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Cardiac Catheterization & Angiogram

Last updated May 7, 2018

Approved by: Krish Tangella MD, MBA, FCAP

Cardiac Catheterization & Angiogram are diagnostic procedures that involve the use of catheters to study the structure/composition (anatomic study), and functioning of the heart and its vessels.

Background Information:

What are the other Names for the Procedure?

  • Cardiac Catheterization & Angiography

What is Cardiac Catheterization & Angiogram surgical procedure?

Cardiac Catheterization & Angiogram are diagnostic procedures that involve the use of catheters to study the structure/composition (anatomic study), and functioning of the heart and its vessels.

What part of the Body does the Procedure involve?

The procedure involves the coronary arteries, muscles of the heart, its valves, and a large artery in the arm or leg.

Why is the Cardiac Catheterization & Angiogram surgical procedure Performed?

There could be various reasons for performing a Cardiac Catheterization & Angiogram procedure. Some of the reasons include:

  • To study the cause of chest pain, or pain in the jaw, arm, and neck
  • To identify any obstruction in the arteries
  • To check the heart’s ability to pump blood
  • Diagnose heart-related defects, congenital heart problems
  • To study diseases of the heart valves

What are some Alternative Choices for the Procedure?

To study and diagnose any ailment related to the coronary artery, or the heart, this procedure remains the gold standard technique.

What are the Recent Advances in the Procedure?

The recent advance in the procedure is on the technical side, which helps in performing the procedure in such a way that the patient requires a lesser hospital stay.

What is the Cost of performing the Cardiac Catheterization & Angiogram surgical procedure?

The cost of Cardiac Catheterization and Angiogram procedure depends on a variety of factors, such as the type of your health insurance, annual deductibles, co-pay requirements, out-of-network and in-network of your healthcare providers and healthcare facilities.

In many cases, an estimate may be provided before the procedure. The final amount depends upon the findings during the surgery/procedure and post-operative care that is necessary.

When do you need a Second Opinion, prior to the Procedure?

  • It is normal for a patient to feel uncomfortable and confused with a sudden inflow of information regarding Cardiac Catheterization and Angiogram procedure and what needs to be done
  • If the patient needs further reassurance or a second opinion, a physician will almost always assist in recommending another physician, if required
  • Also, if the procedure involves multiple surgeries or has many alternatives, the patient may take a second opinion to understand and choose the best one. They can also choose to approach another physician independently

What are some Helpful Resources?

http://www.mayoclinic.com/health/coronary-angiogram/MY00541/DSECTION=what-you-can-expect (Accessed on 17th July, 2012)

http://www.nhlbi.nih.gov/health/health-topics/topics/cath/during.html (Accessed on 17th July, 2012)

Prior to Cardiac Catheterization & Angiogram surgical procedure:

How is the Cardiac Catheterization & Angiogram surgical procedure Performed?

  • In a Cardiac Catheterization & Angiogram procedure, a long thin tube called catheter is inserted through the arm, neck, or upper thigh of the patient. It is slowly guided to the coronary artery
  • The physician is able to direct the catheter to the exact location with the help of X-ray imaging techniques and the use of radio contrast dye, injected into the patient’s blood.
  • The physician may proceed with diagnosis, take blood pressure readings, and check for any ailment of the heart muscles, and so on
  • After the diagnostic study is performed, the catheter is withdrawn, and the site of puncture pressed down with compression bands, till bleeding stops completely
  • Next, the patient is asked to lie down flat for at least 6 hours, after the puncture site has been bandaged tightly

Where is the Procedure Performed?

The Cardiac Catheterization & Angiogram procedure is performed in a hospital. The patient is admitted, undergoes the procedure and is discharged, as per the instruction of the physician.

Who Performs the Procedure?

The surgery is performed by a cardiologist along with a radiologist, or by a team of healthcare providers specialized in cardiovascular care.

How long will the Procedure take?

The procedure may take anywhere between 1-3 hours.

What do you need to tell your Physician before the Procedure?

It is very important to provide the following information to your healthcare provider. This enables your healthcare provider in assessing the risks for the surgical procedure and helps avoid unnecessary complications.

