When a person is experiencing shortness of breath and fatigue when they are mowing the lawn or doing other physical exertion, their doctor may first order a stress test and depending on what it shows, a cardiac catheterization may be needed.

What is a cardiac catheterization and what is its purpose?

A cardiac catheterization, which is sometimes called a cardiac cath or a coronary angiogram, is an “invasive imaging procedure” that allows heart doctors to evaluate the heart’s function. According to the Cleveland Clinic, Cleveland, Ohio, its used to evaluate or confirm the presence of coronary artery disease, valve disease or disease of the aorta; evaluate the heart muscle function or to determine if there is need for further treatment such as coronary artery bypass surgery.

What happens during a cardiac cath?

A catheter, which is a long narrow tube, is inserted through a hollow tube that has been inserted into a blood vessel in a patient’s leg or arm. The catheter is guided to the coronary arteries in the heart with the use of a special X-ray machine.

A contrast material or dye is injected via the catheter and X-rays are taken as the dye moves through the chambers of the heart, as well as the heart valves and major vessels.

The photographs are used by the doctor to identify any narrowing of the arteries or blockages.

During a heart cath, the doctor may perform an angioplasty, which is a non-surgical procedure to open narrowed arteries and increase blood flow.

A balloon angioplasty uses a balloon at the tip of the catheter to open the artery by inflating the balloon and compressing the fatty plaque or blockage against the artery wall and thus widening the diameter of the blood vessel to increase blood flow to the heart.

This type of angioplasty most times includes stenting. A stent is basically a tiny, metal mesh tube that acts as support inside the coronary artery by holding the plaque or blockage back against the arteries walls, thus keeping it from narrowing again. Once the stent is placed against the artery’s walls, the balloon is deflated and the stent remains, holding the artery open. Stents are usually permanent placements in the artery.

Catheterization and angioplasty is done with the patient awake. They are given a mild sedative as well as a local anesthetic at the catheter insertion site.

After a catheterization

A catheterization takes about 30 minutes but it is the preparation and the time after the procedure that makes it a long day for a patient. A patient lays flat for about 6 hours after the procedure to allow the catheter insertion site to close. While at one time they would go through the groin and use sandbags to apply pressure to the insertion site, today catheterizations are often down using the arm. A clear plastic cuff is placed around the wrist over the insertion site and air pressure is applied.

From time to time while the patient is in recovery, the site is checked easily without disturbing the site as it can be easily seen through the clear plastic cuff to determine if there is any blood leakage. After a set amount of time, air pressure will be removed a little at a time, with a waiting period in between each removal. Finally all of the air pressure is removed and the cuff can be as well.

Caring for insertion site

When a patient goes home there is a bandage over the insertion site. The morning after that bandage can be removed and it can be covered with a small Band-Aide. The site itself will likely be black and blue for several days. There may even be a small lump at the site.

Usually a patient is told to take it easy for the first couple of days and avoid any heavy lifting. This is to make sure the strain of heavy lifting doesn’t break open the clot at the insertion site so that it begins bleeding. If that happens pressure needs to be held on the site until the bleeding stops. If one follows directions given at discharge, this is very unlikely to happen.

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