The Cardiology Group, P.A.



What is cardiac catheterization?	What happens on the day of the procedure?
Why is cardiac catheterization necessary?	What does the procedure consist of?
What your doctor should know before the test.	What happens after the procedure?
What happens before catheterization?	When are the pictures reviewed?
What happens the night before the catheterization?	What happens after I leave the hospital?

Cardiac Catheterization Video	Do you need a copy of the Video sent to you? Dvd or VHS? Ask for one to be sent to your home. Don't forget your address: info@cardiologygrouppa.com

Virtua Memorial Hospital of Burlington County, Mt. Holly, NJ opened the Low Risk Cardiac Catheterization Lab, April 1, 2003. Cardiologists from Deborah Heart and Lung Center perform the Cardiac Catheterizations on low-risk patients who must meet certain clinical criteria. It is most often an outpatient procedure.
Cardiac Catheterization assists your doctor in diagnosing heart disease. Patients are now able to stay closer home for low risk cardiac catheterization procedures.

What is cardiac catheterization?
Cardiac catheterization is a diagnostic tool used by heart specialists (or cardiologists) to evaluate the heart. Cardiac catheterization is an important method for detecting a range of heart problems. Specifically, the test enables physicians to view your coronary arteries, which supply the heart with blood and oxygen. Cardiac catheterization also allows physicians to evaluate your heart valves and to detect the presence of any structural heart defects, both congenital (inherited) or acquired. Back To Top
Why is cardiac catheterization necessary?
When coronary arteries become narrow or blocked, it often prevents the heart from receiving enough oxygen. This can lead to chest pain (called angina) and may eventually result in heart damage or a heart attack. Proper diagnosis of narrowed or blocked arteries can lead to effective treatment and may also help prevent a possible heart attack. If a heart attack has already occurred, a catheterization will assess the amount of damage and help the doctors plan the best treatment. Back To Top
All of the above procedures are used together to obtain as much information as possible so that accurate diagnosis can be made and proper treatment provided.
What your doctor should know before the test: Any documented or suspected allergy to medications, x-ray contrast media or foods Are you diabetic and on insulin? Are you pregnant? Are you taking aspirin, aspirin-containing products, or "blood thinners," such as Coumadin or Warfarin, or do you have a history of excessive bleeding? Whether you have difficulty lying flat for an extended period of time Do you have difficulty breathing or urinating? Back To Top
What happens before catheterization?
Prior to catheterization, you will be required to have blood tests, an ECG and a chest x-ray. These tests can be performed at Virtua or at a site directed by your health insurer. If your pre-admission tests are performed at Virtua, a staff member of the Cardiac Catheterization Lab (Cath Lab) will meet with you to explain the procedure and answer any questions. Your medical history and current medications will be reviewed. If you have your pre-admission work performed elsewhere, a staff member will contact you by phone to do this. Back To Top
What happens the night before the catheterization?
The evening before the procedure, you will be called by a staff member of the Cath Lab to review your pre-catheterization instructions and answer any additional questions. You will be instructed to arrive at the hospital approximately one to two hours prior to the scheduled test. General instructions: Eat nothing after midnight. Take your normal morning medications with sips of water, unless otherwise instructed. Wear loose-fitting, comfortable clothes. Since the Cath Lab is kept at cool temperatures, heavy socks are recommended. Be sure to inform the Cath Lab if you are a diabetic so that your medication can be adjusted. If you are taking GLUCOPHAGE, be sure to inform both your physician and the Cath Lab. If you are ALLERGIC to contrast, dye, shellfish or beef, inform your doctor or the staff before your procedure so that pre-medication can be ordered for you. YOU MAY NOT DRIVE HOME. Please make arrangements for transportation on the day of your procedure. Please note that parking is free. Back To Top
What happens on the day of the procedure?
On the day of your procedure, please report to Admissions and sign in at the registration desk. Please arrive on time because there is a lot to do before your procedure. A staff member will escort you to the Cath Lab. Relatives or friends accompanying you will be shown to a nearby waiting area. They cannot accompany you to the Cath Lab since it is an area restricted to staff and patients. You will be given a locker for your belongings (a lock is provided) and asked to change into a hospital gown. Next, you will be placed on a stretcher and attached to heart monitors. An intra-venous (IV) will be started to give you medication. Your heart rate and blood pressure will be taken. You will be asked to read and sign a medical consent form. At this time, the cardiologist who will be performing your catheterization will meet with you to discuss the procedure and to answer any last-minute questions. This physician will also review your medical history and conduct a brief physical examination. Back To Top
