IF YOU HAVE HEART FAILURE sooner or later you will face what is termed a "heart catherization". There are many reasons for performing heart or cardiac catherization. Some of the primary reasons include:
     <> Evaluation of the heart valves.
     <> Evaluation of the internal pressure of the heart.
     <> Evaluation of the contractility of the heart.
     <> Evaluation of the blood flow through the vessels of the heart.


1. In the Cardiovascular Holding area, have a list of your medicines
    and allergies ready for the nurse.
2. Undress, put on your gown and get comfortable in bed.
3. You may keep glasses on, dentures in, and wear socks or slippers
    if you wish.
4. Your blood pressure and vitals will be taken.
5. A nurse will ask about your medical history.
6. An IV will be started and blood will be drawn (at the same time).
7. The consent form for the procedure will need to be signed.
8. You will be taken to the Specials Lab by cart (in your bed) 15
    minutes before the test. Your family will wait in the Radiology
    waiting area and the doctor will speak to them in that area after
    the procedure.
Once in the Lab, your vital signs will be monitored. Your groin will be shaved and cleaned with a cleansing scrub. You will be draped with sterile sheets. Once you are prepped for your catherization, your cardiologist will order medication for sedation, if indicated. (DISCUSS THIS WITH YOUR DOCTOR PRIOR TO THE TEST!!!) This medication will be given directly into your IV line.
The doctor will inject the groin area with Lidocaine, a numbing medicine. For about 20 seconds you may have a burning sensation. As the area becomes numb, a sheath (a large IV) is put in place. Through this sheath the doctor will place a flexible guide wire and catheter. The doctor will direct the catheter through the arteries to the coronary arteries that feed the heart its blood supply. Once there, the doctor will inject a dye that will show the arteries by X-ray. You cannot feel the catheter being directed through to your arteries. You may feel a warm sensation when the dye is injected. This is a normal reaction.
After the arteriogram is finished, the sheath will be removed from your artery and pressure applied for ten minutes or until there is no bleeding. Once there is no bleeding, you will be taken back to you room. Time flat will be from 2 to 6 hours, varies on the size of the sheath used. You will be checked for signs of bleeding at the site and vital signs taken. It is very important that you lie flat, keeping your leg straight. The nurses will give you complete instructions.

Depending upon what  the test reveals, your doctor  may treat you with medication or he may suggest another procedure, such as:
     <> If the doctor finds significant narrowing or blockage of the coronary arteries, he may decide to do a PRECUTANEOUS TRANSLUMINAL CORONARY ANGIOPLASTY (PTCA). This is a tiny balloon threaded through the sheath on the guide wire. It is inflated at the site of the blockage. This usually opens the blocked area and allows more blood to flow through the artery and back to the heart. If this procedure is done, you will be required to stay in the hospital for one to two days.

     <> There are occasions when this procedure doesn't open the blockage enough to allow the necessary blood flow. If this should occur, another type of angioplasty procedure called a STENT PLACEMENT is done. A stent is a tiny metal coil threaded through the sheath on the angioplasty balloon.When it reaches the blockage, it is expanded to help support the vessel wall allowing for improved blood flow through the coronary artery. It is possible for more than one stent to be implanted.

     <> If your cardiologist finds very significant blockage during your catherization, he may recommend open heart surgery (bypass). It is possible for you to stay in the hospital until your surgery, or you may be sent home and the surgery will be scheduled for a later date. This depends on the severity and location of the blockage.

A personal note if I may. I have had occasion to have the use of Lidocaine numerous times. It is very trustworthy in my opinion; I am always glad to hear that is what will be used in a procedure.