Cardiac catheterization - discharge
Catheterization - cardiac - discharge; Heart catheterization - discharge: Catheterization - cardiac; Heart catheterization; Angina - cardiac catheterization discharge; CAD - cardiac catheterization discharge; Coronary artery disease - cardiac catheterization discharge
Cardiac catheterization involves passing a thin flexible tube (catheter) into the right or left side of the heart. The catheter is most often inserted from the groin or the arm. This article discusses how to care for yourself after this procedure.
Millions of Americans are living with heart disease and some of them don't even realize they have it. Heart disease is the number one cause of death; above cancer, diabetes, and injuries. That's why it's important to get it diagnosed and treated quickly. Fortunately, we doctors have a lot of tests and treatments at our disposal to combat heart disease. One procedure that is both a test AND a treatment is called cardiac catheterization. It can show your doctor how healthy your heart and blood vessels are, and treat heart valve problems, clogged arteries, and heart defects. Let's talk today about cardiac catheterization. So, why would you even need cardiac catheterization? Well, doctors use cardiac catheterization to diagnose and evaluate common heart and blood vessel problems, like chest pain or an abnormal stress test due to coronary artery disease, heart valve conditions like a leaky or narrowed valve, a high blood pressure condition in the lungs, blood clots in the lungs from an embolism, and an enlarged heart. You'll need to have this procedure in a supervised hospital setting. You may need to stay overnight at the hospital the night before the test, or you may be admitted the morning of the procedure. The whole cardiac catheterization procedure takes about 30 to 60 minutes. You'll be given medicine to help you relax, but you'll be awake during the procedure. First, the doctor will insert an intravenous, or IV line into one of the blood vessels in your groin or neck. Through this IV line, your doctor will pass a thin, flexible tube called a catheter. That tube will be threaded into either the left or right side of your heart. The doctor will use an x-ray as a guide to see where the catheter is going. While the catheter is in place, your doctor can check how well the blood is flowing into and out of your heart, and through the arteries around your heart, collect blood samples from your heart, measure the oxygen level in your heart, and even take a tiny piece of heart tissue, called a biopsy, when there's a situation of unexplained heart failure. Cardiac catheterization is a safe procedure when performed by an experienced medical team. But, some possible risks include bleeding, infection, and blood clots. A heart attack or a stroke can happen in very rare situations. But, remember, it's done in a closely supervised setting in a hospital. After a cardiac catheterization, your doctor should have a pretty good idea of what's causing your heart, valve, or blood vessel problem. Knowing exactly what the problem is can help your doctor find just the right way to treat your particular problem.
When You're in the Hospital
A catheter was inserted into an artery in your groin or arm. Then it was carefully guided up to your heart. Once it reached your heart, the catheter was placed into the arteries that deliver blood to your heart. Then contrast dye was injected. The dye allowed your doctor to see any areas in your coronary arteries that were blocked or narrowed.
If you had a blockage, you may have had angioplasty and a stent placed in your heart during the procedure.
What to Expect at Home
You may feel pain in your groin or arm where the catheter was placed. You may also have some bruising around and below the incision that was made to insert the catheter.
Self-care
In general, people who have angioplasty can walk around within 6 hours or less after the procedure. Complete recovery takes a week or less. Keep the area where the catheter was inserted dry for 24 to 48 hours. If the catheter was inserted into your arm, recovery is often faster.
If the doctor put the catheter in through your groin:
- Walking short distances on a flat surface is OK. Limit going up and downstairs to around twice a day for the first 2 to 3 days.
- Do not do yard work, drive, squat lift heavy objects, or play sports for at least 2 days, or until your health care provider tells you it is OK.
If the doctor put the catheter in your arm:
- Do not lift anything heavier than 10 pounds (4.5 kilograms). (This is a little more than a gallon of milk).
- Do not do any heavy pushing, pulling, or twisting.
For a catheter in your groin or arm:
- Avoid sexual activity for 2 to 5 days. Ask your doctor when it will be OK to start again.
- You should be able to return to work in 2 to 3 days if you do not do heavy work.
- Do not take a bath or swim for the first week. You may take showers, but make sure the area where the catheter was inserted does not get wet for the first 24 to 48 hours.
You will need to take care of your incision.
- Your provider will tell you how often to change your dressing.
- If your incision bleeds, lie down and put pressure on it for 30 minutes.
Many people take aspirin, often with another medicine such as clopidogrel (Plavix), prasugrel (Efient), or ticagrelor (Brilinta), after this procedure. These medicines are blood thinners, and they keep your blood from forming clots in your arteries and stent. A blood clot can lead to a heart attack. Take the medicines exactly as your provider tells you. Do not stop taking them without talking to your provider.
You should eat a heart-healthy diet, exercise, and follow a healthy lifestyle. Your provider can refer you to other health experts who can help you learn about exercise and healthy foods that will fit into your lifestyle.
When to Call the Doctor
Contact your provider if:
- There is bleeding at the catheter insertion site that does not stop when you apply pressure.
- Your arm or leg below where the catheter was inserted changes color, is cool to the touch, or is numb.
- The small incision for your catheter becomes red or painful, or yellow or green discharge is draining from it.
- You have chest pain or shortness of breath that does not go away with rest.
- Your pulse feels irregular -- it is very slow (fewer than 60 beats a minute) or very fast (over 100 to 120 beats a minute).
- You have dizziness, fainting, or you are very tired.
- You are coughing up blood or yellow or green mucus.
- You have problems taking any of your heart medicines.
- You have chills or a fever over 101°F (38.3°C).
References
Dangas GD, Mehran R. Coronary angiography and intravascular imaging. In: Libby P, Bonow RO, Mann DL, Tomaselli GF, Bhatt DL, Solomon SD, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 12th ed. Philadelphia, PA: Elsevier; 2022:chap 21.
Kern MJ, Kirtane AJ. Catheterization and angiography. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 51.
Kern MJ, Seto AH, Herrmann J. Invasive hemodynamic diagnosis of cardiac disease. In: Libby P, Bonow RO, Mann DL, Tomaselli GF, Bhatt DL, Solomon SD, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 12th ed. Philadelphia, PA: Elsevier; 2022:chap 22.
Kumbhani DJ, Bhatt DL. Percutaneous coronary intervention. In: Libby P, Bonow RO, Mann DL, Tomaselli GF, Bhatt DL, Solomon SD, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 12th ed. Philadelphia, PA: Elsevier; 2022:chap 41.
Version Info
Last reviewed on: 8/16/2022
Reviewed by: Michael A. Chen, MD, PhD, Associate Professor of Medicine, Division of Cardiology, Harborview Medical Center, University of Washington Medical School, Seattle, WA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