What does the procedure consist of?
You will be taken to the Cath Lab where you may encounter: a cardiologist who will perform the procedure, registered nurses, registered invasive cardiovascular specialists and radiology technicians. After being transferred to an exam table, you will be placed on a heart and blood pressure monitor. Next, your groin area will be shaved and prepped for the procedure. Once this catheterization site is prepared, you will be covered with a sterile blanket. The cardiologist begins the procedure by numbing the site at your groin area with a local anesthetic. (For some patients, the doctor may choose to use your arm for the procedure.) Remember that this is a local anesthetic; you will be awake during the procedure. Most people are concerned to hear they will be awake during the procedure, however, you will be given a sedative prior to the procedure to help you relax. You should only experience minimal discomfort during the procedure and you'll be able to talk with the cardiologist during the test. You will not receive a urinary catheter and if you have to urinate during the test you will be given a urinal or low-profile bedpan. Once the groin area is fully anesthetized, the physician will insert the catheter, a thin tube, into the body through an artery in your groin (sometimes a site on the arm is selected). With this tube, your physician can measure the pressures in your heart. You should not feel the tube. Next, a contrast dye is injected into the arteries through the tube and a picture is taken. The clear dye contains iodine which makes the dye visible on x-ray. Later, the dye will be removed naturally from your body by your kidneys. As the picture is taken you will hear a loud sound and your physician may ask you to hold your breath for a moment. When the dye is injected you will feel a warm, flush feeling. It is not painful, and you will be told when to anticipate this reaction. If you want, you may see the x-ray pictures on the TV screen beside the table where you will be lying. Although it varies, catheterization routinely takes 45 minutes. Back To Top
What happens after the procedure?
Once the catheterization is completed, you will be taken by stretcher to a recovery area. The catheter tube will be removed and pressure will be placed on the puncture site for 20 minutes. In some instances, a collagen plug may be inserted into the puncture site. Your physician will make that determination at the time of your procedure. After approximately half an hour, you will be transported to a room where you must remain in bed for four to six hours. Your family members or friends can join you in your room. You will be allowed to eat and drink at this time. Routine post-procedure medicine is ordered to reduce discomfort. After the procedure, you must keep the affected arm or leg straight for four to six hours. The bed can be adjusted to make you comfortable. Typically, patients can sit up four to six hours following the procedure and get out of bed six to eight hours after the procedure. Back To Top
When are the pictures reviewed?
The pictures taken during the cardiac catheterization will be available immediately following your procedure. The cardiologist will visit with you and your family to review the results of the test and to discuss treatment options. If requested, the film can be sent to another doctor for a second opinion. Back To Top
What happens after I leave the hospital?
Cardiac catheterization is often performed on an outpatient basis (i.e., with no overnight hospital stay.) You may be discharged four to six hours following removal of the catheter. However, someone must drive you home and stay with you that first night. The IV will be removed when you are going home. Discharge instructions will be reviewed with you before you leave the hospital. In addition, someone from the Cath Lab will contact you the day following your procedure to check on your condition. You will be instructed to schedule a follow-up visit with your physician within one to two weeks after your catheterization. If there is no discomfort in the arm or groin, patients can drive the day after the procedure. Patients can typically return to work after several days, however your doctor will give you more exact information after the catheterization. Back To Top

LINKS
American Heart Association www.americanheart.org Virtua Health www.virtua.org Penn Presbyterian Medical Center www.pennhealth.com/cardiac
LOCATIONS
Virtua Memorial Hospital of Burlington County 175 Madison Avenue Mt. Holly, NJ 08060 609-267-0700 Penn Presbyterian Medical Center 38th and Market Streets Philadelphia, PA 19104 215-662-9000 or 800-789-PENN (7366)