The Cardiac Cath learning module is made up of 6 parts or sections. You may navigate through the pages by clicking on the green arrows or numbers (above), the specific questions (below) or the gray menu items on the left.
What is Cardiac Catheterization?
What Preparations are Needed?
How is Cardiac Cath performed?
What do I need to know about the equipment?
What is experienced in the Cath lab?
How long does it take?
What preparations are needed?
What happens after arrival in the cath lab area?
How safe is the procedure?
What is the reliability of the test?
How quickly will I get the results?
Show me a panoramic view of the Cardiac cath lab?
How Long Does It Take?
The actual left heart cath procedure usually takes approximately 10 to 15 minutes. However, it may take longer if the patient has unusual anatomy of the arteries and there are technical difficulties. Additional time will be needed if the patient has had prior bypass surgery since additional pictures of the bypass vessels are needed. This can add another 10 to 15 minutes to the procedure time. An additional 10 to 15 minutes are needed if the patient requires right heart catheterization.
Approximately three to four hours after the procedure, the patient gets out of bed. The patient is usually discharged within six hours of the procedure unless additional treatment or procedures are required. A little soreness and a Band-Aid are usually the only traces of the procedure. Some patients may display a bruise at the site.
Following discharge, the mild soreness and slight bruising should resolve. However, some patients may experience tenderness and mild pain that can last a few days. If there was bruising at the time of discharge, the area of discoloration may increase in size. This does not necessarily indicate additional bleeding and may be due to the spread of blood pigments under the skin. However, you must notify your cardiologist if you note an increased swelling, particularly if it pulsates. Persistent fever is rare and also requires that the patient contact the cardiologist's office. You may be instructed to drink plenty of fluids on the night of the procedure to compensate for the urinary fluid loss induced by the contrast material.
How Safe is the Procedure?
Cath is a relatively safe procedure and is carried out all over the world on an outpatient basis. However, it must be recognized that the procedure is frequently carried out in patients with heart disease and that catheters have to be inserted into blood vessels. Despite this, the risk of a serious complication is estimated to be less than 4 and probably around 1 to 2 per thousand. Rare serious complications can include death, a heart attack, stroke and need for emergency surgery. Occasionally, patients may exhibit a rash as an allergic reaction to the contrast material. Serious allergic reactions are rare and can usually be controlled. Rarely, the contrast material may affect kidney function. This problem is more likely to occur if the patient has underlying kidney disease, and is more likely among diabetics than among non-diabetics. Other infrequent complications can include bleeding that requires blood transfusion or surgical repair, blood clots, and a sustained abnormal cardiac rhythm.
What is the Reliability of the Test?
Cardiac Cath is the "gold standard" against which all other coronary diagnostic tests are measured. However, it should be remembered that it can only pick up "fixed" Coronary Artery Disease (CAD) and may miss coronary spasm where the blockage may come and go. In these cases, medications can be used to provoke and confirm, or exclude, the presence of spasm.
How Quickly Will I Get the Results?
The cardiologist will give the patient and family a preliminary report immediately after the procedure. However, a final report will not be available until the patient is ready to go home. Some cardiologists will meet with the family prior to discharge, while others will set up a subsequent appointment to go into the details of the procedure and how it will change treatment. If there are serious blockages, and if indicated by the patient’s clinical picture, hospitalization for medical treatment may be scheduled. Others may be set up for a balloon angioplasty or stent procedure, or even bypass surgery. In some cases, the angioplasty and stent procedure may be required and carried out immediately following cardiac cath. This will be discussed with the patient and family before it is performed. However, the far majority of patients go home on the same day of the procedure.
Shown on the left, is a movie of the Left Coronary Artery (LCA) as it was filmed in various projections while the camera was tilted from one view to another. You may click on the labels to view each of the projection as it is "seen" by the x-ray tube. Note how each view produces more or less overlap of specific branches. The picture on the right displays the Right Coronary Artery (RCA).
Shown below is a 95% blockage in the left anterior descending coronary artery (LAD)