Let's learn about Cardiac Catheterization in a simple way!

Have you ever gone to see a doctor because of a chest pain or difficulty breathing and they told you that you needed to have a 'Cardiac Catheterization'? You might have been a little scared when you heard this name. It's normal to feel scared when you hear the word 'putting something in your heart'. But it's actually not as big a deal as we think, and it's not something to be afraid of. Let's talk about this in a simple way today, and find answers to all the questions you have in your mind.

What is Cardiac Catheterization?

Simply put, this is not open-heart surgery. This is a special test to check how your heart is working. It's like looking inside your heart.

In this procedure, a doctor inserts a very thin, flexible tube (catheter) through a vein in your arm or groin and into your heart. This tube allows the doctor to see clearly the condition of the coronary arteries, the blood vessels that supply blood to the heart, and the chambers of the heart.

Are there any types of this test?

Yes, there are two main types. It depends on the blood vessel where the catheter is inserted and the part of the heart that is being examined.

Why would a doctor recommend this test?

There may be several reasons why your doctor may recommend this test.

• Find out the exact cause of your frequent chest pain or abnormal heartbeat .
• Check for blockages in the blood vessels of the heart or problems with the heart valves .
• Take a small piece of heart muscle for testing (biopsy) .
• Look into conditions that weaken the heart muscle (cardiomyopathy) .
• Check for high blood pressure in the blood vessels connected to the lungs (pulmonary hypertension) .
• Obtain information that could not be found in other tests (such as ECG, Echo).
• This test is important to determine the best course of treatment. For example, whether to perform angioplasty , stent placement, or coronary artery bypass grafting (CABG) to treat a blocked artery.

How does this work? What happens inside?

Once the catheter is near the heart, a special liquid (contrast material) is injected into the blood vessels through it. Because this liquid is clearly visible on X-rays, the doctor can watch the blood flow inside the heart's blood vessels live on X-ray videos taken at the same time (this is called a coronary angiogram ).

From these X-ray images, the doctor can:

• Find exactly where a blood vessel is blocked or narrowed .
• Examine the size and shape of the heart's chambers and blood vessels.
• Check for any unusual holes or blood leaks anywhere in the heart.

Sometimes, the doctor can also perform further treatment while performing this test. This means that if a problem is detected, it is possible to provide a solution right away.

• Angioplasty: Reopening a blocked blood vessel by inflating it with something like a balloon.
• Stent placement: Inserting a small mesh-like device into the opened blood vessel to keep it from closing again.
• Valvuloplasty: Opening a narrowed heart valve.

How long will this take?

The test itself only takes about 30 minutes . But it also takes time to prepare you for the test and to be monitored after the test. So all in all, you may have to stay in the hospital for 5-9 hours or more . So, expect to be in the hospital all day on the day you have this test.

What to expect before, during and after the test?

It is very important that you are aware of this process in advance.

Before the test

• You will be advised to refrain from eating or drinking for 6-8 hours before the test.
• Your doctor may tell you to temporarily stop or change the dosage of some medications you are taking (especially blood thinners).
• Tell your doctor about any allergies you have and all medications you use.
• When you go to the hospital, you will be given a special outfit to wear.
• A cannula (IV line) is inserted into a vein in the arm to give medications and fluids.
• To monitor your heart rate, electrodes, similar to stickers, are placed on your chest. These are connected to an EKG machine.
• They'll give you a mild sedative to relax you. But you're conscious and can hear what the doctor is saying.

During the test

• The area where the catheter will be inserted (arm or groin) is numbed with a small needle.
• The catheter is then passed through the vein to the heart. You may feel a slight pressure at this point, but there will be no pain .
• When the contrast fluid is injected to look inside the heart, you may feel a slight warmth . This will go away in a few seconds.
• You will be asked to hold your breath for a while while taking the X-ray.
• When the test is finished, the catheter is removed.

After the test

• The catheter is inserted and the area is tied tightly to stop bleeding.
• If done by hand: You need to keep your arm straight for about an hour. You can walk.
• If it was done in the groin: You will need to lie in bed with your leg straight for a few hours (about 2-6) to prevent bleeding.
• You need to drink plenty of water to help the contrast fluid leave your body quickly.
• You can usually go home the same day, but sometimes you may be asked to stay in the hospital overnight.
• You can't drive a car when you're going home , you need someone to take you home.
• You should avoid heavy lifting and strenuous work for a few days.
• You can shower, but it is not good to soak the wound in water (e.g., take a bath, swim) for a week.

What are the risks of this?

As with any medical procedure, there are some risks involved, but remember, serious complications are very rare .

• An allergic reaction to the contrast fluid or other medication.
• Bleeding, bruising, or infection at the catheter insertion site.
• Abnormal heartbeat.
• Low blood pressure.
• There is a very small risk of blood clots, heart attack, or stroke.
• Kidney damage (especially in people with pre-existing kidney disease).

When you need to see a doctor quickly

If you experience any of the following symptoms after returning home, notify your doctor immediately .

• If you get a fever .
• If you feel dizzy or faint.
• If the area where the catheter was inserted becomes swollen, painful, or if blood or other fluid leaks from there .
• If you develop new chest pain or difficulty breathing .
• If you experience discoloration, numbness, or coldness in your arm or leg (on the side where the catheter was inserted).

If you are experiencing symptoms that resemble a heart attack or stroke, don't waste time and go to a hospital's Emergency Department (ETU) immediately.