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Heart Catheterization

AMBULATORY CARE:

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 the valves, blood vessels, or 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:

  • Your healthcare provider will tell you how to prepare. He or she may tell you not to eat or drink after midnight on the day of the procedure. Arrange to have someone drive you home after you are discharged.
  • Tell your provider if you are sick or have been sick during the week before the procedure.
  • Tell your provider about all medicines you currently take. He or she will tell you if you need to stop any medicine for the procedure, and when to stop. He or she will tell you which medicines to take or not take on the day of your procedure.
  • You may get contrast liquid to help the parts of your heart show up more clearly in pictures. Tell your provider if you had an allergic reaction to contrast liquid or other medicines.
  • You may need a chest x-ray, ultrasound, or blood tests before the procedure. You may also need an electrocardiogram (ECG). Talk to your provider about these or other tests you may need.

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 medicine 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, but you should not feel pain. You may need to stay 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 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. Contrast liquid may be used to help heart tissues, blood vessels, or valves show up more clearly on the x-ray. Oxygen and pressures may be measured in parts of your heart and blood vessels. Blockages in your blood vessels may be fixed. Valves in your heart may be opened, repaired, or replaced. A small piece of heart tissue may be removed to stop irregular heartbeats. An atrial or ventricular septal defect may be repaired. A stent (small tube) may be left inside your artery to hold it open.
  • Your provider will remove the catheter. He or she may use clamps, stitches, or other devices to close the procedure area. Pressure will be applied to the area for several minutes to stop any bleeding. A pressure bandage or other pressure device may be placed over the area to help prevent more bleeding.

What to expect after heart catheterization:

  • You will be attached to a heart monitor until you are fully awake. Healthcare providers will check your pressure bandage often 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. When your providers see you are okay, you may be able to go home. If you will stay in the hospital overnight, you will be taken to a hospital room.
  • You may have pain, swelling, or bruising at the catheter site for a few days.

Risks of heart catheterization:

You may bleed more than expected or develop an infection. You may need surgery to repair damage from the catheter to your heart or blood vessels, or to stop bleeding. You may develop a life-threatening blood clot in your arm or leg. You could have a heart attack or stroke during or after the procedure. You could also develop irregular heartbeats.

Call your local emergency number (911 in the US) if:

  • Your catheter site does not stop bleeding even after you apply firm pressure for 10 minutes.
  • You have any of the following signs of a heart attack:
    • Squeezing, pressure, or pain in your chest
    • You may also have 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, or have chest pain.
  • You cough up blood.
  • You have trouble breathing.

Seek care immediately if:

  • Blood soaks through your bandage.
  • Your stitches come apart.
  • Your arm or leg feels numb, cool, or looks pale.
  • Your procedure area gets swollen quickly.

Call your doctor if:

  • You have a fever or chills.
  • Your procedure area is red, swollen, or draining pus.
  • Your procedure area 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.

Medicines:

You may need any of the following:

  • Blood thinners help prevent blood clots. 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 a blood thinner. Wear a bracelet or necklace that says you take this medicine.
    • Do not start or stop any other medicines unless your healthcare provider tells you to. Many medicines cannot be used with blood thinners.
    • Take your blood thinner exactly as prescribed by your healthcare provider. Do not skip does or take less than prescribed. Tell your provider right away if you forget to take your blood thinner, 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 decreases pain and fever. It is available without a doctor's order. Ask how much to take and how often to take it. Follow directions. Read the labels of all other medicines you are using to see if they also contain acetaminophen, or ask your doctor or pharmacist. Acetaminophen can cause liver damage if not taken correctly. Do not use more than 4 grams (4,000 milligrams) total of acetaminophen in one day.
  • 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.

Care for your procedure area:

  • Keep the area clean and dry. Do not take baths or go in hot tubs or pools. You may be able to shower the day after your procedure. Remove your pressure bandage before you shower. Carefully wash the procedure area with soap and water. Then pat the area dry. Change your bandage when it gets wet or dirty. Check the area 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 the area.
  • Apply firm, steady pressure if bleeding occurs. A small amount of bleeding from the area is possible. Apply pressure with a clean gauze or towel for 5 to 10 minutes. Call your local emergency number if bleeding becomes heavy or does not stop after 10 minutes of pressure.
  • Do not lift anything heavier than 5 pounds until directed by your healthcare provider. Heavy lifting can put stress on the area 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 the area. 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. This helps prevent bleeding from the area. Do not climb stairs more often each day than your provider says is okay.

Self-care:

  • Your healthcare provider will tell you when you can drive and return to work and other daily activities.
  • Drink liquids to flush the contrast liquid from your body and 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 your blood thinners after your procedure, or he or she may have you wait a few days.
  • Manage other medical conditions, if needed. Diabetes or 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.

If you have a stent:

  • Carry your stent card with you at all times.
  • Let all healthcare providers know that you have a stent.

Follow up with your doctor as directed:

Write down your questions so you remember to ask them during your visits.

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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.

Further information

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