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What you need to know about heart catheterization:
Heart catheterization is a procedure that helps diagnose and treat some heart problems. Healthcare providers can measure oxygen levels and pressures in your heart. They can also fix problems with your valves, blood vessels, or the walls of your heart. You may need this procedure if you have chest pain, heart disease, or your heart is not working properly.
How to prepare for heart catheterization:
- You may need blood tests, a chest x-ray, ultrasound, or electrocardiogram (ECG) before your surgery. Talk to your healthcare provider about these or other tests you may need. You will need someone to drive you home and stay with you after your procedure.
- Your healthcare provider will talk to you about how to prepare for your procedure. He or she may tell you not to eat or drink anything after midnight on the day of your procedure. He or she will tell you what medicines to take or not take on the day of your procedure. You may need to stop taking blood thinners several days before your procedure. You can continue taking aspirin. You may be given an antibiotic through your IV to help prevent a bacterial infection.
- Contrast liquid may be used during your procedure. Tell a healthcare provider if you have an allergy to any contrast materials or other medicines.
What will happen during heart catheterization:
- You may be given general anesthesia to keep you asleep and free from pain during your procedure. You may instead be given IV sedation to make you feel calm and relaxed during the procedure. You may also be given local anesthesia to numb the surgery area. With local anesthesia, you may still feel pressure or pushing during your procedure, but you should not feel any pain.
- If you are given IV sedation or local anesthesia, you will be awake enough to follow directions. You may be asked to cough, deep breathe, or hold your breath. This will help your healthcare provider see your heart structures more clearly on x-ray.
- Your healthcare provider will insert a catheter and wire into a blood vessel in your neck, arm, wrist, or groin. He or she will move a wire through the catheter and up into your heart. Your healthcare provider may inject contrast liquid so he or she can see your heart tissue, blood vessels, or valves more clearly on the x-ray. He or she may measure oxygen and pressures in different parts of your heart and blood vessels. He or she may also fix blockages in your blood vessels or open up valves in your heart. He or she may repair or replace one of your heart valves. A small piece of your heart tissue may be taken to stop irregular heartbeats. Your healthcare provider may also repair an atrial or a ventricular septal defect.
- Your healthcare provider will remove the catheter. He or she may use clamps, stitches, or other devices to close the wound. Pressure will be applied to the wound for several minutes to stop any bleeding. A pressure bandage or other pressure device may be placed over the wound to help prevent more bleeding.
What will happen after heart catheterization:
- You will be attached to a heart monitor until you are fully awake. A heart monitor is an EKG that stays on continuously to record your heart's electrical activity. Healthcare providers will monitor your vital signs and pulses in your arm or leg. They will frequently check your pressure bandage for bleeding or swelling.
- You will need to lie flat with your leg or arm straight for 2 to 4 hours. Do not get out of bed until your healthcare provider says it is okay. Arm or leg movements can cause serious bleeding. After you are monitored for several hours, you may go home or may need to stay in the hospital overnight.
Risks of heart catheterization:
You may bleed more than usual or get an infection. You may have bruising or pain where the catheter was. You may need surgery to repair damages from the catheter to your heart or blood vessels or stop bleeding. You may get a blood clot in your arm or leg. You could have a heart attack or stroke during or after the procedure. Your heart could have irregular heart beats. The contrast liquid may cause kidney damage or an allergic reaction.
Call your local emergency number (911 in the US) for any of the following:
- You have chest pain.
- You have any of the following signs of a heart attack:
- Squeezing, pressure, or pain in your chest
- and any of the following:
- Discomfort or pain in your back, neck, jaw, stomach, or arm
- Shortness of breath
- Nausea or vomiting
- Lightheadedness or a sudden cold sweat
- You have any of the following signs of a stroke:
- Numbness or drooping on one side of your face
- Weakness in an arm or leg
- Confusion or difficulty speaking
- Dizziness, a severe headache, or vision loss
- You feel lightheaded, short of breath, and have chest pain.
- You cough up blood.
- You have trouble breathing.
- You cannot stop bleeding from the wound even after you hold firm pressure for 10 minutes.
Call your doctor if:
- Blood soaks through your bandage.
- Your stitches come apart.
- Your arm or leg feels numb, cool, or looks pale.
- Your wound gets swollen quickly.
- You have a fever or chills.
- Your wound is red, swollen, or draining pus.
- Your wound looks more bruised or there is new bruising on the side of your leg or arm.
- You have nausea or are vomiting.
- Your skin is itchy, swollen, or you have a rash.
- You have questions or concerns about your condition or care.
You may need any of the following:
- Blood thinners help prevent blood clots. You may need to take blood thinners after your procedure if your healthcare provider finds problems in your heart or blood vessels. You may also need them if he or she replaces one of your heart valves. Examples of blood thinners include heparin and warfarin. Clots can cause strokes, heart attacks, and death. The following are general safety guidelines to follow while you are taking a blood thinner:
- Watch for bleeding and bruising while you take blood thinners. Watch for bleeding from your gums or nose. Watch for blood in your urine and bowel movements. Use a soft washcloth on your skin, and a soft toothbrush to brush your teeth. This can keep your skin and gums from bleeding. If you shave, use an electric shaver. Do not play contact sports.
