​                         Professor Francisco Leyva-León

Cardiac catheterization ('heart cath' or 'angiogram') involves the insertion of a catheter into a heart chamber or a blood vessel. This is done for for both the diagnosis and treatment of coronary heart disease.



The procedure

The test will be performed in the “Cardiac Catheter Lab” where a doctor, nurse, technician and radiographer will be with you at all times. The doctor will insert a catheter - a fine tube - into an artery and/or vein (usually in the right groin) after deadening the area with local anaesthetic.  The catheter is passed up to your heart, guided by an x-ray machine that will rotate around you.  You will be awake during the catheterisation and you will be asked by the doctor to breathe deeply or to cough.  Pressure measurements are taken from the various chambers of the heart and blood vessels, and the doctor then injects some "dye" through the catheter. This allows visualisation of your coronary arteries, as well as the valves and the pumping chamber of the heart.  These pictures of are recorded on film to be studied later.

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Preparation
• Tell the consultant if you are on warfarin, clopidogrel, prasugrel or metformin, as these drugs may need to be stopped prior to the procedure. If you have had a valve operation, do not stop taking warfarin unless this has been discussed with the consultant. If you had a metal valve operation, we may decide to admit you in advance so that we can change you over to another drug whilst in hospital.



• Take a bath or shower the night before your test and wash your groin areas and both arms around the elbow.  A small puncture will be made in one of these areas during the test.  On arrival, you will be informed which one of these areas will be used and you will be asked to shave that area.



• Do not to eat for 4 hours before the test.  You may drink water until one hour before.



• Please bring all your tablets in their original packets. All valuables should be left at home.



​On arrival at the hospital
A nurse will take your blood pressure, temperature, pulse, height and weight. A doctor will take your medical history, examine you and take a blood sample. The procedure for cardiac catheterisation will be explained to you by a doctor and a nurse. This is an opportunity for you to ask questions and tell us any concerns you may have about the procedure. The doctor will then ask you to sign a consent form showing that you understand what is involved and agree to the procedure.



​​Will it hurt?

The place where the catheter is inserted into the artery will be anesthetised.  You will feel a needle prick and a mild stinging sensation from the local anaesthetic. A small puncture will then be made in your skin. Otherwise, there is little or no discomfort or pain during the procedure.  You may experience a brief warm sensation when the dye is injected and may feel a sensation of passing urine.  You will not feel the catheter inside the body.



After the procedure
On the ward, your blood pressure, pulse, wound site and foot pulses will be monitored by the nurse.  If the procedure has been performed from the groin you will be asked to stay in bed for about 2-4 hours.  You should try to keep your leg straight (but not stiff) during this time. If you cough or sneeze, put your fingers over the dressing and hold it firmly. If your arm was used for the test, keep it straight for 2 hours and don’t use it for carrying things until the soreness has gone. The hospital doctor will see you on the same day as your test and discuss the results with you.

 

At discharge
We strongly advise you not to drive yourself home, but to arrange to be collected from the hospital. You should not bathe for 24 hours, although a shower is permitted. Avoid lifting and exercise for 1 week. You will be given a brief letter for your GP. 



​Angiogram links:
http://en.wikipedia.org/wiki/Cardiac_catheterization