Angiography (Cardiac Catheterization)
Cardiac Catheterization is used in heart failure patients because it's one of the most useful and accurate test for diagnosing heart problems. It can detect
- Where arteries are narrowed or blocked
- The blood pressure inside the heart
- The amount of oxygen in the blood
How it is done.
First the patient will consult by the Cardiologist who will perform the procedure. The doctor will explain in detail about the procedures how it is done and its risks.
Cardiac Catheterization is relatively safe. Still there are small risks (less than one person in 250 procedures) like bleeding, infection , allergic reaction to the dye, damage to blood vessels, or kidney failure associated with the procedure. In an average patients, the risks are severe complications such as stroke, heart attack and a death on one person in 1,000 procedures.
Hospital stay is limited to 24 hours.
Most of the patients are conscious during the procedure.
Once inside the Cardiac Catheterization Laboratory, you will be transferred to the Cardiac Catheterization table. Cardiac Catheterizations are done through the artery in the groin area or wrist. (Elbow area) Your groin area and or arm will be cleansed and shaved. You will then be covered with sterile drapes. Next the doctor will anesthetize the area with one or two injections. After that, a small straw sixed tube ( called a sheath) will be inserted into the artery in your groin or arm. A special iodine based X-ray dye is injected into the left main coronary artery and its branches. As the dye is injected, X-rays take pictures of the arteries. The X-ray camera is rotated or moved around the patients to give different views of the coronary arteries. Most patients do not feel anything as due is injected into the coronary arteries.
After pictures of the coronary arteries are obtained ( or sometimes before) , another special catheter is threaded into the heart's left ventricle. Then dye is injected into the left ventricle, allowing the doctors to assess how well it's pumping blood. This picture ( a ventriculogram) also can show if one of the heart valves has become "leaky".
The entire catheterization can take as little as 20 minutes or sometimes more than an hour. The time it takes depends on what measurements are needed during the catheterization and other factors related to your heart's particular anatomy.
After the Cardiac Catheterization
After the procedure, the sheaths that have been placed in your groin or arm will be removed. A nurse or other cath lab team member will compress the puncture area for a time to help the small hole in the artery to close ( form a clot). Then you will have to rest for a few hours to ensure the small hole stays sealed. A special dressing will be done on the groin area or arm at the same time.
Most of the patients can go home next day after the procedure. Because of the invasive procedure and may have been given medicine to relax you, plan on having someone else drive you home.
Following the procedure, the puncture area in your groin may be a little tender. There may be a small, swollen area for a day or two. This may be normal, but if there is a tenderness , pain, swelling or bleeding talk to your cardiologist. It is important to make sure that nothing needs further evaluation. In rare cases the artery does not completely seal or an infection may develop.