- Tell your dentist and other healthcare providers that you take anticoagulants. Wear a bracelet or necklace that says you take this medicine.
- Do not start or stop any medicines unless your healthcare provider tells you to. Many medicines cannot be used with blood thinners.
- Tell your healthcare provider right away if you forget to take the medicine, or if you take too much.
- Warfarin is a blood thinner that you may need to take. The following are things you should be aware of if you take warfarin.
- Foods and medicines can affect the amount of warfarin in your blood. Do not make major changes to your diet while you take warfarin. Warfarin works best when you eat about the same amount of vitamin K every day. Vitamin K is found in green leafy vegetables and certain other foods. Ask for more information about what to eat when you are taking warfarin.
- You will need to see your healthcare provider for follow-up visits when you are on warfarin. You will need regular blood tests. These tests are used to decide how much medicine you need.
- Acetaminophen may be given to decrease your pain and fever. This medicine is available without a doctor's order. Ask how much medicine is safe to take, and how often to take it. Acetaminophen can cause liver damage if not taken correctly.
- Take your medicine as directed. Contact your healthcare provider if you think your medicine is not helping or if you have side effects. Tell him or her if you are allergic to any medicine. Keep a list of the medicines, vitamins, and herbs you take. Include the amounts, and when and why you take them. Bring the list or the pill bottles to follow-up visits. Carry your medicine list with you in case of an emergency.
You may be able to shower the day after your procedure. Remove your pressure bandage before you shower. Do not take baths or go in hot tubs or pools. Carefully wash the wound with soap and water. Pat the area dry.
Care for your wound as directed:
Change your bandage when it gets wet or dirty. A small band-aid can be placed on your wound after you remove the pressure bandage. Monitor your wound every day for signs of infection such as redness, swelling, or pus. Mild bruising is normal and expected. Do not put powders, lotions, or creams on your wound.
- Apply firm , steady pressure if bleeding occurs. A small amount of bleeding from your wound is possible. Apply pressure with a clean gauze or towel for 5 to 10 minutes. Call 911 if bleeding becomes heavy or does not stop.
- Do not lift anything heavier than 5 pounds until directed by your healthcare provider. Heavy lifting can put stress on your wound and cause bleeding. Do not push or pull with the arm that was used for the procedure.
- Do not do vigorous activity for at least 48 hours. Vigorous activity may cause bleeding from your wound. Rest and do quiet activities. Short walks to the bathroom and around the house are okay. Ask your healthcare provider when you can return to your normal activities.
- Limit stair climbing to prevent bleeding from your wound. Plan activities on one floor and use stairs 2 times a day or less.
- Drink liquids to flush the contrast from your body. Also drink liquids to prevent blood clots. Ask how much liquid to drink each day and which liquids are best for you.
- Restart your blood thinners as directed. Your healthcare provider may tell you to start taking blood thinners after your procedure or he or she may have you wait a few days.
Manage other medical conditions:
Diabetes and high cholesterol increases your risk for another heart attack and stroke. Talk to your healthcare provider about your management plan. He or she will make a plan that helps you manage your conditions.
Follow up with your healthcare provider as directed:
Write down your questions so you remember to ask them during your visits.
Healthy living tips:
The following are general healthy guidelines. If your chest pain is caused by a heart problem, your healthcare provider will give you specific guidelines to follow.
- Do not smoke. Nicotine and other chemicals in cigarettes and cigars can cause lung and heart damage. Ask your healthcare provider for information if you currently smoke and need help to quit. E-cigarettes or smokeless tobacco still contain nicotine. Talk to your healthcare provider before you use these products.
- Eat a variety of healthy, low-fat, low-salt foods. Healthy foods include fruits, vegetables, whole-grain breads, low-fat dairy products, beans, lean meats, and fish. Ask for more information about a heart healthy diet.
- Drink plenty of water every day. Your body is made of mostly water. Water helps your body to control your temperature and blood pressure. Ask your healthcare provider how much water you should drink every day.
- Ask about activity. Your healthcare provider will tell you which activities to limit or avoid. Ask when you can drive, return to work, and have sex. Ask about the best exercise plan for you.
- Maintain a healthy weight. Ask your healthcare provider how much you should weigh. Ask him or her to help you create a weight loss plan if you are overweight.
- Get the flu and pneumonia vaccines. All adults should get the influenza (flu) vaccine. Get it every year as soon as it becomes available. The pneumococcal vaccine is given to adults aged 65 years or older. The vaccine is given every 5 years to prevent pneumococcal disease, such as pneumonia.
If you have a stent:
- Carry your stent card with you at all times.
- Let all healthcare providers know that you have a stent.
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