What to expect when you're expecting...a cardiac catheterization!

Factual Questions
1

The day after tomorrow, I get to experience the wonder of having a doctor slice open an artery in either my wrist or my thigh, insert a long plastic tube up to my heart, and inject a dye into the arteries he finds. If I am very lucky, he will find a blockage or two, and install a stent. (Or schedule me for a bypass.) On the plus side, I do get to see what my beating heart looks like; that’s kinda cool, even if I’ll be too blissed out to appreciate it.

Any Dopers ever had a cardiac cath done? What can I expect, in terms of the length of the procedure, the time from arriving at the clinic to leaving, pain or discomfort during the procedure, time of recovery?

I’m not looking for medical advice; just what to expect.

2

I had one last April. It wasn’t fun, but it wasn’t horrible either. I had to get to the hospital at the butcrack of dawn, was not allowed to eat or drink anything after midnight prior to the procedure.

After checking in, I was shown to a room, given a robe. The worst part was the two nurses coming in to shave my junk. Really didn’t like that, not one little bit. They also shaved part of my chest. They hooked up an IV, and that needle stick was the most painful part of the whole thing. Not a big deal. Eventually they wheeled me down to the staging area for the operating room, and parked me where I could see a TV for a few minutes.

Next, it was in to the actual operating room itself. Cold as the ninth circle of Dante’s Hell in there. After that, things get a little fuzzy. I remember a nurse telling me she was going to give me the sleepy stuff, and a sensation like she’d just injected ice water into my left arm (where the IV was). I somewhat blurrily remember some masked doctor looking guy standing over me and saying…something. Next thing I knew, I woke up to the same guy saying they were done, and I was lucky…no blockage.

I’m buzzing pretty good now…from whatever they gave me to knock me out. Rumor has it I made several WEEEEEEEEEEEE! sounds as they wheeled me back to the room. My Druidess was there waiting for me, relieved the thing had gone so well. The next few hours remain blurry…I kept drifting in and out of a dreamless sleep.

Eventually, they came in to take the IV out, let me get dressed, and made me ride a wheelchair down to the exit. I could have walked, but apparently the 11th Demandment of OG says “Thou shalt de-ass a hospital in a wheelchair, no matter what”.

I was obviously in no condition to drive, so my Druidess took me home and put me to bed, where I slept for the rest of the day and night.

I think I was actually in the hospital from about 5:00 AM until about 2:30 or so.

Really didn’t experience any pain to speak of—but again, I really hated getting my junk shaved. Most undignified thing that has happened to me in years.

3

But you can watch your heart beat in an ultrasound also - I saw mine, it was spiffy.

At least part of it was fun :smiley:

4

Thank you, Oakminster - that’s exactly the kind of thing I was looking for when I started this thread.

5

I had a similar procedure about 1 year ago.

In my case they were zapping a nerve in the heart (which was screwing up my heart’s rhythm), using a catheter.
But my experience was much the same as Oakminster, so I’ll just mention the things that were different.

In my case I was asked to shave my groin myself. Then, on seeing what a poor job I’d done, the nurse came and shaved the area again.
But seriously, it was the crappest razor I’d ever seen. (Might be worth bringing along a decent wet razor).

I was awake for the whole procedure but “blissed out” on something, and my recollection of most of it is vague. But towards the end my alertness rose and there was pain at that point. Not huge pain – ironically it was somewhat like heartburn.
This won’t apply for you (though you may find it interesting), but they had control of my heart rate and had to slow and speed my heart as part of the procedure. Which felt very weird.

After the procedure, for some reason the catheters had to stay in for an hour or two, which was annoying more than anything because it meant they wouldn’t let me sit up, because I could bend the catheters.

For me, the most painful bit was after removing the catheters. They had inserted a total of six into my groin and just pressing on the resulting wound would be insufficient to stop the bleeding. So they had a belt and an inflatable plastic ball thing that could apply strong, sustained pressure.
A couple of quite hot nurses actually applied this device and I mention that because it was extra motivation not to scream like a little girl when the ball inflated. Which I (just) managed not to do.

The ball was there for another half hour or so, though the pressure of it is gradually reduced over that period.

Oh, and for about 10 days after the op, I had at least one migraine a day. As someone who’d only had 4 or 5 migraines in my life before that point, this was quite worrying for me.
But I haven’t had one since then, so it was probably just a reaction to one of the drugs (as well as “happy drugs”, they also have to thin and thicken the blood), or just the stress of the whole thing. Either way it’s a very rare side effect.

Anyway, good luck, hope I haven’t made it sound too scary. It’s really not that much to go through :slight_smile:

6

My husband had an emergent cardiac cath and for a time held the record for the shortest time from arrival to completion (38 minutes) at the heart center he went to. He was amazed that it didn’t hurt much at all, and he was not sedated. He and the doctor talked throughout the procedure. He felt the IV (a little pinch) and the access into the groin was slightly painful, but he was comfortable for the rest of the process.

