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. Learn about your child's health condition and how it may be treated. Discuss treatment options with your child's caregivers to decide what care you want for 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.

Getting Ready

The Week Before Your Child's Heart Cath:

• Talk about medicines and allergies with your child's caregiver.
  
  
  • Talk to your child's caregiver about all your child's medicines. Tell the caregiver about all prescriptions, over-the-counter medicines, vitamins, and herbs that you give your child. Your child's caregiver may tell you not to give your child certain medicines before the heart cath. Do not stop giving your child any medicines without first asking your child's caregiver.
    
    
  • A dye is a liquid that will be used during your child's heart cath. It helps the parts of the heart to show up better. People who are allergic to shellfish (lobster, crab, or shrimp) may also be allergic to this dye. Tell your child's caregiver if your child is allergic to any of these.
    
    
  • Make sure you understand clearly about the heart cath and why it is being done. If you do not understand, write down your questions and ask your child's caregivers. Tell caregivers about any long-term health problems your child has.
  
  
• Take your child for tests. Your child may need an echocardiogram, EKG, or chest x-ray before his surgery. Ask your child's caregiver for information about these and other tests he may need. Write down the date, time, and location of each test.
  
  
• Arrange family support.
  
  
  • Talk to your child about the heart cath. Talking about the heart cath may decrease your child's fear or anxious feelings. Ask caregivers about ways to talk to your child to help him get ready for the heart cath.
    
    
  • Plan to be at the hospital during and after your child's heart cath. If this is not possible, ask a family member to stay while you cannot be there. This is especially important after the heart cath. Your child will need to lie flat. He will need to keep the leg or place that had the catheter in it very still. Caregivers may ask you to help your child lie flat and still.

The Day Before Your Child's Heart Cath:

• Your child may be admitted to the hospital the night before the heart cath.
  
  
• Ask caregivers about directions for eating and drinking.

The Day of Your Child's Heart Cath:

• Write down the correct date, time, and location of your child's procedure.
  
  
• Ask your child's caregivers before giving your child his medicines today. Your child may not be allowed to take them. These medicines include insulin, diabetic pills, or heart pills. Bring a list of your child's medicines or the pill bottles with you to the hospital.
  
  
• Have your child wear his glasses. If your child wears contact lenses regularly, he should not wear them the day of the heart cath. Have him wear his glasses instead. Leave your child's jewelry at home.
  
  
• Bring your child's personal belongings. If your child is staying in the hospital before or after the heart cath, bring his personal belongings. These include your child's pajamas and bathrobe, toothbrush, hairbrush, and slippers. Bring an object that is special to your child, like a favorite toy or blanket.
  
  
• Have your child take a full bath or shower before the heart cath. Your child should wash his hair and body well. He may not be able to fully bathe until a few days after the procedure. Remove your child's nail polish.
  
  
• Make sure you have signed an informed consent. You or a close family member may be asked to sign a legal piece of paper (consent form). It gives your child's caregiver permission to do a heart cath. Be sure all your questions have been answered before you sign the form.

Treatment

What Will Happen:

• Your child will change into a hospital gown. Your child will get medicine to help him relax or make him drowsy. He will be taken on a stretcher to the room where the heart cath will be done. Your child will get an IV and may get more medicine to make him sleep. Caregivers may first put a special numbing cream on the area where the catheter will go in.
  
  
• 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 a machine called a fluoroscope (FLOOR-o-skop) that sends a constant beam of x-ray pictures to a TV screen. Caregivers watch the pictures on the TV screen. This helps them push the catheter to the right places in the heart and blood vessels. At certain times, caregivers will give dye through the catheter. This helps your child's heart and blood vessels show up better on the x-ray pictures.
  
  
• 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. Sometimes, a pressure bag may be put in place to help stop the bleeding. Your child may have stitches to stop the bleeding. It is very important for your child to lie flat. The leg or place that had the catheter must be kept very flat and still to prevent bleeding.

After Your Child's Heart Cath:

• Your child will be taken to a recovery area. Your child will need to lie flat and keep his leg or arm still for about 4 hours. You may be asked to hold your child to help your child keep still. Your child may feel like napping or feel very sleepy for a few hours after the heart cath. Bring favorite books, electronic games, or videotapes that your child enjoys. These may help him to lie still after the heart cath.
  
  
• 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. Do not let your child get out of bed until his caregiver says it is OK.

Waiting Room:

This is a room where you and your family can wait until your child is ready for visitors after the heart cath. Your child's caregivers can then find you to let you know how the heart cath went. If you leave the hospital, leave a phone number where you can be reached.

Contact a caregiver if

• Your child cannot make it to the heart cath appointment on time.
  
  
• You have questions or concerns about your child's heart cath.
  
  
• Your child has a fever.
  
  
• Your child's heart problems get worse.

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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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