Cardiac Catheterization

You’ll remove any jewelry or other objects that may interfere with the procedure. You may wear your dentures or hearing aids if you use either of these.

Before the procedure, you should empty your bladder then change into a hospital gown.

A healthcare provider may shave the area where the catheter will be put in. The catheter is most often put in at the groin area. But other places used are the wrist, inside the elbow, or the neck.

A healthcare provider will start an IV (intravenous) line in your hand or arm before the procedure to give you IV fluids and medicines, if needed.

You will lie on your back on the procedure table.

You will be connected to an ECG monitor that records the electrical activity of your heart and keeps track of your heart during the procedure using small electrodes that stick to your skin. Your vital signs (heart rate, blood pressure, breathing rate, and oxygen level) will be tracked during the procedure.

Several monitor screens in the room will show your vital signs, the images of the catheter being moved through your body into your heart, and the structures of your heart as the dye is injected.

You will get a sedative in your IV line before the procedure to help you relax. But you will likely be awake during the procedure.

Your pulses below the catheter insertion site will be checked and marked so that the circulation to the limb can be checked after the procedure.

Your healthcare provider will inject a local anesthetic (numbing medicine) into the skin where the catheter will be put in. You may feel some stinging at the site for a few seconds after the local anesthetic is injected.

Once the local anesthetic has taken effect, your healthcare provider inserts a sheath, or introducer, into the blood vessel. This is a plastic tube through which the catheter is thread into the blood vessel and advanced into the heart. If the arm is used, your provider may make a small incision (cut) to expose the blood vessel and put in the sheath.

Your healthcare provider will advance the catheter through the aorta to the left side of the heart. They may ask you to hold your breath, cough, or move your head a bit to get clear views and advance the catheter. You may be able to watch this process on a computer screen.

Once the catheter is in place, your provider will inject contrast dye to visualize the heart and the coronary arteries. You may feel some effects when the contrast dye is injected into the catheter. These effects may include a flushing sensation, a salty or metallic taste in the mouth, nausea, or a brief headache. These effects usually last for only a few moments.

Tell the provider if you feel any breathing difficulties, sweating, numbness, nausea or vomiting, chills, itching, or heart palpitations.

After the contrast dye is injected, a series of rapid X-ray images of the heart and coronary arteries will be made. You may be asked to take a deep breath and hold it for a few seconds during this time. It’s important to be very still as the X-rays are taken.

Once the procedure is done, your provider will remove the catheter and close the insertion site. They may close it using either collagen to seal the opening in the artery, sutures, a clip to bind the artery together, or by holding pressure over the area to keep the blood vessel from bleeding. Your provider will decide which method is best for you.

If a closure device is used, a sterile dressing will be put over the site. If manual pressure is used, your healthcare provider (or an assistant) will hold pressure on the site so that a clot will form. Once the bleeding has stopped, a very tight bandage will be placed on the site. 

The staff will help you slide from the table onto a stretcher so that you can be taken to the recovery area. Note: If the catheter was placed in your groin, you will not be allowed to bend your leg for several hours. If the insertion site was in your arm, your arm will be elevated on pillows and kept straight by placing it in an arm guard (a plastic arm board designed to immobilize the elbow joint). In addition, a tight plastic band may be put around your arm near the insertion site. The band will be loosened over time and removed before you go home.