Coronary arteries supply your heart muscle with the blood it needs to work properly. When these arteries become clogged or narrowed, blood flow to the heart can decrease. This can cause chest pain, shortness of breath and other symptoms. A complete blockage can cause a heart attack.
If your doctor recommends a cardiac catheterization — also called an angiogram — understanding why it’s done and what happens during the procedure can help you feel more prepared.
An angiogram allows doctors to assess the pumping function of the heart and determine if there is any significant blockage in the arteries. A doctor might order an angiogram to help diagnose a heart condition, treat a blockage, or investigate vascular issues like aneurysms.
People experiencing symptoms such as pain in their chest, jaw, neck or shortness of breath, which could indicate possible blockages in the coronary arteries, or who have an abnormal stress test, are commonly recommended for an angiogram.
The procedure involves threading a tiny tube through an artery to the heart, either through the groin or wrist area, and injecting dye into the arteries that transport blood through the heart using X-ray imaging.
What can you expect in a heart catheterization procedure? Here is a step-by-step guide:
How to prepare for heart catheterization
Talk with your doctor about which method of access — the femoral artery in the groin or radial artery in the wrist — is best for you. It’s also important to discuss any possible need for intervention during the procedure, such as angioplasty, where a stent is placed to open a blocked artery.
Let your doctor know if you have any upcoming surgeries, such as a colonoscopy, knee, hip or eye surgery, and discuss any history of bleeding, like stomach ulcers or bleeding in the brain. When reviewing your medical history, be sure to share if you are allergic to contrast or shellfish and information about any previous heart-related intervention or surgery.
A nurse from the hospital Pre-Admission Testing department will call you with a date for your procedure, review your medical history and current medications, and discuss what to expect during the procedure.
The afternoon before your procedure, you’ll receive a phone call with details about when to arrive at the hospital and an approximate procedure time. You’ll find out when you need to stop eating and drinking prior to your procedure and you’ll be able to ask any questions. You will need to arrange for a friend or family member to provide transportation home after your procedure.
What happens during heart catheterization
It’s common for patients to wonder if they will be asleep or feel any discomfort during heart catheterization. In most cases, patients receive a low dose of sedation and pain management through an IV (also known as “twilight sedation”) that allows them to be comfortable and drift off during the procedure. Most patients don’t remember much of the procedure once the sedation wears off. You will be comfortable during the procedure and should not have significant pain.
While sedated, your care team will administer a local anesthetic (numbing agent) before inserting a small needle to access the artery in your groin or wrist. Then they place a small plastic tube into the vessel that allows the physician to place a catheter into the heart chamber and arteries.
Once the catheter is in place, your doctor performs specific tests to assess the condition of your heart. If blocked arteries are identified, angioplasty with a balloon or heart stent may be performed. If there are multiple blockages or if the location of blockages is not appropriate for a heart stent, heart surgery may be recommended. If the blockages are minor, your doctor may choose to treat them with medication.
When the procedure is completed, the tube is removed, and pressure is applied to the access site to prevent bleeding. If the procedure is performed through the groin, a closure device or manual pressure may be used. If the radial artery in the wrist is used, a compression band is applied to maintain pressure. Typically, the procedure takes about one hour.
What happens after heart catheterization
After the cardiac catheterization is complete, you will go to an outpatient area where you’re monitored closely during recovery. If your procedure involved groin access, you lie flat for up to 6 hours and then move to a sitting position to ensure bleeding is controlled. If a vessel in your wrist has been accessed, the compression band will be removed after sitting for one hour. You may need to spend 2 to 6 hours in the recovery area.
If you received a stent, you may stay overnight, but many patients are discharged six hours after the procedure. Throughout the recovery time, your access site and vital signs are monitored for any changes.
Prior to discharge, you will take a walk and use the restroom. From beginning to end, the time spent at the hospital ranges from 4 to 8 hours. Before you leave, you can speak with your physician and nurse about test results, discharge instructions and future care needs.
Cardiac catheterization is a routine procedure but carries some risk. The most common complication is bleeding at the location of tube insertion in the groin area. Your doctor will discuss the risk of other complications.
Heart catheterization recovery at home
Patients typically feel well after the procedure but may have some soreness or bruising around the access site. Physical restrictions may include not driving for 24 hours or submerging the access site underwater for 72 hours. You may have other limitations based on the location of the access site, such as decreased stair climbing or weightbearing activities.
You will be sent home with instructions related to post-catheterization care. If abnormal bleeding at the site occurs, you should apply pressure for 20 minutes and let their physician know. Also call your doctor if you have symptoms such as fever, chills, signs of infection or numbness, and tingling or loss of feeling in the limb where the incision site was located. In very rare situations, continued bleeding may occur that requires a visit to the emergency room.
Cardiac catheterization is a commonly performed procedure that helps physicians evaluate how well the heart and its arteries are functioning. In many cases, it can also allow doctors to treat certain blockages during the same visit.
Related Articles
