Cath Lab Procedure Guide

Pre-Register

Pre-registering for your procedure makes the process easier and saves you time. To pre-register, be prepared with the following information:

• Your Social Security number
• Your current address
• Names of emergency contacts
• Name of your family physician
• Insurance and/or Medicare/Medicaid cards
• Physician orders
• Consent form given by your doctor
• Date procedure is scheduled

Registration at GRMC is open on weekdays from 5:30 am – 6:00 pm except some holidays. If you do not reach a registrar immediately, please leave a message and your call will be returned as soon as possible. Allow 15 minutes to register and bring your insurance card. If your physician has ordered pre-procedure tests, registration may take more time. If you are unable to pre-register in person, please call 830.401.7445.

Getting ready for your procedure

1. Please pre-register at the Hospital at least two days before your procedure. See pre-registration instructions.
2. For your procedure date and time, call your physician’s office.
3. Arrange for a family member or friend to accompany you to the hospital to drive you home after the procedure.
4. Please leave personal articles such as jewelry, piercings, money, valuables, purses and wallets at home. You may bring eyeglasses, contact lenses with storage case and solution, dentures or bridgework case, as well as hearing aids.
5. If on the day of your scheduled procedure, you have a change in your physical condition such as a cold, congestion, flu, diarrhea, rash, sore throat, nausea, vomiting, etc., please contact the Cath Lab staff immediately at 830.401.7170 or 830.401.7175.

Pre-procedure

1. It is very important that you not eat or drink anything 6-8 hours before procedure. This includes: food, beverages, smoking, chewing gum, tobacco, mints or hard candy.
2. You should take your morning heart or blood pressure medications with a sip of water.
3. If you are diabetic: do not take insulin or medications for diabetes. Do not take Lantus the night before your procedure. If you take Glucophage, Glucovance or Metformin, do not take the day before or the morning of the procedure.
4. Do not stop taking blood thinners such as Aspirin, Plavix, Effient or Brilinta unless your physician advises otherwise.
5. Do not take Coumadin (Warfarin) 4 days prior to the procedure; or Xarelto, Pradoxa, or Eliquis 2 days prior to the procedure.
6. If you might be pregnant, please notify your doctor.
7. Increase fluid intake a few days before the procedure; preferably with water.
8. Notify your physician of any iodine allergies.

If you are allergic to iodine or shellfish, or have diabetes or kidney problems, you may have an increased risk to an allergic reaction to the iodine in the contrast dye. You should notify the physician of their allergy before the procedure to prevent any symptoms from occurring.

Failure to follow the above may delay or cancel your procedure.

When arriving to GRMC, please remember to bring:

• All paperwork and test results from the physician office(s)
• Insurance and/or Medicare/Medicaid cards
• A valid picture ID
• Payment for your co-pay or deductibles
• Hospital pre-registration paperwork
• Consent form (if given) from physician

Park in the Patient Entrance Parking lot located in the center of the hospital’s campus, just east of the ER.

Remember: Even if you have pre-registered, you still have to begin your visit at Registration. Please check in at the Patient Tower Information Desk.

Other than a sedative, patients having a cardiac catheterization usually do not receive any other drugs. Catheterized patients need to remain alert so they can describe sensations to the physician performing the test and report any chest pain. The test otherwise, is generally painless.

Cardiac catheterizations are typically performed with the patient lying flat on a table with an X-ray machine above or on the side of the table. After the insertion point is numbed with a local anesthetic, physicians make a tiny incision in the skin to access the artery. A guide wire is then inserted in the artery and the catheter is guided over the wire. When catheters are inserted, most people feel a slight pressure or a sensation of mild tugging. With the catheter inserted, doctors then guide it to the area of the heart being studied.

A contrast dye is injected through the catheter and will flow in the coronary arteries. Many people report a sensitive feeling to their heartbeats and a warm, flushing sensation when the dye is injected–a normal reaction lasts anywhere from 20-30 seconds. The patient may be asked to cough to help move the dye through the arteries. The dye blocks X-rays, flows through the heart’s arterial system and allows the physicians to get pictures of the heart’s blood vessels. During an angiography, more than dye injection may be used.

When the procedure is complete, the catheter is removed through the sheath at the insertion site. Typically, the sheath stays in the artery for a short time and is covered with a small dressing. The sheath may be left in as a precaution in case any problems such as bleeding, pain, or decreased circulation in the leg or foot result from the catheterization. In the event a complication arises, the physician will have quick access through the sheath to investigate or treat the problem.

When the sheath is removed, pressure is applied on the insertion site for 15 to 30 minutes to allow the puncture area to close and prevent bleeding. If the access point is through the femoral artery in the groin, the patient may have to rest in bed with the leg held straight for 1 to 4 hours.

Cardiac catheterizations usually take 45 minutes for diagnostic procedures. Cardiac intervention procedures will take an additional hour to complete.

Peripheral Angiography

Peripheral vascular procedures are commonly performed to diagnose and treat blockages in the arm, legs, and vessels which supply blood to the brain (carotid arteries). Preparation and expectations on the day of the procedure are the same as with cardiac catheterizations.

Most people can resume normal activities within a few days to a week after their catheterization if no complications result from the procedure. Some guidelines to follow after a Cardiac Catheterization or Peripheral Angiography include:

• DO NOT drive or operate heavy machinery for 2 days
• DO NOT drink any alcohol for 2 days
• DO NOT make any legal decisions or sign any papers for 2 days.
• Should rest and avoid standing for long periods of time for the first 2 days.
• Monitor puncture site for bleeding or hematoma (lump). If bleeding occurs, apply pressure for 15-20 minutes. If bleeding continues, call 911 and your physician.
• May feel a small pea size knot at the site of procedure for 5-7 days.

Days following the procedure:

• Remove band-aid/dressing, shower as usual, wash the site with soap and water and pat dry
• Avoid baths, swimming, and Jacuzzi’s for 5 DAYS
• Avoid topical powders or lotions
• Expect a little discomfort to affected groin, leg, or arm for 2 days. Avoid bending, straining, lifting heavy objects, or sexual activity for the next 24-48 hours or as instructed.

Contact your physician immediately if you have:

• A temperature greater than 100 degrees F
• Pain to the affected groin, leg or arm
• Symptoms of the affected limb turning blue or numb
• Increased redness, swelling, drainage, bleeding or heat surrounding the puncture site
• Back pain, persistent dizziness, blurred vision or tingling of your face
• Any other problem which concerns you