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Left Heart Catheterization

AMBULATORY CARE:

What you need to know about left heart catheterization:

Left heart catheterization is a procedure to look at your heart and its arteries. You may need this procedure if you have chest pain, heart disease, or your heart is not working as it should.

How to prepare for the procedure:

  • Your healthcare provider will tell you how to prepare. He or she may tell you not to eat or drink anything after midnight on the day of the procedure. Arrange to have someone drive you home when you are discharged.
  • 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 the procedure.
  • Contrast liquid will be used to show the parts of your heart more clearly in pictures. Tell your provider if you have had an allergic reaction to contrast liquid.
  • You may need blood or urine tests before your procedure. Talk to your healthcare provider about these or other tests you may need.

What will happen during the procedure:

  • You will be given medicine to help you relax. You will receive local anesthesia that will numb the area where the catheter will be placed. You will be awake during the procedure so that your healthcare providers can give you instructions. You will need to let them know if you have any discomfort.
  • Your healthcare provider will insert a catheter into an artery in your arm, wrist, or leg. He or she will use an x-ray to guide the catheter to your heart. Contrast liquid will be used to help heart blood vessels, muscle, or valves show up more clearly in the pictures. You may get a warm feeling or slight nausea right after the liquid is injected. This is normal, and will pass quickly. Your provider may remove a small sample of heart tissue and send it to a lab to be tested. He or she may also open a narrow or blocked heart valve or artery. A stent (small tube) may be left inside your artery to hold it open.
  • The catheter may be left in place to monitor pressure in your heart. When the catheter is removed, pressure will be applied to the site for at least 30 minutes to help decrease the risk of bleeding. A collagen plug or other closure device may be used to close the site. If the site is in your wrist, your healthcare provider will place a compression device around your wrist. Healthcare providers will cover the site with a pressure bandage to decrease bleeding.

What to expect after the procedure:

You will be taken to a room to rest until you are fully awake.

  • Do not get out of bed until your healthcare provider says it is okay. Keep your arm or leg straight. Arm or leg movement too soon can cause severe bleeding. Healthcare providers will check the procedure area for bleeding.
  • Extra liquid will help flush the contrast liquid out.
  • If the catheter was put in your wrist, the pressure device will be around your wrist. Healthcare providers will slowly decrease pressure in the device.
  • If the catheter was put in your leg, a pressure bandage will be in place. Apply pressure over the area with your hand if you need to cough.

Risks of left heart catheterization:

During the procedure, the catheter may tear an artery and cause bleeding. An air bubble may enter your lung, or your lung may collapse. You may have a heart attack. After the procedure, you may have bleeding or an infection. You may have damage to a heart valve. A fistula (abnormal opening) may form between an artery and vein. You may have irregular heartbeats that cause dizziness or fainting. You may get a blood clot in your leg or arm. These problems may become life-threatening.

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

Seek care immediately if:

  • Your arm or leg feels warm, tender, and painful. It may look swollen and red.
  • The catheter site is swollen and filled with blood or is bleeding.
  • The leg or arm used for your procedure is numb, painful, or changes color.
  • The bruise at your catheter site gets bigger or becomes swollen.
  • You are dizzy or have a severe headache or vision loss.

Call your doctor if:

  • You have a fever.
  • Your catheter site is red, leaks pus, or smells bad.
  • You have increasing pain at your catheter site.
  • You have questions or concerns about your condition or care.

Limit activity as directed:

  • You may feel like resting more after your procedure. Slowly start to do more each day. Rest when you feel it is needed. Ask your healthcare provider how long you need to limit movement and avoid certain activities. He or she will tell you when you can return to your usual daily activities.
  • If the catheter was placed in your wrist, do not place pressure on your arm, hand, or wrist. Do not push, pull, or lift anything heavy with that arm.
  • If the catheter was placed in your leg, support the catheter site with your hand if you need to cough.

Care for the procedure area:

Your healthcare provider will give you specific instructions. This will include when you can take a shower. Do not soak in a bathtub, pool, or hut tub until your provider says it is okay. Check the area each day for signs of infection, such as swelling, redness, or pus.

Drink liquids as directed:

Liquids help flush the contrast liquid used for your procedure out. Ask your healthcare provider how much liquid to drink each day, and which liquids to drink. Do not drink alcohol for 24 hours after your procedure.

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.

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