They will likely go in through the groin. IME they only use the radial approach when there is some impediment like a blockage in the femorals. They will locally anesthetize the area before they make the incision. They will insert a wire and then a catheter along the wire. They’ll take their pictures and possibly pressure readings, and if they see any blockages that are amenable to balloon angioplasty and/or stenting they’ll take care of that. They’ll check again for proper flow through the arteries before they remove the instruments, and they’ll check the position of the point of entry before they decide to use a closure device on the groin (or arm) incision or simply apply manual pressure.

I think the most common complication (and it’s not very common) is a hematoma at the incision site. My mother had one after her procedure, but she is prone to them. The staff will be well versed in how to treat them.

Here’s hoping for nice, clean arteries and a quick recovery.

7

I’ve had three caths (two while I was in the hospital after my heart attack; the third one was outpatient, 4 months later as a follow-up to check my healing).

For the first two I already had an IV in my arm; for the outpatient one, they had to hook one up. After prepping you, they roll you into the procedure room, which was freezing like Oakminter said. But they put warmed blankets over me to be comfortable. They don’t knock you out but you are kind of “twillighted” - my surgeon told me they use Benadryl. They want you to be awake in case you start having chest pains, you can tell them. I recall “waking up” several times during the first procedure and feeling disoriented; I was not sure how long I’d been asleep (5 minutes? 8 hours?) and not sure if I had been snoring :slight_smile: For the second and third procedures, I don’t really remember waking up during it. I vaguely remember feeling then doctor “moving around” my leg where the catheter went in, felt weird but not painful. And I do remember seeing my heart on the TV screen.

All of my procedures were done through the groin. You aren’t allowed to lift anything heavy or drive for a couple of days, because they can’t stitch an artery, and they don’t want you to strain yourself and start bleeding. The first one was done with some sort of “plug” in the artery that dissolved gradually - I had a little “bump” (about the size of a pea) under the skin for a week or so. The second one was done differently, on the other leg. They did not do the plug but instead put a plastic ball-type thing on my groin and secured it with some sort of strap to put pressure on the artery. THIS was VERY painful while they were securing it (less than a minute, probably), but then after that it was just pressure.

Initially you have to lie flat on your back for a while (maybe 2 hours, I am not sure now) so you don’t bleed, then after that I could sit up a little bit and have lunch. For the one with the plug, I got up and walked to the bathroom a couple hours later. It was, I think, 6-8 hours before I was allowed to get up with the pressure-type seal. I had to go to the bathroom (the nurses told me they had pumped a lot of fluid into me during the procedure to keep my hydrated), so they gave me a bedpan. I couldn’t go (shy bladder, I guess) and they ended up giving me a catheter to empty my bladder.

Afterwards, the groin spot was bruised (in a radius of maybe 6" around the incision) and a little sore at the point of entry for a week or so. For the first two procedures, I was already in the hospital for my heart attack so I stayed there. For the third one, it was outpatient, but they kept me overnight anyway just to keep an eye on me. They do tell you to pack a bag just in case they decide to make you stay the night.

All in all, as procedures go, it was not fun, but not what I would call painful - just uncomfortable. Let us know how it goes! Good luck.

8

I had the procedure last summer. I have a HUGE needle phobia, so you can imagine how I felt about the whole thing. The procedure itself was a piece of cake. Whatever they gave me to sedate me really worked. I remember looking at the monitor, but that was about it.

Of course, the emergency bypass that was the next step was a bit more of an ordeal…

9

The experiences related by others match my own, but some procedures may vary slightly.
For example, for my first two angioplasties i was kept overnight because of the concern the arterial incision in my thigh was vulnerable to reopening. I am aware that this may no longer be standard procedure.
I have been in three cardiac care centers in three different cities. My experience was all positive. The level of professionalism was excellent. In two of these instances they saved my life. (The one in Atlanta they do 50 to 60 of these procedures a day.)
I really try to be a good patient now, respect the process and especially the people involved. The last time I was prepped it was a young man who shaved my groin area. A first for me. He was the best I’ve had! Maybe just because he was on familiar territory.

10

I have no experience with cardiac cath, but if the OP does wind up in the “can’t pee” situation, running water (nearby, or even hand in a basin of warm water) might be sufficient inspiration. When I was in labor with my son and they wouldn’t let me up, I had the nurse turn on the faucet nearby and leave the room, and it helped.

11

i’ve had this done and it was no big deal. Just a little relaxing sedation…awake and aware during the procedure. My arm’s vein was used. The result was excellent since no blockage was found. The doc said i could keep on with my diet of WHITE CASTLE HAMBURGERS.

12

Like Mijin I had a cardiac ablation (twice) in 2008. I’ll just add that my thigh hurt like hell for about a month (I think they tore the muscle up a little) but it’s fine now.