  • Provide a complete list of medications you are currently, taking to your physician. This information is useful for a variety of reasons. For example, it can help your healthcare provider prevent complications due to a drug interaction
  • If you are allergic to any specific medication or food items
  • If you are taking blood thinners, such as aspirin, warfarin, herbal supplements, or any other such medications
  • If you or your family members, have a history of bleeding disorders, or if there is a tendency to bleed more than normal
  • If you have diabetes, high blood pressure, chest pains, or have previously suffered from a heart attack
  • If you have ever been diagnosed with blood clots in your leg (deep vein thrombosis) or lung (embolism of lung)
  • If you have a history of frequent bone fractures (this may affect bone-healing, if bones are involved as part of your procedure)
  • A list of all previous surgical procedures you have undergone, like for example: Removal of appendix, gallbladder, or any other part, of your body; surgical repair of any body part, such as hernia repair, perforation of bowel wall, etc.

What Preparations are needed, prior to the Procedure?

  • The physician may evaluate the individual’s medical history to gain a comprehensive knowledge of the overall health status of the patient including information related to the medications that are being currently taken
  • Some medications increase a person’s chances of bleeding and it may be recommended to discontinue them for a period of time, before the procedure is performed
  • Blood tests may be performed to determine if there is a bleeding tendency or any other medical conditions that prevents the person from undergoing the procedure
  • Normally local anesthesia is not used; however do inform the physician if you are allergic to any local anesthetics, lidocaine, etc.
  • Avoid application of any cosmetics, deodorant, or topical medicines on the area, prior to the procedure
  • It is advisable to quit smoking and the use of any nicotine based products, for a while, before the surgery
  • Consumption of alcoholic drinks must also be avoided for a period of time, as instructed
  • The patient must avoid eating or drinking at least 8 hours prior to the surgical procedure, depending on when the procedure is arranged
  • For persons suffering from diabetes, it is important that the blood sugar stays within the normal range; if not their diabetologist may have to control blood sugar by recommending insulin and/or a combination of oral medicines
  • A physician will request your consent for Cardiac Catheterization & Angiogram procedure using an Informed Consent Form

What is the Consent Process before the Procedure?

A physician will request your consent for Cardiac Catheterization & Angiogram procedure using an Informed Consent Form

Consent for the Procedure: A “consent” is your approval to undergo a procedure. A consent form is signed after the risks and benefits of the procedure, and alternative treatment options, are discussed. This process is called informed consent.

You must sign the forms only after you are totally satisfied by the answers to your questions. In case of minors and individuals unable to personally give their consent, the individual’s legal guardian or next of kin, shall give their consent for the procedure.

What Tests are needed, before the Cardiac Catheterization & Angiogram surgical procedure?

Before a Cardiac Catheterization & Angiogram, the patient has to undergo certain tests such as:

  • Routine blood test
  • Electrocardiogram (ECG)
  • Chest X-ray (this may not be necessary)
  • Transthoracic or transesophageal ECHO
  • The physician may suggest further tests depending on the health of the patient and their medical history.

What are some Questions for your Physician?

Some of the basic questions that you might ask your physician are as follows:

  • What is a Cardiac Catheterization & Angiogram diagnostic procedure?
  • Why is this procedure necessary? 
  • What does the procedure involve?
  • How will this procedure help?
  • How soon should I get it done? Is it an emergency?
  • Who are the medical personnel involved in this procedure?
  • Where is the procedure performed?
  • What are the risks while performing the procedure?
  • What are the complications that might take place while recovering?
  • How long will it take to recover? When can I resume normal work?
  • How many such procedures have you (the physician) performed?
  • Are there any lifestyle restrictions or modifications required, after the procedure is performed?
  • Are there any follow-up tests, periodic visits to the healthcare facility required, after the procedure?
  • Is there any medication that needs to be taken for life, after the procedure?
  • What are the costs involved

During the Cardiac Catheterization & Angiogram surgical procedure:

What kind of Anesthesia is given, during the Procedure?

During the procedure the patient is administered local anesthesia with sedation.

How much Blood will you lose, during the Procedure?

