhesive bandage over the place where the catheter went in.

Gently wash the area with soap and water at least once a day. Then, cover it with a new adhesive bandage.

For 2–3 days, take sponge baths or short showers so that the area where the catheter went in does not get too wet. Avoid baths, hot tubs, and swimming, and don't use any creams, lotions, or ointments on the area.

Are There Any Risks From Cardiac Catheterization?

Cardiac catheterizations are generally safe procedures. It's normal for the area where the catheter went in to be bruised, sore, or slightly swollen for a couple of days afterward.

More serious problems are uncommon, but can happen. These include:

• bleeding
• allergic reaction to the medicines or contrast material
• heart attack
• stroke
• kidney damage
• long-term problems from radiation from the X-rays

When Should I Call the Doctor?

You or your parents should call your cardiologist if you have:

• bleeding where the catheter went in
• swelling or redness that gets worse where the catheter went in
• numbness or weakness of the leg or arm where the catheter went in
• a fever
• chest pain
• trouble breathing

Looking Ahead

Cardiac catheterizations are an important way to diagnose and treat heart problems. Most people have no problem with the procedure. You should be back to your regular activities within a week.