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What to Expect on The Day of Your Heart Catheterization: A Patient Guide

     Here is a quick guide to explain what you should expect on the day of your Heart Catheterization. Before coming to the hospital you should have already seen the doctor in his office and received a pre-operative phone call from a Registered Nurse who will get some information from you regarding your medication and health history. When you arrive at the hospital be prepared to spend the night unless you were told specifically you would be going home the same day. After you have checked into registration you should be led to a pre-operative staging area where you will be prepped for your procedure. After some more intake questions the Registered Nurse (RN) taking care of you will start an IV and shave your groins. If you are having a Radial Heart Catheterization the RN will shave your wrist as well. The radial artery lies on the thumb side of your wrist and can be accessed for a Heart Catheterization procedure. Your femoral artery lies on either side of your groin and is another access point for the procedure.
      I would like to pause here and recommend the radial heart catheterization procedure to anyone offered it by their cardiologist. I also recommend finding a cardiologist who specializes in radial artery heart catheterization if possible. The difference between the radial approach and groin approach is that you don't have to lie flat for 2 to 4 hours after your procedure. It is much safer to undergo a radial heart catheterization due to the decreased bleeding risk. The risk of a major bleed is the most common complication for a heart catheterization procedure and can be reduced by using a radial artery (wrist) approach. 
     Once the pre-op RN has completed their prep, the cardiologist and intra-op RN should interview you. After these interviews you will be taken to the procedural suite where you will meet your procedural team and have monitoring patches placed on your chest, shoulders, and legs. Your procedural sites will be washed with an alcohol based solution called chlorohexadine. You will then be covered by a large blue drape. The procedure will start with a standard surgical time-out and you should hear an audible beep that mirrors your own heart beat. These are two safety features that are extremely important.
     During the procedure you will most likely be lightly sedated. This means that you could sleep, remember parts of the procedure, or remember everything. It all depends on how much sedation medication your cardiologist is willing to give you and how much sedation you are able to tolerate. If you are lightly sedated, do not fear, the heart catheterization procedure is entirely tolerable. I would equate it to being way more tolerable than a typical trip to the dentist.
     Now back to the procedure. During the procedure the lights will be flashing off and on. This is normal and enables the cardiologist and staff to see the black and white x-ray images better in the dark. It is also a signal that the fluroscopy (x-ray) is on. I will post an example of the pictures the cardiologist will be taking below.
     When the procedure is complete the cardiologist may review your images with you if you are awake and if there is something of interest to review. There are typically three outcomes of a heart catheterization. The first one is that the heart cath is purely diagnostic and nothing needs to be done; in other words, your arteries are clear and you will be discharged home. The second possibility is that you had blockages in your coronary arteries and the cardiologist was able to place small stents to scaffold open your arteries. This is called a percutaneous coronary intervention and typically requires you to stay one night. The third option is that you need bypass surgery or open heart surgery. This will require a surgeon to talk to you and may be completed during the same hospitalization. The surgeon may also schedule your surgery sometime in the next few weeks. If this is the option given to you, do not fear. Coronary artery bypass surgery is an excellent procedure and the bypass grafts that the surgeon places typically last 20 plus years.
     After you are done with your procedure you will be given information regarding your medication regimen and procedural site care. Depending on what care is necessary for you, you will stay the night or go home the same day. As previously stated, the recovery for a radial heart catheterization procedure is much easier and several hours faster then a femoral or groin heart catheterization.
     I hope that the information I provided will help the reader through their procedure and give you an idea of what you can expect from your heart catheterization procedure. Please leave a comment below and subscribe for more blog posts on everything Cath Lab.



   


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