Preparation for Cardiac Catheterization

Welcome and thank you for choosing Conemaugh Memorial Medical Center for your cardiac catheterization.  Our physicians and nurses are dedicated to providing highly skilled and compassionate care for you and your family.  We understand that you may be apprehensive about your procedure.  We hope the following information will be helpful to you as you prepare for your procedure and during your recovery.

The Cardiac Catheterization Lab is on the 2nd floor of Memorial’s Clinical Pavilion. 

We want to make your experience as comfortable as possible.  If you have any questions or concerns that are not answered here, please do not hesitate to call your physician or the Cardiac Catheterization Lab at (814) 534-9005 between 11:00 AM and 7:00 PM.

BEFORE CATHETERIZATION

Before Your Procedure

Your cardiologist or PCP will do a history and physical examination prior to your procedure. This may be done in the office or upon arrival in the Catheterization Lab.

Your physician may order laboratory tests, x-rays or EKG’s.  These tests should be done 1 to 3 days prior to your procedure date. You may have repeat labs drawn the day of your procedure depending on your previous results or the medications you are currently taking. Outpatient testing is located on the first floor of Conemaugh Memorial.  As you arrive through the main entrance on Franklin Street, Pre-Testing is on the left just before you enter the Atrium. 

The physician will specify when to stop taking certain medications prior to the procedure. They may also have you take additional medications prior to your catheterization depending on your allergies. Do not stop taking your Aspirin, Plavix, Brilinta, or Effient unless instructed to do so by your cardiologist.

If you develop an abnormal temperature or a communicable disease prior to your procedure please call your physician.  It may be necessary to reschedule your procedure for a time when you are feeling better.

The Day before the Procedure

A Registered Nurse from the catheterization lab will contact you 24 to 48 hours before the day of your catheterization for your medical history.  The day prior to your scheduled procedure the Cath lab staff will call to schedule the time you need to arrive at the hospital. 

You may eat and drink until midnight on the day before your catheterization. Depending on the time of your catheterization you may be able to have a light breakfast.  If scheduled for later in the day you may be able to eat a light meal up to 4 hours prior to your arrival time at the hospital with your cardiologist’s order.

On the Morning of Catheterization

Shower or bathe the morning of the procedure. Do not use any lotion, cream, or powder on your body.  Wear loose fitting, clean, comfortable clothing and flat shoes. We have lockers available for your clothing.  Please leave all your valuables at home.

You can take most of your medications the morning of your procedure with a sip of water.  Do not take any Coumadin, Xarelto, Pradaxa water pills, or any diabetic medications the day of the procedure unless instructed to take it by the physician or nurse.

Please bring all insurance forms / cards with you.  If you have questions about your insurance coverage or pre-certification, call your insurance company.  If you are not covered by insurance, please make arrangements for payment by calling 814-534-9000 and ask for the Business Office.  No financial arrangements are made on the day of the procedure.

Children under 18 years of age or incapacitated adults must be accompanied by a parent or legal guardian.  You may be accompanied by two adult family members or friends.  Children should not accompany adults having a procedure.  Because you are not permitted to drive after your catheterization, an adult must accompany you to drive you home.  A responsible adult should stay with you the night following your procedure.  

Arrival at the Hospital

Parking is available with the valet at the Main entrance or in the outpatient/visitor parking lot across from the Emergency Room on Franklin Street.  Please remember to bring your parking ticket with you to obtain a free token to exit the parking lot.

When you arrive at the hospital on the day of your procedure, check in at the Outpatient Registration desk to the left on the 1st floor of the clinical pavilion.  Once you are registered a Volunteer will escort you to the catheterization lab.

One of our staff will meet you and take you to the Outpatient holding area in the Catheterization Lab.  They will assist you to change into a hospital gown.  You will be asked to remove any body piercing from the chest.

Healthcare professionals will be available in this area to make you comfortable and to answer your questions.  Your safety is our number one priority. 

It is necessary to remove body hair where the catheter will be inserted in the groin or arm.  The staff at the cath lab will do this prior to your procedure.  Do not shave the area.  Shaving can cause skin irritation and nicks, which can causes problems for skin healing postoperatively.  The catheterization may be cancelled.

