Where to go:
Park in front of hospital, go to Patient Registration, and report directly to Admissions Desk.
- Please report to the Hospital two hours prior to your procedure time.
- If possible and if you are not on Coumadin or Lovenox (blood thinners) please have your blood tests and chest x-ray done 1 or 2 days before the procedure.
- If you must have your blood tests and chest x-ray done the same day as your heart catheterization, the Registration staff will escort you to the Outpatient Lab. If you have not had a chest x-ray within 3 months the Outpatient Lab will escort you to Radiology.
- After your chest x-ray is complete our transportation staff will escort you to Day Hospital where our Nurses will prepare you for your Heart Catheterization.
- Do not eat or drink anything after midnight the night before your procedure. Take only a sip of water with prescribed medications as directed by your physician the day of your procedure.
- If you are taking medications for diabetes your Cardiologist may give you special instructions on how to take these medicines the day of the procedure.
- If you have any questions please call the Cath Lab at 291-6733 or your Physicians office.
What to expect before the procedure:
Your Cardiologist has explained to you that you need to have a Cardiac Catheterization; here is what you can expect. There are many reasons for why a heart catheterization is performed and your doctor will take time to explain your specific situation. Many times this procedure is performed because your doctor has noticed something abnormal on a diagnostic test such as a Stress Test, EKG or Echocardiogram. After the doctor explains the procedure to you the office staff or the Nurse if you are already in the hospital will schedule the procedure with the Cath Lab.
If you are already in the hospital the Nursing staff will prepare you for the test and make sure that all of the pre procedure tests are completed and on your chart. If you are scheduled as an outpatient you will be instructed to report to the hospital 2 hours before your procedure so that all lab work and x-rays can be completed, or your Cardiologist will schedule you to get your testing done the day before the test.
Once you have had all of your pre cath tests completed you will be escorted to Day Hospital, which is our medical and surgical outpatient unit. At Day Hospital you will be greeted by the unit clerk in the waiting room and then escorted back to the unit by the Day Hospital staff.
The Nurses and staff in Day Hospital will prepare you for your Cath Lab procedure, which includes:
- Changing your clothes into a hospital gown.
- Performing a complete Nursing assessment (vital signs, weight, temperature, listening to your heart and lungs and checking your medical chart etc.)
- Starting an intravenous line.
- Shaving your groin for the procedure.
- Administering any medications that have been ordered by your doctor for the day of your procedure.
After your Nurse has completed your pre procedural preparation you will be taken to the Cath Lab. Every attempt will be made to get your procedure started on time however there are times that unanticipated emergencies will need to be done immediately which could delay your procedure. In any case you will need to allow for a whole day for any cath lab procedure.
- 2 hour prep time
- 1-2 hours for the procedure
- 2-6 hours for recovery
What to expect during your procedure:
During your heart catheterization there will be 3 Cath Lab staff members and your Cardiologist in the room with you. One of the Cath Lab staff will explain the procedure and answer any questions you might have. The rest of the team will start to get you ready for your procedure, which will include:
- Talking to you and making you feel comfortable.
- Placing you on a heart, and blood pressure monitor.
- Preparing your groin for the procedure.
- Placing sterile drapes over your lower body.
- Reading your chart and asking you questions regarding your medical history.
Once the team has made you ready the Cardiologist will come into the room and start the procedure. The Cardiologist will introduce him or herself to you and let you know that he or she will be starting.
The only pain you should feel is at the very beginning when the doctor injects the local anesthetic into your groin, this will feel like a sting and burn for a few seconds until the anesthetic medicine starts to work. Once the medication starts to work you should not feel any more sharp pain, however you may feel some pressure while the doctor inserts the catheter into the blood vessel in your groin (sheath). Once the sheath is inserted the team will measure pressures and take pictures of your heart under the x-ray camera.
Taking pictures includes inserting a longer catheter through the sheath in your groin, which will then be advanced through your blood vessels to your heart. You will not feel the catheters moving inside of your body. You can watch the pictures if you wish on the computer monitor to your left.
What is the Cardiologist looking for during a Heart Catheterization?
