Coronary arteries supply blood to the heart muscle. Like all other tissues in the body, the heart muscle needs oxygen-rich blood to function, and oxygen-depleted blood must be carried away. The coronary arteries run along the outside of the heart and have small branches that supply blood to the heart muscle.
Cardiac Catheterization is performed to further evaluate coronary artery disease, valvular heart disease, congestive heart failure, and/or certain congenital (present at birth) heart conditions, such as atrial septal defect or ventricular septal defect, when other less invasive types of diagnostic tests indicate the presence of one of these conditions.
Since coronary arteries deliver blood to the heart muscle, any coronary artery disorder or disease can have serious implications by reducing the flow of oxygen and nutrients to the heart, which may lead to a heart attack and possibly death. Atherosclerosis (a build-up of plaque in the inner lining of an artery causing it to narrow or become blocked) is the most common cause of heart disease.
Coronary heart disease, or coronary artery disease (CAD), is characterized by the accumulation of fatty deposits along the innermost layer of the coronary arteries. The fatty deposits may develop in childhood and continue to thicken and enlarge throughout the life span. This thickening, called atherosclerosis, narrows the arteries and can decrease or block the flow of blood to the heart.
Risk factors for CAD often include:
Controlling risk factors is the key to preventing illness and death from CAD.
The symptoms of coronary heart disease will depend on the severity of the disease. Some people with CAD have no symptoms, some have episodes of mild chest pain or angina, and some have more severe chest pain.
If too little oxygenated blood reaches the heart, a person will experience chest pain called angina. When the blood supply is completely cut off, the result is a heart attack, and the heart muscle begins to die. Some people may have a heart attack and never recognize the symptoms. This is called a “silent” heart attack.
When symptoms are present, each person may experience them differently. Symptoms of coronary artery disease may include:
In addition to a complete medical history and physical examination, diagnostic procedures for coronary artery disease may include any, or a combination of, the following:
Cardiac catheterization is performed to further evaluate coronary artery disease, valvular heart disease, congestive heart failure, and/or certain congenital (present at birth) heart conditions, such as atrial septal defect or ventricular septal defect, when other less invasive types of diagnostic tests indicate the presence of one of these conditions.
In cardiac catheterization (often called cardiac cath or coronary angiogram – CAG), a very small hollow tube, or catheter, is advanced from a blood vessel in the groin or arm through the aorta into the heart. Once the catheter is in place, several diagnostic techniques may be used. The tip of the catheter can be placed into various parts of the heart to measure the pressures within the chambers. The catheter can be advanced into the coronary arteries and a contrast dye injected into the arteries.
The use of fluoroscopy (a special type of X-ray, similar to an X-ray “movie”) assists the doctor in locating any blockages in the coronary arteries as the contrast dye moves through the arteries.
The patient will remain awake during the procedure, although a small amount of sedating medication will be given prior to the procedure to ensure the patient remains comfortable during the procedure.
Before the Procedure
During the Procedure
A cardiac catheterization or coronary angiogram (CAG) may be performed on an outpatient basis or as part of stay in a hospital. Procedures may vary depending on the condition of the patient and the doctor’s practices.
Generally, a cardiac catheterization follows this process:
After the Procedure
After the procedure, the patient may be taken to the recovery room for observation or returned to the hospital room. The patient will remain flat in bed for several hours after the procedure. A nurse will monitor the vital signs, the insertion site, and circulation/sensation in the affected leg or arm. The patient should immediately inform the nurse in case of any chest pain or tightness, or any other pain, as well as any feelings of warmth, bleeding, or pain at the insertion site. Bed rest may vary from two to six hours depending on the patient’s specific condition. If the physician has placed a closure device, bed rest may be of shorter duration. In some cases, the sheath or introducer may be left in the insertion site. If so, the period of bed rest will be prolonged until the sheath is removed.
The patient may feel the urge to urinate frequently because of the effects of the contrast dye and increased fluids. After the specified period of bed rest has been completed, the patient may get out of bed. The patient should move slowly when getting up from the bed to avoid any dizziness from the long period of bed rest. Pain medication may be given for pain or discomfort related to the insertion site or having to lie flat and still for a prolonged period. The patient will be encouraged to drink water and other fluids to help flush the contrast dye from the body. Normal diet may be resumed after the procedure, unless the doctor decides otherwise. When the recovery period is completed, the patient may be discharged.
Once at home, the insertion site should be monitored for bleeding, unusual pain, swelling, and abnormal discoloration or temperature change at or near the insertion site. A small bruise is normal. If a constant or large amount of blood is noticed at the site that cannot be contained with a small dressing, the doctor needs to be notified.
If a closure device has been used for the insertion site, specific information will be given regarding the type of closure device that was used and how to take care of the insertion site. There may be a small knot, or lump, under the skin at the site. This is normal. The knot should gradually disappear over a few weeks. It will be important to keep the insertion site clean and dry. Specific bathing instructions will be given. The patient will be advised not to participate in any strenuous activities for a period of time after the procedure.
The doctor needs to be notified in case of the any of the following:
Risks / Complications
Complications occur in less than 2% of the cases
Radiation risk: There is always a slight risk of damage to cells or tissues from being exposed to any radiation, including the low levels of X-ray used for this test. But the risk of damage from the X-rays is usually very low compared with the potential benefits of the test.
Cardiac catheterization is a test to check the heart and coronary arteries. Test results will be reviewed by a cardiologist and will be available after the procedure. The doctors will be able to talk to the patient about some of the results immediately after the test.
Results will include whether:
Many conditions can affect the results of a cardiac catheterization. The doctors will discuss any significant abnormal results and further treatment plan.
Coronary artery disease is caused by build-up of plaque in the walls of the coronary arteries that supply blood to the heart and other parts of the body. Plaque is made up of deposits of cholesterol and other substances in the artery. Plaque build-up causes the inside of the arteries to narrow over time, which could partially or totally block the blood flow. This process is called atherosclerosis.
Following are the factors which increase the risk for heart disease:
Your doctor will probably prescribe you the either 2 or more of the following tests to detect of you have any heart related condition:
You should do regular exercise to prevent heart diseases like aerobic exercise which are walking, jogging, jumping rope, bicycling (stationary or outdoor), cross-country skiing, skating, rowing and low-impact aerobics or water aerobics. You can also include Strengthening exercises in your regime of you do not have heart failure.
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