Heart Catheterization In Children

WHAT YOU SHOULD KNOW:

• A heart catheterization or "heart cath" is a test to look inside your child's heart. During the test, a catheter (long, thin, bendable tube) is put into a large blood vessel. It is usually put in your child's groin. The groin is the area between the abdomen (belly) and the top of each leg. If caregivers cannot use the groin area, they may put the catheter in your child's neck or arm. Using a TV screen and x-rays, caregivers gently thread (push) the catheter into your child's heart. Caregivers move the catheter into different areas of the heart and blood vessels to see how they look inside.
  
  
• A heart cath may be put into the right or left side of the heart. With a heart cath, caregivers can check the pressure in the chambers (rooms) inside the heart. They can inject (give shots of) dye to look at how well blood flows through the chambers and blood vessels. This is called an angiogram (AN-g-o-gram). They can take blood samples and check how much oxygen is in different parts of the heart. Caregivers also look at the heart valves (doors) between each chamber. If certain heart problems are found during the heart cath, caregivers may fix them.
  
  
• Caregivers may do a heart cath to learn if your child has a heart defect. A heart defect is a heart problem that your child may have been born with. It may also be called a congenital (con-JEN-ih-tull) heart defect. Your child may be able to go home after the heart cath or may have to stay in the hospital.

CARE AGREEMENT:

You have the right to help plan your child's care. To help with this plan, you must learn about your child's health condition and how it may be treated. You can then discuss treatment options with your child's caregivers. Work with them to decide what care may be used to treat your child.

RISKS:

• Most children do not have problems having a heart cath. There are risks in making a hole in a blood vessel with the catheter. This could cause bleeding, a bruise, and soreness around the place where the catheter went in. Your child could bleed so much that he may need a blood transfusion or surgery to repair the hole. Your child could get a blood clot. Blood clots may go to your child's lungs or brain and cause a stroke. The clots may go to your child's arm or leg. Clots could stop blood flow and cause pain or death of the arm or leg.
  
  
• Your child could have an irregular heartbeat or heart attack. He could get a collapsed lung or an infection from having the heart cath. Your child could have an allergic (uh-LER-jik) reaction or kidney problems from the dye used during the test. If caregivers use a special device to fix your child's heart problem, the device could move out of place. If this happens, caregivers may take your child to surgery to remove the device and fix the heart problems. If your child does not have a heart cath, his health condition could get worse. Call your child's caregiver if you are worried or have questions about your child's illness, medicine, or heart cath.

WHILE YOU ARE HERE:

Before Your Child's Heart Cath:

• Informed Consent:
  
  
  • You have the right to understand your child's health problem. You should understand what tests, treatments, or procedures may be done to treat your child's problem. Your child's caregiver should also tell you about the risks and benefits of each treatment.
    
    
  • You may be asked to sign a consent form. If you are unable to give your consent, someone who has permission can sign this form for your child. A consent form is a legal paper that gives a caregiver permission to do certain tests, treatments, or procedures. This form should tell you exactly what will be done to your child. Your child's caregiver should explain what the risks and benefits of each treatment are before you sign the form. Before giving your consent, make sure all your questions have been answered. This way you will understand what may happen to your child.
  
  
• Gown: A hospital gown is needed so caregivers can easily check and treat your child. Your child's gown should be put on so it opens in the back. Your child may be able to wear regular pajamas or clothes after the heart cath.
  
  
• Blood Tests: Your child may need blood taken for tests. The blood may be taken from your child's arm, hand, finger, foot, heel, or IV. It is tested to see how your child's body is doing before the heart cath. Your child may need to have blood drawn more than once.
  
  
• Call Button: A call button may be in your child's hospital room. You or your child should use the call button if your child is having problems and a caregiver is needed. You can also use the call button if you or your child have questions for a caregiver. Be sure to keep the call button near you or your child at all times.
  
  
• Chest X-ray: This is a picture of your child's lungs and heart. Caregivers use it to see how your child's lungs and heart are handling his heart problem.
  
  
• Heart Monitor: This is a machine used to see how your child's heart is doing before, during, and after the heart cath. 3 or 5 sticky pads are placed on your child's chest. Each pad has a wire that is hooked to a TV-type screen or to a small portable box. This screen or box shows a picture of your child's heartbeat. Caregivers watch this picture to make sure your child's heart is doing well.
  
  
• IV: An IV is a tiny tube placed in your child's vein (blood vessel). Your child's IV may be hooked to a machine that will give your child liquids and medicine. The IV may be put in your child's hand, arm, ankle, or foot right before the heart cath. Before putting in the IV, caregivers may put a special numbing cream on your child's skin. This is so your child will feel no pain or much less pain when the IV is put in.
  
  
• Pulse Oximeter (oks-IH-mih-ter): This is a machine that tells caregivers how much oxygen is in your child's blood. It will tell caregivers how well your child is doing during the heart cath. A cord with a clip or sticky strip is placed on your child's foot, toe, hand, finger, or earlobe.
  
  
• Vital Signs: This may include taking your child's temperature, pulse (heartbeats), respirations (breaths), and blood pressure. Your child's temperature may be taken in the mouth, ear, armpit, or rectum (rear-end). Caregivers may also listen to your child's heart and lungs by using a stethoscope (STETH-o-skop).
  
  
• Pulse Check: Caregivers will check your child's pulses (heartbeat) in his feet and ankles. The pulse is the feeling under the skin when the heart pushes blood through the arteries (blood vessels). Your child's caregiver may put an "X" over the spots on your child's feet and wrists where the pulse is strongest.
  
