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Cardiac Catheterization with Coronary Angiogram
What is an Angiogram?
An angiogram is a remarkable type of procedure that allows doctors to
use an X-Ray camera outside your body to see how blood circulates within
the walls of your heart. This is accomplished with only one small incision,
typically at the very top of your leg. Through this incision, a very small
tube - a catheter - is threaded to your heart. When the tube is exactly
in place at the openings to each of the coronary arteries, X-ray dye is
released. The X-ray camera outside of your body will show exactly where
the dye reaches, and where it doesn't. If the dye doesn't make it to part
of the heart wall, it indicates that there's a blockage in the vessel
feeding that portion of the heart wall muscle.
Heart Anatomy
Your heart is your body's hardest-working muscle- a hollow shape about
he size of your fist, pumping blood throughout your body, day after day.
Like nay muscle, the heart needs a constant supply of oxygen and nutrients.
These reach the heart walls via the three coronary arteries. In spite of
all the blood passing through your heart every minute, your heart muscle
can starve when any of the three coronary arteries become too clogged.
Unfortunately, partially blocked arteries are not uncommon- over 7 million
Americans have this condition, known as coronary heart disease (CHD).
Coronary Heart Disease
CHD is caused by a thickening of the inside walls of the coronary arteries.
This thickening, called atherosclerosis (ath a row skle row sis), narrows
the space through which blood can flow, decreasing and sometimes completely
cutting off the supply of oxygen and nutrients to the heart.
Atherosclerosis usually occurs when a person has high levels of cholesterol,
a fat-like substance, in the blood. Cholesterol and fat, circulating in the
blood, build up on the walls of the arteries. The buildup narrows the
arteries and can slow or block the flow of blood. When the level of
cholesterol in the blood is high, there is a greater chance that it will
be deposited onto the artery walls. This process beings in most people
during childhood and the teenage years, and worsens as they get older.
Right now your symptoms suggest that you have coronary heart disease. If
that is the case, your doctor will recommend changes in your lifestyle,
possibly medications, and possibly procedures to reestablish blood flow to
the heart muscle that needs it. But first it's important to confirm that
your symptoms are caused by blockages in your coronary arteries. If there
are blockages, it's important to see just how serious the blockages are.
All this can be done with an angiography.
Before Your Catheterization:
Your catheterization is not a surgical procedure, but a few guidelines
need to be followed:
Do not eat or drink anything after midnight the night before your procedure
If your test is scheduled later in the day, go at least six hours without eating or drinking
You may take necessary medications with a sip or two of water
Prior to your test a chest X-ray, blood tests and an EKG will be performed
You will be asked to sign an informed consent to undergo this procedure
The floor nurse will obtain a brief history, start an IV and prepare your catheterization site
You may wear your glasses, dentures, and rings to the Cath Lab
The only clothing allowed is a hospital gown and sock or slippers
During the Procedure:
You will be brought to the Cath Lab by wheelchair or stretcher. Once in
the Cath Lab, the nurses and technicians will assist you onto the X-ray
table, attach you to a monitor and start IV fluids. The arm or groin
will be painted will an antiseptic solution and draped with sterile sheets.
You will be asked to keep your hands at your side unless the staff helps
you reposition them. You will be given a local anesthetic where the
catheter will go in. Once the anesthetic has taken effect, a needle is
inserted into the blood vessel. Using a tiny, flexible wire, the needle
is removed over the wire and is replaced by a small, hollow tube called
a sheath. The catheter is placed through the sheath and guided up to
the heart.
When the doctor is ready to take the X-ray pictures, he/she will ask you
to take in a deep breath and hold it. Since your cooperation is needed
for this, you will be awake during the procedure, though perhaps mildly
sedated. You may experience slight chest discomfort when asked to take
a deep breath, but this should go away when you resume normal breathing.
Please report if this feeling does not go away. You may also be asked
to cough several times during the test.
A picture of the ventricle (the heart's main pumping chamber) will cause
you to feel a warm, flush sensation. The procedure will last approximately
30-60 minutes, depending on each individual's anatomy.
Once the procedure is completed, the catheters and sheaths are removed
and pressure is applied to the site to prevent bleeding.
Your family will be notified when the procedure is completed, and may be
asked to join you for the viewing of the films.
Following the Procedure:
You will be returned to your room by cart. The majority of patients will
remain on bedrest for six to eight hours to prevent any bleeding from
the catheterization site. In selected patients a wound sealer called an
Angio-Seal may be sued which would reduce the bed rest time by several
hours. However, use of this sealer cannot be determined until the test
is over. During the bed rest phase you will be asked to keep your leg
straight and to report any bleeding or swelling at your catheterization
site to the nurses. If you should feel any bleeding or swelling, you
should apply pressure with our hand and call for a nurse. The nurses
will routinely check your vital signs and your cath site. You will be
asked to keep the head of your bed elevated no more than 30 degrees.
Since your head cannot be raised, you may need assistance to eat and
drink. You will need to drink plenty of fluids while you are on bed
rest.
Obtaining Your Test Results
Your cardiologist will discuss the findings of your catheterization
with you following the procedure. He/she will talk with your primary
care physician, and together they will make recommendations on your
follow-up care.
Your Recovery:
Your physician will discuss with you how soon you can take part in
physical activities and when you will be able to resume driving. If you
have any questions regarding your test, call the office where you
scheduled your test:
Cardiology, Normal, IL 309-828-1166 or Toll-Free 1-877-828-1166
Cardiology, Bloomington, IL 309-663-2496 or Toll-Free 1-888-663-2496
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