I also had to have a needle inserted into the pericarduim as my electrical issue was on the outside as well as the inside of the heart. beowulff, they put a needle up under my sternum through the diaphragm. That was also sore for about a month but then was fine. All in all it was tame as far as medical procedures can go.

My procedures were done at Allegheny General Hospital in Pittsburgh and Cleveland Clinic.

13

I had a bad time with mine, I was insufficiently anaesthetized for the insertion and then in recovery I had some sort of drug reaction that caused me a lot of emotional distress. Apparently it was traumatic for my family but I don’t have a very clear memory of it. Possible the two things are related because they kept stopping to give me more drugs.

This seems to have been pretty unusual, and I know other people for whom the cath procedure was a breeze.

Recovery is pretty quick, although the incision sites remain sore for a couple of weeks.

14

Thanks, all - this is very reassuring.

I have an atrophied nudity taboo, so having a nurse give the boys a haircut is no big deal. In fact, if she’s hot…no, no, better not go there. Better just lie there and think about batting averages.

This is what I’m hoping for. I’m 43, no family history of heart disease, overweight but not obese, nonsmoker, nondrinker, and run 12 - 20 miles a week. I’m more pissed than anything else at the thought of having a blockage.

Still, I’m having the procedure done at Emory Hospital, by the Professor of Medicine who is the Director of the Cardiac Catheterization Lab and the Director of Interventional Cardiology. So it’s not like I’m not in pretty good hands.

15

I had one done as well. I don’t remember being sedated. The worst part was when they injected the xylocaine (the local anesthetic). The nurse warned me it would sting, and boy, did it ever!

The OR itself was freezing, but they gave me a blanket hot from the blanket warmer, and that was a big help.

As soon as they finished, the doctor went out and told my wife that I was “a very very sick man.” I had bypass surgery 4 days later. I was 34 at the time.

16

Believe me when I say there was nothing remotely sexual about the experience. The nurses were very clinical about it. I found it undignified, but that’s about it. I guess somebody with a medical/submission fetish might find that fun somehow…but definitely not my scene.

17

I’ve had one to fix Wolff-Parkinson-White syndrome. Actually, I’ve had two, since the first one went awry.

Watching my heart and a little thing wiggling around in there on the screens was pretty awesome. Honestly, I was too distracted by that to really notice any discomfort at the time. I conversed with the surgeon a bit as well, like wondering if the glass he was behind had lead in it. Yeah, they shaved my junk and stuff… whatever, I go into “this is doctor stuff” mode and don’t worry about it. I did make a joke about this being the most expensive shave job I’ve ever had.

The worst part was having to lay on my back for like 8 hours afterward with a weight on my thigh. Not painful; just annoying.

I had to do it twice because the first time, the cath actually got caught in a tangle of valve strings, and they had a heck of a time removing it; ultimately they put me under general anesthetic and had to cut off the handle of the cath, and sliding another (hollow) cath over it to push the tangle away. They didn’t get to finish the ablation that time. It almost ended up as open-heart surgery; if that last strategy hadn’t worked, they were ready to wheel me to the OR.

The first time I had to stay at the hospital overnight but the second I left the same day (both procedures were early morning). I think the bandages were gone in a week, though I did get bruising that lasted longer.

This was almost 3 years ago; I was 30 at the time and in otherwise excellent health.

18

Oh, I believe you - I’ve had to drop trou for female docs and nurses before, and it’s very clinical and professional. I wonder, in fact, if female healthcare providers are trained to be clinical in those situations precisely because so many pornos start with “hot nurse walks into a patient’s room…”

19

Last update - I had the procedure done today, and am home and resting. No blockage, but some plaque in an artery, and apparently the lining of my arteries don’t open as much as they should, but these things can be treated medically. Because I was an atypical cardiac patient, I was asked to take part in some research studies, which meant that in addition to the dye, I also got optical and ultrasound imaging as well.

Thanks again to everyone who responded to this thread - my experience was pretty much exactly like everyone else’s, except that I didn’t get the good drugs for very long, was awake and alert for most of the procedure, and didn’t actually get to see my heart, since I couldn’t see the monitors. On the other hand, taking out the catheters didn’t hurt, and I wasn’t subjected to the inflatable ball torture that several of you have described.

20

okay, so reading this thread has taught me(a medical coward, who squeams easily) a lot about a scary procedure…But I’m left with one burning question:
Why the (dreaded!) shaving?
They’re operating on your heart, aren’t they?
Yes, I know they do something gross and scary with an artery in your leg, too…but that’s a leg. Lots of men shave their legs ( atheletes, mostly, I think), and I wouldn’t object to being treated once like a champion swimmer. And, wherever that artery is, surely it’s only a pretty narrow spot where they insert the catheter wire that needs to be sterilized…

How much shaving are we talking about here? And, umm, where?