  
• Bathroom: Have your child go to the bathroom (empty his bladder or urinate) before the heart cath. Otherwise, he may need to wait until after the procedure is over.
  
  
• Transport: Your child will be taken on a stretcher or crib to the room where the heart cath will be done. Your child's caregivers will help your child get comfortable on the bed. A belt may be put over your child's legs for safety. Your child's arms may be tucked at his sides to give caregivers more room to work during the heart cath.
  
  
• Medicines: Your child may be given a sedative (SEH-duh-tiv) right before the procedure. He may take the sedative by mouth or through an IV. This medicine may make your child feel relaxed and drowsy. It may make your child go to sleep.
  
  
• Anesthesia (an-iss-THEE-zuh):
  
  
  • This medicine makes your child comfortable during surgery. Caregivers may work with you to decide which anesthesia is best for your child. After taking this medicine, your child may feel drowsy, dizzy, or have unclear thinking. Your child may sleep for a few hours after the heart cath because of the anesthesia.
    
    
  • Caregivers may put a special numbing cream on the skin where the catheter may go in. This will make the skin lose feeling. A shot of numbing medicine may also be given right before the catheter goes in. Your child may also be given medicine through his IV. This medicine will keep your child comfortable and asleep during the heart cath.

During Your Child's Heart Cath:

• Your child will lie on a hard, movable x-ray bed. There will be large x-ray machines and other equipment in the room. Caregivers will clean an area of your child's skin with soap. This soap may make your child's skin yellow, but it will be cleaned off later. Sterile (no germs) sheets will be put over your child to keep the area clean.
  
  
• A catheter will be put into a blood vessel in your child's groin or arm. The catheter is gently threaded (pushed) through the chambers (rooms) in the heart.
  
  
• If the procedure is a right heart cath, the catheter will go through the right atrium, the right ventricle, and into the pulmonary artery. The pulmonary artery is the blood vessel that takes blood from the heart to the lungs to get oxygen.
  
  
• If the procedure is a left hearth cath, the catheter will go into the left atrium, the left ventricle, and into the aorta. The aorta is a large artery (blood vessel) that takes oxygen-filled blood to the rest of the body. Sometimes caregivers will use 2 catheters to look at both sides of the heart.
  
  
• Caregivers will use an x-ray machine that sends a constant beam of x-ray pictures to a TV-like screen. Caregivers watch the pictures on the TV screen to help them push the catheter to the right places in the heart and blood vessels. At certain times, caregivers will give a shot of dye through the catheter.
  
  
• When the heart cath is finished, the catheter will be removed. Caregivers will put pressure on the area where the catheter came out. This is to stop the bleeding. A pressure bag may be put in place for 2 or more hours. Your child may have stitches to stop the bleeding. It is very important for your child to lie flat and to keep the leg or arm that had the catheter very still. This is to prevent bleeding.

After Your Child's Heart Cath:

• Aftercare: Your child will be taken to a recovery area. Caregivers will watch your child closely for any problems. Caregivers will take your child's vital signs every 15 minutes for 1 to 2 hours. The pulses in your child's feet or wrists will also be checked often. Your child's toes or fingers will be checked to see if they are warm. Caregivers will watch your child closely for problems that can happen after a heart cath. Tell your child's caregiver if your child has any of the following:
  
  
  • Chest pain or discomfort.
    
    
  • Change in color or temperature of your child's arm or leg.
    
    
  • Swelling or bleeding from the area where the catheter was.
    
    
  • Pain, numbness, or tingling in your child's arm or leg.
    
    
  • Pain in your child's back, thigh, or groin.
    
    
  • Nausea. Your child feels sick to his stomach.
    
    
  • Sweating a lot.
  
  
• Activity:
  
  
  • Your child will need to lie flat and still in bed for about 4 hours. Lying flat and still is very important. This helps to prevent bleeding. You may be asked to hold your child to help your child keep still. Your child's caregiver will tell you when it is OK for your child to get out of bed.
    
    
  • Bring favorite books, electronic games, or videotapes that your child enjoys. These may help him to lie still after the heart cath.
    
    
  • Do not raise the head or foot of your child's bed without asking a caregiver. Do not remove your child's pressure bag or bandage.
    
    
  • Tell your child's caregiver if your child is uncomfortable or tired of lying on his back. Caregivers may have ways to make your child more comfortable.
    
    
  • Help your child or call a caregiver to help the first time your child gets out of bed. Your child may feel weak, dizzy, or sleepy. Help your child when he gets out of bed to prevent him from falling or hurting himself.
  
  
• Bathroom: Your child must use a bedpan or urinal during the time that he must lie flat. After your child's caregiver says it is OK to get out of bed, you may help your child walk to the bathroom.
  
  
• Eating: Your child may be on a clear liquid diet. Your child may have things like water, apple juice, soup broth, or clear soda pop. If he does not feel sick to his stomach, your child may be able to eat "finger foods." These are foods that can be eaten while your child is lying flat in bed. Help your child to drink as much water as he can after the heart cath. This will help to flush out the dye from your child's body. It will also help keep your child hydrated (keep good body fluid levels).
  
  
• Anti-Nausea Medicine: This medicine may be given to calm your child's stomach and control vomiting (throwing up). Your child may have an upset stomach after the heart cath. Anti-nausea medication will usually be given through an IV or in your child's rectum (rear-end).

Copyright © 2008 Thomson Healthcare Inc. All rights reserved. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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