Since the procedure involves inserting a needle in the artery and is less invasive, there is a minimal amount of blood loss involved. This also varies from person to person.

What are the possible Risks and Complications during the Cardiac Catheterization & Angiogram surgical procedure?

The possible risks or complications that may arise during the surgery are:

  • Excessive bleeding
  • Infection
  • Accidental injury to the neighboring tissue or bone
  • Arrhythmia or irregular heartbeat
  • Blood clot formations
  • Rupture of the arterial lining or damage to the coronary artery (In this case, the patient may need immediate bypass surgery)
  • Allergy/reaction to the dye used for X-ray imaging
  • Blockage of the artery
  • Heart attack
  • Stroke

What Post-Operative Care is needed at the Healthcare Facility after the Cardiac Catheterization & Angiogram surgical procedure?

At the healthcare facility, generally there is no requirement for any post-procedure care, unless any complications arise. 

After the Cardiac Catheterization & Angiogram surgical procedure:

What are the possible Risks and Complications after the Cardiac Catheterization & Angiogram surgical procedure?

Post Cardiac Catheterization & Angiogram procedure, the following complications may arise:

  • Infection in the puncture site
  • Hematomas (collection of blood at the puncture site)
  • Kidney damage
  • Bleeding from the puncture site
  • Pseudo aneurysm at the puncture site

What is the Prognosis after the Surgery?

Cardiac Catheterization and Angiogram procedure provides information that helps the physician to successfully diagnose or eliminate any coronary artery, or heart related disorders.  The recovery from the procedure is excellent.

When do you need to call your Physician?

Do contact your physician if you notice any of the following symptoms:

  • Pain around the surgical wound
  • Swelling and redness
  • Bleeding or drainage
  • Loss of sensation in the legs or feet
  • Constipation
  • Fever
  • Dizziness
  • Muscle ache
  • Nausea or vomiting
  • Signs of Infection
  • If any new symptom or discomfort is observed

What Post-Operative Care is needed at Home after the Cardiac Catheterization & Angiogram surgical procedure?

At home, the following post-operative care is recommended, after a Cardiac Catheterization & Angiogram procedure:

  • Complete the course of medication
  • Avoid strenuous exercises
  • Keep the puncture site clean and dry
  • Wash the puncture site with mild soap while bathing
  • Put pressure against the puncture site, if it starts bleeding
  • Resume daily activity only after the patient feels better
  • Use warm compress to reduce pain, swelling, and bleeding; or follow the physician’s directions
  • Avoid taking non-prescribed medications

How long does it normally take to fully recover, from the Procedure?

It takes about 2 weeks to fully recover from the procedure.

Additional Information:

What happens to tissue (if any), taken out during the Procedure?

The procedure does not involve the surgical removal of any tissue.

When should you expect results from the pathologist regarding tissue taken out, during the Procedure?

Since no tissue is removed during the procedure, a pathologist does not get involved in the care of the patient.

Who will you receive a Bill from, after the Cardiac Catheterization & Angiogram surgical procedure?

It is important to note that the number of bills that the patient may receive depends on the arrangement the healthcare facility has with the physician and healthcare providers.

Sometimes, the patient may get a single bill that includes the healthcare facility charges and the physician charges. Alternatively, the patient might get multiple bills depending on the healthcare provider involved. For instance, the patient may get a bill from:

  • The hospital
  • A cardiologist
  • A healthcare provider specialized in cardiovascular care
  • A radiologist (if radiological tests were performed during the procedure)

The patient is advised to inquire and confirm the type of billing, before a Cardiac Catheterization & Angiogram surgical procedure is performed. 

Thanks and Gratitude:

We sincerely acknowledge and thank Dr. Douglas J. Jones for reviewing the article. His valuable input and feedback has helped enrich the contents of this article.

Douglas J. Jones, MD FACS
Board Certified General Surgeon and Faculty Member
University of Illinois, College of Medicine at Urbana-Champaign
506 S. Mathews Ave., Urbana, IL 61801, USA

Reviewed and Approved by a member of the DoveMed Editorial Board
First uploaded: June 15, 2013
Last updated: May 7, 2018