You have been scheduled for a Heart Catheterization…

WHY A HEART CATHETERIZATION?

Heart catheterization allows cardiologists to directly measure pressures within the heart, evaluate heart function and most importantly it allows them to see the arteries that supply blood to the heart – the “coronary arteries”.

Blockage of the coronary arteries is called “Coronary Artery Disease” (CAD) and it is the number one cause of death in the United States.

The heart is a pump, and it requires a healthy supply of blood flow to keep it working normally. Heart attacks and heart failure can occur when the flow of blood to the heart is limited or interrupted.

Two arteries supply blood to the heart, the left and right coronary arteries. The left coronary artery supplies the majority of blood to the heart and divides itself into a “Left Anterior Descending” (LAD) and a “Left Circumflex” (LCX). Large branches called “Diagonal” and “Obtuse Marginal” branches arise from these arteries. Blockages in the major arteries and their large branches are a common cause of heart failure and death.

WHAT DO I DO?

First, RELAX! It sounds like a major undertaking but the truth is that Heart Catheterization is a commonly used, safe and effective tool to evaluate and treat heart disease. The use of small flexible catheters and new contrast agents combined with the high level of skill and experience of the modern catheterization laboratory make this a relatively simple and painless procedure. The risk of a major complication (Heart Attack, Stroke, Death) is very small, less than one in a thousand. Minor complications such as bleeding or pain, while more common (less than one in twenty), usually resolve without further treatment.

Eat no food after Midnight prior to the Heart Catheterization.

Take your scheduled medications on the morning of the Heart Catheterization with a small amount of water.

If you take Insulin take only ½ your usual morning insulin dose. For example if you usually inject 20 units of insulin, you should only inject 10 units.

If you are diabetic and on Metformin (Glucophage) do not take this medication on the morning of the procedure or for 48 hours (two days) after the procedure. If you are on other oral agents you should take these as scheduled.

If you are diabetic bring a sugary drink with you. You may drink this if your blood sugar becomes low prior to arriving at the hospital.

Bring a change of clothes and be prepared to stay over night in the Hospital if angioplasty or stenting of the coronary arteries is required.

Tell us if you have had any prior reactions to contrast agents. These agents are used for CT scans and some other imaging studies.

We will shave the right and left groin on the morning of the procedure. You are free to do this yourself on the morning of the procedure before coming to the hospital.

You will receive a combination of medications to help you relax during the Heart Catheterization. Do not be surprised if you do not remember the procedure. Bring a family member or friend with you to drive you home after the Heart Catheterization. Because of the medications you receive to relax, it will not be safe for you to drive yourself home.

A small plug or “closure device” is often used at the end of the Heart Catheterization. This may cause a small, noticeable pea-sized “lump” or “bump”. This is normal and should not cause concern.

You may shower on the day following your Heart Catheterization.

You may resume usual daily activity (walking, dressing, cleaning) after your Heart Catheterization but we recommend that you not pursue exercise or heavy lifting (>20 pounds) for 48 hours.

If your catheterization is scheduled after 1pm you may eat a light breakfast prior to 8am.

WHAT DOES THE CARDIOLOGIST DO?

The Cardiologist will place a small “sheath” in the femoral artery. This is sheath is similar to the “IV” catheters that are often put into veins to deliver medications or fluids. Through this sheath the Cardiologist will slide small flexible “catheters” or tubes through which pressures can be measured and contrast injected. The whole procedure usual takes 15-20 minutes depending on the difficulty of manipulating these catheters into position.

If a critical blockage is identified in a major artery and Angioplasty or “Balloon Treatment” may be used to treat the blockage. A metal STENT may be used to prevent further blockage from occurring. The Heart Clinic of Austin collaborates with experienced Interventional Cardiologists who will participate in your care should you require such treatment. If CABG or “Bypass” surgery is needed you will have an opportunity to speak to one of several experienced Cardiac Surgeons who work to help care for our patients.

HAVE MORE QUESTIONS?

JUST ASK!

We are available to answer any question that arises prior to, or after, the procedure.

Jeffrey Michel, MD FACC
Heart Clinic of Austin, PA
7/28/09