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.

Getting Ready

The week before your procedure:

• Bring your medicine bottles or a list of your medicines when you see your caregiver. Tell him if you are allergic to any medicine. Tell him if you use any herbs, food supplements, or over-the-counter medicine. Ask if you need to stop using blood thinners or other medicines before your procedure.
  
  
• You will get dye called contrast through your IV to show the parts of your heart more clearly. Tell the caregiver if you are allergic to iodine or seafood. You may also be allergic to the dye. You may be given antihistamine medicine to help prevent a reaction to the dye.
  
  
• Tell your caregiver if you have any medical conditions, such as diabetes, kidney problems, or peripheral vascular disease. Tell him if you have had a stroke or gastrointestinal (stomach and intestines) bleeding.
  
  
• If you have diabetes, ask your caregiver for special instructions about what you may eat and drink before your procedure. If you use medicine to treat diabetes, your caregiver may have special instructions about using it before the procedure. You may need to check your blood sugar more often before and after having your procedure.
  
  
• Tell your caregiver if you know or think you are pregnant.
  
  
• Ask your caregiver for information about the tests you need. Write down the date, time, and location of each test.
  
  
• You or a close family member will be asked to sign a legal document called a consent form. It gives caregivers permission to do the procedure or surgery. It also explains the problems that may happen, and your choices. Make sure all your questions are answered before you sign this form.

The night before your procedure:

Ask caregivers about directions for eating and drinking.

The day of your procedure:

• Caregivers may insert an intravenous tube (IV) into your vein. A vein in the arm is usually chosen. Through the IV tube, you may be given liquids and medicine.
  
  
• An anesthesiologist may talk to you before your surgery. This caregiver may give you medicine to make you sleepy before your procedure or surgery. Tell your caregiver if you or anyone in your family has had a problem using anesthesia in the past.

Treatment

What will happen:

• You will be given either local or general anesthesia medicine. Local anesthesia will numb the area where the catheter will be put in. General anesthesia will keep you asleep during your heart catheterization.
  
  
• An incision will be made into the skin and vein of your arm, neck, or groin. The catheter will be put into your vein. Dye will be given through the catheter. X-ray pictures will be taken as the catheter is guided through the vein and into your heart. A piece of heart tissue may be collected and tested during your heart catheterization.
  
  
• The pressure in your heart will be measured. The catheter may be left in place to monitor your pressures constantly, or it may be removed. If the catheter is removed, firm pressure may be held for up to 30 minutes to help the vein stop bleeding. A pressure bandage will be placed over your procedure area wound. If the catheter is left in, it will be 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.

Contact a caregiver if

• You are late or cannot make it to your procedure.
  
  
• You have a fever.
  
  
• Your symptoms, such as chest pain or shortness of breath, get worse.
  
  
• You have questions or concerns about your procedure.

Seek Care Immediately if

• Discomfort in the center of your chest that feels like squeezing, pressure, fullness, or pain, that lasts for more than a few minutes or keeps returning
  
  
• Discomfort or pain in your back, neck, jaw, stomach, or one or both of your arms
  
  
• Feeling sick to your stomach
  
  
• Having trouble breathing
  
  
• A sudden cold sweat, particularly in combination with chest discomfort or trouble breathing
  
  
• Feeling very lightheaded or dizzy, particularly in combination with chest discomfort or trouble breathing