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Cardiac Catheterization - What To Expect

BEFORE YOUR HEART CATHETERIZATION

A day or two prior to your appointment, you will receive a phone call from a boarding clerk and/or pre-screening nurse with information on your appointment time and specific medication instructions. Please tell your physician if you have any allergies especially to latex, iodine/contrast or aspirin. Prior to the procedure you will also discuss your medications with your physician as some medications may require adjusting.

What to bring to your appointment

  • physician scripts
  • referrals/authorization, if required
  • picture ID
  • health insurance information
  • list of medications and doses currently taking
  • co-pay will be collected at time of service 

General directions

  • No vitamins or supplements the day of procedure.
  • You may shower, but no powder or lotions; deodorant is acceptable.
  • Wear comfortable clothing.
  • You will not be permitted to drive home after your procedure. Therefore, you will need a family member and/or friend to travel with you.
  • You may be admitted to the hospital so pack toiletries or other items that will make your stay more comfortable. You can leave them in your car and family can retrieve them if needed. Please leave valuables at home.
  • Cardiac catheterization is not generally a long procedure, but preparation and recovery will add several hours to your appointment. Please expect to stay most or all of day for your procedure.

Specific reminders

  • If you are diabetic, no diabetic pills the morning of procedure.
  • If you are diabetic on insulin, you will receive specific instructions from your physician or pre-screening nurse on how to adjust your insulin.
  • If you have allergies to iodine/contrast, you will require pre-medication to prevent reactions. Your physician will provide a prescription for this pre-medication.
  • Plan to take four baby aspirins (325 mg) prior to your catheterization as instructed by your physician. If you are on Brilinta (ticagrelor), you will only need 81 mg of aspirin.

Medications patients may be taking

  • Take prescription medications with sips of water in the morning unless otherwise instructed.
  • Plavix (clopidogrel), Effient (prasugrel) or Brilinta (ticagrelor) should continue if currently taking it.
  • Coumadin (warfarin) will be stopped several days prior to procedure. Your physician will provide you with a stop taking date.
  • Pradaxa (dabigatran), Xarelto (rivaroxaban) or Eliquis (apixaban) will be stopped prior to procedure. Your physician will provide you with a stop taking date.
  • No diuretic (water pill) the morning of procedure.

If your appointment time is before noon

  • You should not eat after midnight.
  • You are allowed to drink clear liquids until you leave for the hospital (water, tea, black coffee only).

If your appointment time is after noon

  • You may eat a light breakfast before 8 a.m. but nothing after that.
  • You are allowed to drink clear liquids until you leave for the hospital (water, tea, black coffee only).

WHEN YOU ARRIVE FOR THE PROCEDURE

  • Please bring a complete list of your medications, including dosages.
  • A nurse will review medications and allergies with you as you are prepped for your procedure. You may be repeatedly asked allergies during your stay. This is for your safety.
  • Baseline blood pressure, heart rate and rhythm will be recorded.
  • The nurse may need to shave the groin or forearm area to prepare for catheter insertion. The chest may also be shaved to allow for ECG lead placement.
  • An IV line will be started to give fluids and medications.

IN THE CARDIAC CATHETERIZATION ROOM

  • The catheterization room may be cool and dimly lit.
  • You will lie flat on a narrow procedure table. Staff will keep you as warm and comfortable as possible.
  • The groin or forearm will be cleaned to reduce infection.
  • Your blood pressure and ECG will be monitored throughout the procedure.
    Sterile drapes will cover you during the procedure.
  • You will receive an intravenous sedative medicine to relax. You may feel drowsy or sleepy during the procedure.
  • The access area will be numbed with local anesthetic called lidocaine. You may feel stinging as the local anesthetic is given.
  • The cardiologist will insert a short plastic tube called a sheath into your wrist, leg or arm. You may feel pressure at this point, but should not feel pain. Tell the doctor or nurse if you experience pain.
  • The catheters will be put through the sheath, into the blood vessel and to your heart. You should not feel the catheters in your heart. Tell the doctor or nurse if you feel pain. 
  • Contrast will be injected through the catheter to visualize blood vessels, valves, and chambers.
  • Pictures and videos of your heart will be recorded with the X-ray camera. These pictures and videos will be seen on the monitors in the room.
  • You may have an interventional procedure performed with your catheterization (angioplasty or stent)
    Sheaths may be removed during or after your procedure.

AFTER THE PROCEDURE

  • Sedation will wear off as you wait in post-procedure area.
  • You may eat and drink after your procedure, but the nurse may ask you to wait until the sedation wears off to prevent nausea.
  • If catheter was inserted in the arm, the site will be bandaged or have a pressure device applied. You will be able sit up, but your arm will be immobilized. You will be observed for several hours post-procedure for side-effects.
  • If catheter was inserted at the groin, the puncture site will be closed with manual pressure or a special closure device. You will need to lie flat for two to six hours after the sheath is removed from your leg.
  • You will be hydrated post procedure to clear the contrast from your body. You may need to urinate frequently. You will need to use a bed pan or urinal while on bed rest.
  • The cardiologist will share results of catheterization. We recommend a family member be present as sedatives may cause you to be forgetful.
  • The doctor will determine if you are going home or need to be admitted after your procedure. If you are discharged, this will generally be three to six hours after your procedure. 

Discharge instructions

  • Plan for a family member or friend to drive you home.
  • Arrange for an adult to be with you for 12 hours upon arrival at home.
  • Your driving will be restricted for two days.
  • Lifting and strenuous activity is generally restricted for three to five days post procedure.
  • Detailed discharge instructions regarding medications, diet, wound site care, activity, and follow-up care will be provided prior to leaving the hospital.
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