Left heart catheterization is the passage of a thin flexible tube (catheter) into the left side of the heart. It is done to diagnose or treat certain heart problems.
You may be given a mild medicine (sedative) before the procedure starts to help you relax. The health care provider will place an IV into your arm so that you can get medicine during the procedure.
You will lie on a padded table. Your doctor will make a small surgical cut on your body. A flexible tube (catheter) is inserted through the cut into an artery. It is most often inserted through the groin, but may be placed in your arm or wrist. You will be awake during the procedure.
Live x-ray pictures are used to help guide the catheters up into your heart and arteries. Dye will be injected into your body to highlight blood flow through the arteries. This helps show blockages in the blood vessels that lead to your heart.
The catheter is then moved through the aortic valve into the left side of your heart. The pressure is measured in the heart in this position. Other procedures, such as ventriculography to check the heart's pumping function and coronary angiography to look at the coronary arteries can be done at this time. Sometimes procedures to correct blockages in the arteries are then performed, such as angioplasty with or without stenting.
The procedure may last from less than 1 hour to several hours.
In most cases, you should not eat or drink for 8 hours before the test. (Your health care provider may give you different directions.)
The procedure will take place in the hospital. You may be admitted the night before the test, but it is common to come to the hospital the morning of the procedure.
Your health care provider will explain the procedure and its risks. You must sign a consent form.
You will be given medicine (a sedative) to help you relax before the procedure. However, you will be awake and able to follow instructions during the test.
You will be given local numbing medicine (anesthesia) before the catheter is inserted. You will feel some pressure as the catheter is inserted, but you should not feel any pain. You may have some discomfort from lying still for a long period of time.
The procedure is done to look for:
The procedure may also be done to repair certain types of heart defects, or to open a narrowed heart valve.
When this procedure is done with coronary angiography, it can open blocked arteries or bypass grafts.
The procedure can also be used to:
Swan-Ganz catheterization is the passing of a thin tube (catheter) into the right side of the heart and the arteries leading to the lungs. It is done to monitor the heart's function and blood flow. This test is most often done in persons who are very ill.
The test can be done while you are in bed in an intensive care unit (ICU) of a hospital or in special procedure areas such as a cardiac catheterization laboratory.
Before the test starts, you may be given medicine (sedative) to help you relax.
You will lie on a padded table. Your doctor will make a small surgical cut near the groin or in your neck. A flexible tube (catheter or sheath) is placed through the cut into a vein. Sometimes, it will be placed in your arm. You will be awake during the procedure.
A larger catheter is inserted and carefully moved into the upper chamber of the right side of the heart. X-ray images may be used to help the health care provider see where the catheter should be placed.
Blood may be removed from the catheter to measure the amount of oxygen in the blood.
During the procedure, your heart's rhythm will be constantly watched using an electrocardiogram (ECG).
You should not eat or drink anything for 8 hours before the test starts. You may need to stay in the hospital the night before the test. Otherwise, you will check in to the hospital the morning of the test.
You will wear a hospital gown. You must sign a consent form before the test. Your health care provider will explain the procedure and its risks.
You may be given medicine to help you relax before the procedure. You will be awake and able to follow instructions during the test.
You may feel some discomfort when the IV is placed into your arm. You may also feel some pressure at the site when the catheter is inserted. In people who are critically ill, the catheter may stay in place for several days.
You may feel discomfort when the area of the vein is numbed with anesthetic.
The procedure is done to evaluate how the blood moves (circulates) in people who have:
It may also be done to monitor for complications of heart attack and to see how well certain heart medicines are working.
Swan-Ganz catheterization can also be used to detect abnormal blood flow between two areas of the heart that are not normally connected.
Conditions that can also be diagnosed or evaluated with Swan-Ganz catheterization include:
Coronary arteriography, also known as coronary angiography, is an invasive procedure that involves cardiac catheterization. It's used to diagnose coronary artery disease.
Coronary arteriography, also called coronary angiography, is the standard diagnostic test for coronary artery disease, but because it's an invasive test it's often ordered only after you've had a series on noninvasive heart tests.
Coronary arteriography is a procedure in which a very thin catheter, or tube, is threaded through an artery from the groin, neck, or arm to the coronary arteries around the heart. The doctor uses this catheter to put a contrast dye into the blood of the coronary arteries. The dye shows up on X-rays and highlights the coronary arteries. The X-rays are called angiograms.
