Cardiac Catheterization (Cath)

Cardiac catheterization, also known as cath or cardiac cath, is a minimally invasive procedure (no incisions required / small puncture / low to moderate sedation) in which a thin tube called a catheter will be inserted through an artery and guided to your heart to identify specific locations where your arteries may be narrowed or blocked.

This procedure also allows your doctor to measure the pressure of blood in each heart chamber and in blood vessels connected to the heart, evaluate the ability of the pumping chambers to contract, look for defects in the valves or chambers of the heart, take blood samples to measure the oxygen content in the heart chambers and remove heart tissue sample (myocardial biopsy).

If your doctor thinks that a further medical procedure should be implemented, then an angioplasty — also known as a percutaneous coronary intervention (PCI) — may be performed as a way to open up the narrowed or blocked arteries.

Do you have a question? Request more information and we will connect you with an RWJBarnabas Health cardiovascular expert.

How to Prepare for the Procedure

Before the procedure, your doctor and treatment team will explain to you what to expect before, during and after the procedure, and potential risks of the procedure. Talk to your doctor about:

• All medications, herbal products and dietary supplements you are currently taking and ask for their recommendations about each.
• Diabetes and how to adjust your medicine on the day of the procedure.
• Radiation exposure, especially for those that are pregnant.
• Any allergies to medicines, latex, tape, iodine, and anesthetic agents.
• Any history of bleeding disorders.
• Any implanted device (e.g. pacemaker or ICD).
• Any body piercings on your chest or abdomen.

Other recommendations include:

• Eat a normal meal the evening before the procedure. However, do not eat, drink or chew anything after midnight before your procedure. If you must take medications, only take them with sips of water.
• Leave all jewelry at home.
• Remove all makeup and nail polish.
• Wear comfortable clothing when you come to the hospital.
• If you normally wear dentures, glasses, or hearing devices at home, plan to wear them during the procedure.

What to Expect Before the Procedure

To determine whether you need a cardiac catheterization, your doctor might perform a variety of tests, including:

• Blood tests
• Angiogram
• X-Rays
• Echocardiogram (ECHO)
• Electrocardiogram (EKG/ECG)
• Stress test
• Computed tomography (CT scan) or magnetic resonance imaging (MRI) may be performed if the patient does not have a pacemaker or implantable cardioverter defibrillator.

What to Expect During the Procedure

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A cardiac catheterization procedure usually takes about 30 minutes (longer if you undergo a PCI), but the preparation and recovery time may add several hours. Therefore, plan on being at the hospital all day for the procedure. The procedure is usually done in the catheterization lab. Check with your doctor about the details of your procedure. In general:

• You will change into a hospital gown.
• A nurse will start the intravenous (IV) line in your hand or arm which will administer medications and fluids.
• Prior to starting the procedure, you will receive a local anesthetic to numb the catheter insertion site. Once the local anesthetic has taken effect, a catheter (thin tube) will be inserted and guided via a special x-ray machine.
• A contrast material (dye) is injected through the catheter to allow your doctor to see the x-ray images of your valves, arteries and heart chambers. These images will help identify exactly where the narrowing or blockage is occurring.
• Once your doctor has enough images, the procedure is finished. The catheter is then removed and the insertion site is closed off via a closure device (collagen) or sutures.

What to Expect After the Procedure

After the procedure, you may be taken to the recovery room for observation or returned to your hospital room. You will be in bed rest for a couple of hours as recommended by your doctor. A nurse will monitor your vital signs, the insertion site, circulation and sensation in the affected leg or arm.

General Guidelines

• You must stay in bed for as long as your doctor recommends.
• Tell your nurse right away if you feel any chest pain or tightness, or any other pain, as well as any feelings of warmth, bleeding or pain at the insertion site.
• You’ll be encouraged to drink water and other fluids to help flush the dye from your body.
• Your doctor will give you instructions to follow during your recovery.

Do you have a question? Request more information and we will connect you with an RWJBarnabas Health cardiovascular expert.