During the procedure the doctor will take measurements of certain pressures in your heart using the catheters. Some procedures require more measurements than others and you will need to lie still and quiet so that accurate measurements can be obtained. After the measurements are complete the doctor will take x-ray pictures of your heart arteries (coronary arteries) and the important pumping chamber of your heart (left ventricle). X-ray dye will be injected into your heart arteries, which will momentarily take the place of the blood and outline the heart arteries under the x-ray camera.
The doctor will take several pictures of each of the 4 major arteries. The 4 major arteries are the Right Coronary Artery, Left Main Coronary Artery, Left Anterior Descending Coronary Artery and Left Circumflex Coronary Artery. All of these arteries also have smaller branches associated with them. If you have had bypass surgery in the past the doctor will also take pictures of your bypass grafts. The doctor is looking for segments on these arteries that are pinched and might be restricting the flow of blood to your heart.
After or just before the arteries are imaged the doctor will take a picture of the Left Ventricle. The left ventricle is the major pumping chamber of your heart and is responsible for pushing blood through your entire body. During this picture you may feel a warm sensation travel through your body that will subside within about 30 seconds. The Cardiologist uses this picture to assess the strength of your heart and how well it pumps blood to your body.
After all of the diagnostic information is obtained the Cardiologist will determine if any interventions need to be performed. If any abnormal findings are discovered the Cardiologist will discuss all of your treatment options. If the doctor recommends that an angioplasty or stent be performed these procedures are usually done on the same day as the diagnostic portion of the test. Please see the links below for descriptions of Stent Implantation and Angioplasty.
What to expect after the procedure:
After the procedure the Cardiologists will discuss what he or she sees on the images. If there is no angioplasty, stents or surgery needed you will be taken off of the procedure table and moved into the recovery area.
If your Cardiologist feels that an angioplasty or stent procedure is warranted you will most likely stay on the table and have that completed at the same time. If your Cardiologist determines that surgery is the best option you will be taken to the recovery area where one of our heart surgeons will explain how they can help treat your heart disease.
In the recovery area the Nurse or Technologist will remove the tubes from your groin. If you are on blood thinners, we will perform blood tests to determine when it is safe to remove the tubes.
The procedure for removing the tubes takes approximately 15 – 20 minutes. In order to remove the tubes safely a Technologist or Nurse will need to put pressure on your groin for about 15 minutes. Discomfort is minimized because the groin is usually still anesthetized from the procedure however you will feel firm pressure while the tubes are being removed.
The Tubes are placed in an artery and arteries have a high pressure that is why an outside force is needed to help the artery heal itself. A small patch is also used to aid in sealing the artery. This patch is a small piece of paper with a medicine in it that promotes clotting of the blood in the skin and muscle above the artery.
Once the Technologist or Nurse has successfully stopped the bleeding they will remind you of the following instructions to comply with while you are on bedrest:
- Keep your leg straight, do not bend at the knee
- Do not try to lift your head off of the pillow as this increases the pressure in your leg artery (femoral artery) and may cause it to bleed.
- If you need to cough or sneeze place firm pressure on the dressing to prevent the artery from bleeding again.
- If you feel anything warm or wet inform your Nurse immediately.
- Your Nurse will check your groin periodically while you are on bed rest to make sure your site is healing appropriately.
- Remove the dressing in 24 hours with warm water.
Keep in mind that a Nurse or Cath Lab Technologist will be nearby at all times while you are in the recovery area or in the hospital. If you have any questions or concerns please feel free to ask one of the staff at any time. Our only job is to keep you comfortable and help you get well while you are here at Lancaster Regional.
If you need to remain in the hospital your Nurses and Doctors will keep you informed of your plan of care and what the next step is to get you home. If you will be discharged the day of your procedure you will finish out your bedrest in the Day Hospital and then be released from there.
The Day Hospital Nurses will go over your discharge instructions and make sure you are set up for any medication changes or follow up doctor appointments. The Day Hospital Nurse will also make sure your leg has healed and there is no residual bleeding. The Nurse will instruct you on what your restrictions are and what to do if you notice bleeding at the groin site. In the rare case that you notice bleeding at your groin site at home, apply firm pressure and call 911.