A doctor looking at these images can see whether you have a lot of plaque (fatty buildup) that is causing your coronary artery to be more narrow than normal. As plaque builds up, it is harder for oxygen-rich blood to get to the heart through the coronary arteries. This can cause chest pain, angina, and even heart attack. This is called coronary artery disease (CAD), also known as coronary heart disease.
It's worth noting that just because you have chest pain and other possible symptoms of heart attack does not mean that your angiogram will show signs of coronary artery disease. In fact, in a review of patient data from 238 patients who had cardiac catheterization because of chest pain, researchers found that only one-third had coronary artery disease.
This relatively painless test takes less than three hours and gives a definitive answer to the question of whether — and where — you have buildup in your coronary arteries. In emergency situations, it may help open up a blocked artery to get blood flowing again.
Coronary arteriography is performed on millions of adults every year and has minimal risks associated with it. However you should be aware that:
You probably won’t be able to drive after the procedure, so make sure you have someone who can take you home.
People who are over age 75, have diabetes, have kidney disease, are female, or are receiving coronary arteriography on an emergency basis are more likely to have complications than other patients. Despite the possibility of damage to kidneys, coronary arteriography has been shown to be safe and informative in preparation for kidney transplants.
Although coronary arteriography remains the gold standard for diagnosing coronary artery disease, cardiac computed tomography (CT) is a noninvasive test that offers much the same information, according to researchers.
Electrophysiology studies (EPS) are tests that help doctors understand the nature of abnormal heart rhythms (arrhythmias).
When someone’s heart doesn’t beat normally, doctors use EPS to find out why. Electrical signals usually travel through the heart in a regular pattern. Heart attacks, aging and high blood pressure may cause scarring of the heart. This may cause the heart to beat in an irregular (uneven) pattern. Extra abnormal electrical pathways found in certain congenital heart defects can also cause arrhythmias.
During EPS, doctors insert a thin tube called a catheter into a blood vessel that leads to your heart. A specialized electrode catheter designed for EP studies lets them send electrical signals to your heart and record its electrical activity.
During an EPS, about 3 to 5 electrically sensitive catheters are placed inside the heart to record electrical activity.
Risks may include:
At a hospital or clinic, doctors and nurses do EPS in a room that has special equipment for the tests. You may hear this room called the electrophysiology laboratory, or EP lab. Some call it the catheterization laboratory (cath lab). During the test:
If the type and location of the arrhythmia is identified and an appropriate therapy decided, cardiac ablation or insertion of a pacemaker or ICD may be performed during or immediately after the EPS.
“I could feel my heart speeding up, which was weird. But it didn’t hurt. It was more like hiking up and down hills really fast.” Esmerelda, age 38
You’ll be moved to a recovery room where you should rest quietly for 1 to 3 hours. During this time:
Follow the instructions your nurse or doctor gave you, including taking any new medicines that were prescribed. Most people can start eating food and taking their medicines within 4 to 6 hours after the test. Most can do their usual daily activities the day after the test. Don’t drive for at least 24 hours.
The puncture site may be sore for several days. A small bruise at the puncture site is normal. If the site starts to bleed, lie flat and press firmly on top of it. Have someone call the doctor or EP lab.
A peripheral angiogram is a test that uses X-rays and dye to help your doctor find narrowed or blocked areas in one or more of the arteries that supply blood to your legs (View an animation of an angiogram). The test is also called a peripheral arteriogram.
Doctors use a peripheral angiogram if they think blood is not flowing well in the arteries leading to your legs or, in rare cases, to your arms. The angiogram helps you and your doctor decide if a surgical procedure is needed to open the blocked arteries. Peripheral angioplasty is one such procedure. It uses a balloon catheter to open the blocked artery from the inside. A stent, a small wire mesh tube, is generally placed in the artery after angioplasty to help keep it open. Bypass surgery is another procedure. It re-routes blood around the blocked arteries.
Serious risks and complications from peripheral angiograms are very unlikely. But in rare cases:
A doctor with special training performs the test with a team of nurses and technicians. The test is performed in a hospital or outpatient clinic.
“I watched the whole thing on the screen. It was a pretty easy procedure.” Shirley, age 77
A small bruise at the puncture site is common. If you start bleeding from the puncture site, lie flat and press firmly on that spot. Ask someone to call the doctor who did your peripheral angiogram.
Call your doctor if:
Cerebral angiography is a procedure that uses a special dye (contrast material) and x-rays to see how blood flows through the brain.
Cerebral angiography is done in the hospital or radiology center.
