Question

Dr. Buckwalter asks you to book a cardiac catheterization for Mr. Miller. This is a day stay procedure performed at the local hospital by Mr. Miller’s cardiologist. What information will you need to convey to Mr. Miller, and how will you do so?

Answer 1

Ans) Upon arrival at the Cardiac Catheterization Laboratory, you will need to register with the receptionist.
- You will then be escorted into the catheterization holding area.
- A nurse will check your temperature, pulse, blood pressure, and oxygen saturation.
- A complete review of your medical history and physical examination will be performed by a cardiology nurse practitioner or cardiologist. This is to ensure there are no current conditions present which increase the risk of the procedure. Specific concerns include a history of allergies to medications or contrast (dye), current medications, current illnesses such as a respiratory illness, fever, rash, or signs of infection at the cath site (groin area).
- Blood tests may be performed including a complete blood count, a blood typing if an intervention is scheduled, a pregnancy test for all menstruating females and/or a bleeding time for patients on blood thinning medications (Coumadin or Heparin) or patients with very low oxygen saturation.
- The cardiologist will review the procedure including the risks and benefits associated with the procedure. Since a catheterization is an "invasive" procedure requiring entering into the heart there are some risks. However, the overall risks are relatively low when performed under guidance of a qualified cardiologist and team. The risks of any procedure must be reviewed with the patient when obtaining "informed consent" for the patient to fully understand the procedure.
- Possible risks of the procedure include:
Infection of the cath site or heart
Bleeding or swelling at the cath site
Irregular heart beat
Damage to the heart or blood vessels
Allergic reaction to dye
Stroke or seizure from a blood clot
Death (rare)
An intravenous catheter (IV) will be inserted into a vein if you are not going under general anesthesia.
- If the catheterization is performed under general anesthesia, an anesthesiologist will discuss sedation plans with you and your family.
You will be transferred to the cath lab on a hospital bed. A family member may accompany you up to certain point.
Family members should wait in the cath lab waiting room and will be given periodic updates.
- In the cath lab you will be transferred to the cath lab table. Equipment in the lab includes monitors and large cameras. A Cardiologist and multiple team members will be present.
After you are positioned on the table, various monitors will be connected (heart rhythm, blood pressure, and oxygen).
• General Anesthesia Cases
- The anesthesiologist will administer general anesthesia as previously discussed usually by inhaled gas through a mask.
- Once you are asleep, an IV will be placed and a tube will be placed in your airway to help you breathe.
- After you are asleep, your legs will be washed with special soap and then you will be covered from your neck to your toes with a sterile sheet.
The procedure will be performed.
- At the completion of the catheterization, the catheters will be removed and pressure applied to the groin area, to prevent bleeding.
- A pressure dressing is applied to the groin area.
The anesthesiologist will then wake you up and remove the breathing tube.
- You will be transferred to the recovery room by stretcher.
• Sedation Cases
- If the procedure is performed with sedation, medications will be given through the IV to keep you comfortable and sleepy. Discomfort usually only occurs when putting "numbing" medicine into the groin before insertion of the catheters (this only takes a few seconds).
- During the procedure, you will be told when angiograms are going to be performed. After an angiogram, you may feel a warm sensation lasting a few seconds.
- Lying still on the lab table for an extended period of time may be associated with mild discomfort. You are encouraged to notify the staff if you are uncomfortable anytime in the procedure and additional sedation will be administered. This should not be an unpleasant experience and we want you to be comfortable and relaxed.
- If a catheter intervention is performed, it is completed after the angiograms are reviewed.
After an intervention, repeat measurements and angiograms are performed.
- At the completion of the catheterization, the catheters are removed and pressure is applied to the groin area for 10-20 minutes, to prevent bleeding.
A pressure dressing is applied to area.
- You will be transferred from the cath lab to the catheterization laboratory holding area for post-procedure care.