Right Heart Catheterization

WHAT YOU SHOULD KNOW:

Right heart catheterization is a procedure to check the pressure in your heart and lungs. It is also called a Swan-Ganz or pulmonary artery catheterization. You may need this procedure if you have chest pain, shortness of breath, or decreased oxygen in your body. You may also need this procedure if you need heart surgery or have a heart condition.

CARE AGREEMENT:

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

RISKS:

• The contrast dye may cause kidney problems. The catheter may tear a vein and cause bleeding. An air bubble may enter your lung, or your lung may collapse. You may have a heart attack during this procedure. After the procedure, you may have bleeding that needs to be stopped. You may get a serious infection. Your heart valves may be damaged if the catheter is left in. A fistula (abnormal opening) may form between an artery and vein. You may have irregular heartbeats that make you dizzy or cause you to faint. You may get a blood clot in your arm or leg. The clot may break loose and travel to your lungs or brain. A blood clot in your lungs can cause chest pain and trouble breathing. A blood clot in your brain can cause a stroke.
  
  
• Without this procedure, your heart failure or heart valve disease may get worse. Your caregiver may not learn the cause of your symptoms. You may not get proper treatment. You could have a heart attack.

WHILE YOU ARE HERE:

Before your procedure:

• Informed consent is a legal document that explains the tests, treatments, or procedures that you may need. Informed consent means you understand what will be done and can make decisions about what you want. You give your permission when you sign the consent form. You can have someone sign this form for you if you are not able to sign it. You have the right to understand your medical care in words you know. Before you sign the consent form, understand the risks and benefits of what will be done. Make sure all your questions are answered.
  
  
• Blood tests: You may need blood taken to give caregivers information about how your body is working. The blood may be taken from your hand, arm, or IV.
  
  
• An IV (intravenous) is a small tube placed in your vein that is used to give you medicine or liquids.
  
  
• Medicines:
  
  
  • Antihistamines: These help prevent a reaction to the dye used during your heart catheterization.
    
    
  • Sedative: This medicine is given to help you stay calm and relaxed.
    
    
  • Steroids: These decrease inflammation and help prevent a reaction to the procedure dye.
    
    
  • Local anesthesia: This medicine numbs the area where the surgery or procedure will be done. It is usually injected into the skin.
    
    
  • General anesthesia: General anesthesia may be used if your right heart catheterization is done during surgery. General anesthesia may be given in your IV or as a gas that you breathe. You may wear a face mask, or have a tube placed in your mouth and throat. This tube is called an endotracheal tube, or ET tube. Usually you are asleep before caregivers put the tube into your throat. The ET tube is usually removed before you wake up.
  
  
• Monitoring:
  
  
  • Echocardiogram: This test is a type of ultrasound. Sound waves are used to show the structure, movement, and blood vessels of your heart.
    
    
  • Pulse oximeter: A pulse oximeter is a device that measures the amount of oxygen in your blood. A cord with a clip or sticky strip is placed on your finger, ear, or toe. The other end of the cord is hooked to a machine. Never turn the pulse oximeter or alarm off. An alarm will sound if your oxygen level is low or cannot be read.
    
    
  • Vital signs: Caregivers will check your blood pressure, heart rate, breathing rate, and temperature. They will also ask about your pain. These vital signs give caregivers information about your current health.

During your procedure:

• You will lie face up on a movable x-ray bed. Your caregivers remove the hair from the area where the catheter is inserted. An incision is made into the skin and vein of your arm, groin, or neck. The catheter is put into your vein. Dye called contrast is given through the catheter to help your heart show up better on x-rays. X-rays are taken as the catheter is guided through the vein and into your heart. The catheter is moved through your heart valves, and into your pulmonary (lung) artery.
  
  
• Heart monitor: This is also called an ECG or EKG. Sticky pads placed on your skin record your heart's electrical activity.
  
  
• The pressure in your heart is measured. A piece of heart tissue may be collected and tested during your heart catheterization. The catheter may be left in place to monitor your pressures constantly, or it may be removed. If the catheter is removed, firm pressure is held for up to 30 minutes to help stop the bleeding. A pressure bandage is placed over your procedure site. If the catheter is left in, it is stitched in place and covered with a bandage.

After your procedure:

• Do not get out of bed until your caregiver says it is okay.
  
  
• Lie flat and keep your arm or leg straight for several hours. Arm or leg movement too soon can cause serious bleeding.
  
  
• Caregivers may ask you to drink more liquids after your procedure. Liquids help flush the dye used for your procedure out of your body.
  
  
• If the catheter was in your groin and you need to cough, support the area with your hands.