Right Heart Catheterization

WHAT YOU SHOULD KNOW

Risks

IF YOU'RE HEADING FOR THE HOSPITAL...

Before You Go

• The Week Before Your Right Heart Cath:
• You should stop taking aspirin or ibuprofen a few days before the test; your doctor will tell you when. If you've been told to take aspirin daily, do not stop without asking first.
• If you are taking a blood thinner, you may need to stop 2 or 3 days before the test. Check with your doctor, however, before you stop taking this or any medicine.
• Consult your doctor before taking any over-the-counter medicine.
• A dye will be used during the test to show up the parts of your heart better. People who are allergic to shellfish (lobster, crab, or shrimp) may also be allergic to this dye. If you have such an allergy, make sure the doctor is aware of it.
• You may need to make an appointment to have blood drawn for lab tests.
• The Night Before Your Right Heart Cath:
• You may be given a pill to take to help you sleep.
• You'll need to stop eating and drinking anything (even water). The doctor will tell you when.

When You Arrive

• Before taking any medicine on the day of the procedure, check with your doctor. These medicines include insulin, diabetic pills, high blood pressure pills, or heart pills. Bring a list of your medicines, or the pill bottles themselves, with you to the hospital.
• Do not wear contact lenses the day of your heart cath. You may wear glasses.
• An anesthesiologist may talk to you before the test begins. This is the doctor who will give you medicine to make you sleepy during the procedure.

What to Expect While You're There

• Taking Vital Signs: These include your temperature, blood pressure, pulse (counting your heartbeats), and respirations (counting your breaths). A stethoscope is used to listen to your heart and lungs. Your blood pressure is taken by wrapping a cuff around your arm.
• Dye: You will be given dye through an IV tube to make your heart and arteries show up better on x-rays. As the dye is put into the IV, you may have a reaction. You may feel warm all over, or just in your head. You may get a headache or feel sick to your stomach. Your heart may seem to skip beats or have extra ones. These are normal symptoms that quickly disappear. However, if you feel chest pain or angina while you are getting the dye, let your doctor know immediately.
• Blood Tests: You may need blood taken for tests. It can be drawn from a vein in your hand or from the bend in your elbow. Several samples may be needed.
• Chest X-ray: This is a picture of your lungs and heart that will help the doctor during the procedure.
• Heart Monitor: (Also called an electrocardiogram [e-LEK-tro-KAR-di-o-gram] or EKG). Three to five sticky pads are placed on different parts of your body. Each pad has a wire that is hooked to a TV-type screen or to a small portable box (telemetry unit) that shows a tracing of each heartbeat. Your heartbeat will be carefully monitored throughout the procedure.
• IV: A tube placed in your vein for giving medicine or liquids. It will be capped or have tubing connected to it.
• Oxygen: Your body may need extra oxygen at this time. It is given either through a plastic mask over your mouth and nose or through nasal prongs. Tell your doctor if the oxygen is drying out your nose, or if the nasal prongs bother you. Don't take off your oxygen without asking your doctor or nurse. If you do, your body may not get enough oxygen.
• Pulse Oximeter: To check the amount of oxygen in your blood, you may be hooked up to a pulse oximeter (ox-IM-uh-ter). It is placed on your ear, finger, or toe and connected to a machine that reads the level.
• Blood Pressure: A doctor may take a blood pressure reading in both arms and both legs.
• Pulse: The pulse (heartbeats) in your feet and ankles will be measured. The pulse is the beat you feel under the skin when the heart pushes blood through a vein or artery. A doctor may put an "X" over the spots on your legs and feet where the pulse is the strongest.
• Anesthesia: Right before the procedure, you may be given medicine to make you feel sleepy and more relaxed and to dull pain from the procedure.

When the Procedure Is Over

• Activity: You will need to lie flat and still in bed for at least 4 hours after the procedure (the doctor will tell you when it's OK to get up). If you get tired of lying on your back, let the nurses know. They can help you "log-roll" from side to side. Staying in bed is especially important if the catheter was inserted in your leg because you must keep the leg straight for at least 4 hours after the heart cath. Call for your doctor before getting up for the first time. If you ever feel weak or dizzy, sit or lie down right away and call a nurse.
• Eating: Shortly after the procedure, you may be able to eat "finger foods" while lying flat in bed.
• Pain Medicine: You'll probably be given medicine to ease your pain. This medicine may be given in your IV, as a shot, or by mouth. Tell the nurse if the pain does not go away or comes back.
• Pressure Stockings: These tight elastic stockings keep blood from pooling in the legs and causing clots.
• Pneumatic Boots: These are plastic boots or leggings put on over pressure stockings or ace wraps and connected to an air pump machine. The pump tightens and loosens different parts of the boot to help push the blood back up to the heart and keep clots from forming.
• Tell Your Doctor If:
• You have chest pain.
• The leg or arm where the catheter was inserted feels hot, cold, tingly, or numb, or turns a different color.
• The area where the catheter was inserted is swollen or bleeding.
• You have pain in your back, thigh or groin.
• You feel nauseated or start to sweat a lot.

After You Leave:

• You must take it easy for the rest of the day on which you have your heart cath. Rest or lie down on a couch. Do not walk except to go to the bathroom. You may start your normal activities on the following day.
• Take a sponge bath when you get home to keep the area around the point of entry clean. Keep the bandage clean and dry until the following morning. Then you may take it off and bathe or shower normally.
• If the place where the catheter was inserted starts to bleed, put pressure on the bandage with your hand. Hold this pressure for 30 minutes. Call your doctor to report the bleeding. If it doesn't stop, call 911 or 0 (operator) to get transportation to the nearest hospital or clinic. This is an emergency. Do not drive yourself!
• Watch the place where the catheter was inserted. It is normal to have a bruise. Draw a line with a pen around the edges of the bruise so you can see whether it is starting to get bigger.
• Always take your medicine as directed. If you feel it is not helping, call your doctor, but do not quit taking it without his OK.
• Continue to take the medicines you were taking before the heart cath. If you were taking a blood thinner, such as Coumadin, ask your doctor when you should start taking it again. You may have to have your blood checked if you are taking this type of medication.
• Do NOT take any medicine that contains aspirin or ibuprofen Ask your doctor before taking any over-the-counter medications.
• If your doctor has prescribed antibiotics, continue to take them until they are all gone---even if you feel better.
• Do not lift anything heavier than 20 pounds for 2 days.
• You may eat your regular diet as soon as you get home. Since you will have to lie down and rest on the first day, eat foods that you can swallow easily. Starting on the second day, resume a regular balanced diet. Healthy eating can boost your energy and speed the healing process.
• You may be told to eat foods that are low in fat. You may also be told to limit the amount of salt you eat. This means not adding salt to your food during meals or when you cook. If you need help with your diet, ask your doctor for suggestions.
• Drink 6 to 8 large glasses of liquid each day. (Or follow your doctor's advice if you are on a fluid limit.) Good liquids to drink are water, juices, and milk. Limit the amount of caffeine you drink by cutting down on or eliminating caffeinated coffee, tea, and soda.
• Your doctor will tell you when you can start driving again.

Call Your Doctor If:

• You have nausea or vomiting for several hours.

Seek Care Immediately If:

• Nausea or vomiting continues.
• The vein used for the heart cath begins bleeding and won't stop.
• The bruise where the catheter was inserted gets bigger and becomes swollen.
• The leg or arm used for the heart cath becomes numb or painful, or changes color.