When Olivia went to see the doctor for a checkup, she listened to Olivia's heart for longer than she normally did. She told Olivia and her mom that she thought she heard something called a heart murmur. Olivia was sent to see another doctor who specialized in hearts, and he told Olivia and her parents that he was scheduling her for something called a cardiac catheterization so he could examine her heart and maybe even fix her heart murmur.
What Is Cardiac Catheterization?
Cardiac catheterization (say: kath-uh-tur-ih-ZAY-shun) is a procedure that lets doctors get a better look at a person's heart and blood vessels. A long, thin tube called a catheter is inserted into a blood vessel in someone's leg or arm and then threaded through blood vessels to the heart. Once the catheter is in place, doctors can use it to do tests on the heart and treat some heart problems.
There is almost never any pain involved with a cardiac catheterization. Kids usually sleep through the procedure and go home later that day. Most of them won't even need stitches. They'll just have a bandage covering a small red spot, usually in the groin area near the top of their leg, but sometimes in their arm or neck.
Why Is Cardiac Catheterization Done?
Cardiac catheterization is done to gather information about the heart and its blood vessels and even treat certain types of heart conditions. By doing a cardiac catheterization, a doctor can measure important things like blood pressure and oxygen levels in different parts of the heart.
Doctors also can use a cardiac catheterization to get a tiny sample of heart tissue for examination, a process known as a biopsy. They can take a look at heart defects that are present from birth (congenital defects), check for problems with heart valves, and locate narrowed or blocked blood vessels.
The information they get during a cardiac catheterization helps doctors decide whether a person's heart needs any more treatment or an operation. Treatments for heart conditions that can be done during a cardiac catheterization include:
closing small holes inside the heart
repairing leaky or narrow heart valves
treating arrhythmia (irregular heartbeat) by getting rid of the heart tissue that causes the heart to beat irregularly
removing blood clots
performing operations where tiny balloons are inflated in blocked blood vessels or heart valves to increase the flow of blood
placing wire devices called stents in narrowed blood vessels to help keep them open
How Should You Prepare for a Cardiac Catheterization?
If you're going to have a cardiac catheterization, your doctor will talk to your parents about any allergies you may have, especially to iodine, seafood, latex or rubber products, or contrast material (a special dye that shows up on X-rays).
Your doctor also will want to know about any medicines you're taking. You might be asked to stop taking certain medicines or change how much you're taking for a few days before the cardiac catheterization. Your parent can bring a list of your medicines and dosages with you to the hospital.
The doctor will probably tell you not to have anything to eat or drink for about 8 to 12 hours before the procedure. Having something in your stomach can increase the risk of problems from anesthesia, which is a kind of medicine that helps you sleep during the catheterization. Usually, you'll be able to have something to eat and drink soon after.
When it's time to go to the hospital, wear comfortable clothes and remove any jewelry, especially necklaces that may get in the way when they are trying to take pictures of your heart.
The cardiac catheterization will be performed by a cardiologist, a doctor who specializes in treating hearts, in a room called a catheterization lab. The catheterization lab contains special X-ray and imaging machines.
First, an intravenous (IV) line will be inserted into your arm so you can be given medicines and fluids during the procedure. You will then be given a sedative to help you relax and sleep.
When you're brought into the catheterization lab, you'll lie down on a small table surrounded by heart monitors and other equipment. A team of doctors and nurses will be there to keep you comfortable and work together.
Small, sticky patches called electrodes will be placed on your chest. The electrodes will be attached to an electrocardiograph (ECG) monitor, which will check your heartbeat during the procedure.
A nurse will clean the area where the catheter is going to be put in, and you'll be given an injection to make your upper leg or arm numb. Once the area is numb, a plastic sheath (a short, hollow tube used to guide the catheter into your blood vessel) will be inserted into your groin or arm, and then the catheter itself will follow.
The cardiologist will use X-rays to help direct the catheter as it moves up the blood vessels toward your heart. When the catheter is in place, a small amount of contrast material (a special dye that shows up on X-rays) will be injected into your blood vessels and heart. The contrast material lets the doctors see the vessels, valves, and chambers of your heart more clearly.
X-rays will be taken of your heart as the contrast material flows through it, and then some other procedures may be done, depending on why you're having a cardiac catheterization. These may include:
taking blood samples from blood vessels and heart chambers
removing heart tissue for a biopsy
performing operations to repair heart defects, put stents in place, or open blood vessels
After the cardiac catheterization is done, the catheter will be removed, and the site where it was inserted will be bandaged. You'll then be taken to a room where you'll recover for several hours while the nursing staff keeps an eye on your progress. If the catheter was inserted into your groin, you'll have to keep your leg straight for a few hours to prevent it from bleeding.
If you have a long drive home, your parent should stop every hour so you can walk for 5 to 10 minutes.
The day after the catheterization, you can take off the bandage. This is easily done by getting it wet in the shower first. Once the area is dry again, cover it with a new adhesive bandage. It's normal for the site to be black and blue, red, or slightly swollen for a couple of days after the procedure.
Gently wash the site with soap and water at least once a day, but avoid baths, hot tubs, and swimming for 1 week after the catheterization. Don't use any creams, lotions, or ointments on the site.
The doctor will tell you when it's safe to start doing activities again after a cardiac catheterization. But you probably will feel tired and weak the day after, and need to take it easy for the first couple of days. This means no heavy lifting and no sports. After about a week, you should be able to get back to doing all the things you like to do.