An area of your body, usually the groin, is cleaned and numbed with a local numbing medicine (anesthetic). A thin, hollow tube called a catheter is placed through an artery. The catheter is carefully moved up through the main blood vessels in the belly area and chest into an artery in the neck. X-rays help the doctor guide the catheter to the correct position.
Once the catheter is in place, the dye is sent through the catheter. X-ray images are taken to see how the dye moves through the artery and blood vessels of the brain. The dye helps highlight any blockages in blood flow.
Sometimes, a computer removes the bones and tissues on the images being viewed, so that only the blood vessels filled with the dye are seen. This is called digital subtraction angiography (DSA).
After the x-rays are taken, the catheter is withdrawn. Pressure is applied on the leg at the site of insertion for 10 to 15 minutes to stop the bleeding or a device is used to close the tiny hole. A tight bandage is then applied. Your leg should be kept straight for 2 to 6 hours after the procedure. Watch the area for bleeding for at least the next 12 hours.
Before the procedure, your health care provider will examine you and order blood tests.
Tell the provider if you:
You may be told not to eat or drink anything for 4 to 8 hours before the test.
You must sign a consent form. Your provider will explain the procedure and its risks. When you arrive at the testing site, you will be given a hospital gown to wear. You must remove all jewelry.
The x-ray table may feel hard and cold. You may ask for a blanket or pillow.
Some people feel a sting when the numbing medicine (anesthetic) is given. You will feel a brief, sharp pain and pressure as the catheter is moved into the body.
The contrast may cause a warm or burning feeling of the skin of the face or head. This is normal and usually goes away within a few seconds.
You may have slight tenderness and bruising at the site of the injection after the test.
Cerebral angiography is most frequently used to identify or confirm problems with the blood vessels in the brain.
Your doctor may order this test if you have symptoms or signs of:
In some cases, this procedure may be used to get more detailed information after something abnormal has been detected by an MRI or CT scan of the head.
This test may also be done in preparation for medical treatment (interventional radiology procedures) by way of certain blood vessels.
Coastal Cardiology provides many different procedures, tests and therapies for our cardiac patients.
Nuclear Stress test
Transesophageal Echocardiography (TEE)
Cardiac CT Scan
Left heart catheterization/Coronary Arteriogaphy
Right heart catheterization
Transcutaneous Aortic Valve Replacement
Percutaneous Left Ventricular Assist Devices
Carotid Artery Stenting (CAS)
Thoracic Aortic Aneurysm Repair
Endovascular Aortic Repair of AAA
Temporary and Permanent Pacemaker
Emergency calls can be avoided with foresight. Treatment of a condition before it becomes an emergency is the surest way to better health and few hospitalizations.
It is always best to call your regular physician before going to the Emergency Room, since many hospital visits can be avoided. If you are unsure of whether you have an emergency please call your regular physician to help you determine this. If you are unable to reach your regular physician during a cardiac emergency, you may reach us or our covering physician by calling the office. If your situation does not allow time for a return phone call from the physician please go to the nearest hospital Emergency Room where a 24 hour-a-day Emergency Room Physician can evaluate you quickly and determine the stability of your situation.
Fees for medical services at our office will be due and payable at the time of your visits. By asking you to do this we can cut down the cost of billing and bookkeeping; and hopefully, keep your medical fees down. Our office, of course, will assist you when requested in helping you to collect your entitled reimbursement to the best of their ability.
Our billing office will file all claims to third party contractors after you meet your co-pay and deductible. Should you have any questions concerning your account, please call our billing office number at (361) 887-2970.
We see patients in the office who have either been referred by a personal physician or who have been seen previously in the hospital. Our office staff is available from 9:00 a.m. to 5:00 p.m. Monday thru Friday. We see patients by appointment only from 9:00 a.m. to 4:00 p.m. Monday thru Friday.
We ask that all HMO patients be responsible for obtaining their Primary Care Physician (PCP) referral forms prior to scheduling an appointment. We make every effort to honor all time commitments and request that you extend the same courtesy to us. On occasion, emergencies can cause problems, and whenever possible, you will be fully informed if there will be any delays because of this.
COASTAL CARDIOLOGY PLLC LOCATIONS
613 Elizabeth Street, Suite 402
Corpus Christi, Texas 78404
5920 Saratoga Blvd, Suite 380
Corpus Christi, Texas 78414
13725 Northwest Blvd., Suite 180
Corpus Christi, Texas 78410
613 Elizabeth Street, Suite 102
Corpus Christi, Texas 78404