You will meet a Registered Nurse who will do a nursing assessment, and verify all medications, both prescribed by a physician and over the counter, that you are taking and the last time you took each of your medications.  You will have an IV started.  You will meet the Registered Nurse who will be with you during your procedure

Your interventional cardiologist will ask you to sign a consent form, which legally permits your cardiologist to perform your catheterization.  This may be done in the office or once you arrive on the catheterization department.

The staff may ask you the same questions several times. They will ask your name, birth date, procedure you are having done, your medications and your allergies especially to dye.  By repeating our questions, we are verifying and re-verifying very important information to ensure that your time with us is as safe as possible. 

When you are wheeled into the catheterization lab you will be helped onto the procedure table.  You will be placed on a cardiac monitor and your blood pressure and pulse oximetry will be taken.   The people around you in the room will be preparing for your procedure. Your gown will be removed but the staff in the room will maintain your privacy by keeping you covered as much as possible.  A cath lab tech will prep your groin, arm or wrist with a ChloraPrep to sterilize your insertion site.   The staff will stay by your side and will explain everything that is happening.  There will be x-ray equipment above your head. 

When all the preparation is complete your interventional cardiologist will arrive. 

During the Procedure

• You can stay awake or sleep during the procedure and you may be given medication to relax you.
• It is important that you tell the physician any symptoms you experience during the procedure.
• You will receive a local anesthetic to prevent pain at the insertion site.
• The doctor inserts an introducing sheath into the artery in your groin, arm, or wrist.
• Through the sheath, a long, thin tube called a catheter is placed inside the artery and guided toward your heart. 
• To perform different tests or check other parts of the heart, the doctor inserts a new catheter or moves the catheter or x-ray machine.
• A contrast dye is injected through the catheter.  When this dye is injected you may feel a warm flushing sensation.
• The length of the procedure depends on what the physician is evaluating, what he observes and the treatment options he uses.  You can expect to be in the procedure room from 30 minutes to an hour or more.

After Your Procedure

After your catheterization you will be taken to the holding area.  During this time, the nurse will monitor your blood pressure, pulse, breathing and the insertion site frequently.  If the insertion site was in your groin, you may need to lie down with your leg straight for several hours.

Your sheath may be removed in the procedure room and a hemostatic closure device is placed in the insertion site.  This allows for quicker ambulation times and discharge to home. Otherwise if no closure device was used and you had a diagnostic catheterization, your sheath is removed once you are in the holding area. 

If you had cardiac stents inserted, your sheath will be removed approximately 2 hours after the end of the procedure.  If you are admitted your sheath may be removed when you are in your room on the nursing unit.

Your time in the holding area will vary depending on the procedure you had done, how well you are doing, how comfortable you are, and whether you will be admitted or discharged directly to home.  After your vital signs, blood pressure, pulse, respiration and insertion site are stable you will either be transported to an available room or discharged to home. 

If you are being admitted you will be transported to your room when it is available and the nurse on the floor will follow the physician’s instructions.

If you are going home after your procedure, you will be discharged when your doctor determines that you are ready to leave.  You will be discharged to the care of a friend or family member – you will need an adult available to drive you home.  You will be given written instructions regarding your post catheterization care including a list of symptoms that would require you to notify your cardiologist.

You should rest for the remainder of the day after your procedure.  Drink liquids as tolerated to help flush the dye out of your system. Resume diet as tolerated.  Avoid alcohol for at least 24 hours following your procedure.

It’s normal to find a small bruise or pea size lump at the insertion site. These common side effects should disappear within a few weeks.

The physician will let you know when you can resume your normal activities, drive or return to work.   They will also instruct you on when you should resume your medication and any additional medications you should take.

Notify the Physician

You should call your Cardiologist or 911 immediately for any of the following symptoms: 

Chest pain or angina

Pain, swelling, redness, bleeding, or drainage at the insertion site

Severe pain, coldness, or bluish color in the leg or arm that held the catheter

Blood in your urine, black or tarry stools, or any other kind of bleeding

Fever over 101°

Thank-you for allowing us to take care of you during your cardiac catheterization.