Echo Lab

• Ultrasound procedures for your heart and vascular studies
• Experienced personnel that includes Echo, Vascular and CCT registries
• New digital equipment
• New GXT Treadmill system

Cardiac Cath Lab

• Diagnostic and Interventional procedures are performed by experienced cardiologists
• Most advanced systems in two new labs
• Experienced personnel that includes Registered Nurses and Registered Cardiovascular Invasive Specialists
• New Admission / Holding are for outpatient procedures with individual monitoring capabilities, privacy and comfort

What is a cardiac catheterization (also called cardiac cath)?

In cardiac catheterization (often abbreviated as "cath"), a very small catheter (hollow tube) is advanced from an artery or vein in the groin through the aorta into the heart.

Once the catheter is in place, several diagnostic techniques may be used. The tip of the catheter can be placed into various parts of the heart to measure the pressure within the chambers. The catheter can be advanced into the coronary arteries and a dye injected into the arteries (coronary angiography or arteriography). With the use of fluoroscopy (a special type of x-ray), the physician can tell where any blockages in the coronary arteries are located as the dye moves through the arteries. A small sample of heart tissue can be obtained during the procedure to be examined later under the microscope for abnormalities (this is called a biopsy).

Why is cardiac catheterization done?

Your physician may schedule you for a cardiac catheterization if you have recently had one or more episodes of cardiac symptoms such as, but not limited to, the following:

• chest pain
• shortness of breath
• dizziness
• fatigue
• a combination of any of these symptoms

Other reasons for the cath procedure include evaluation of myocardial perfusion (blood flow to the heart muscle) after heart attack, heart bypass surgery, coronary angioplasty (the opening of a coronary artery using a balloon or other method), or stent placement (a tiny expandable metal coil placed inside the artery to keep the artery open). There may be other reasons for your physician to recommend a cath procedure as well.

How is a cardiac catheterization done?

Once you arrive for your procedure, an intravenous (IV) line will be started in your hand or arm prior to the procedure for injection of medication and to administer IV fluids if needed. The area designated as the cath site (groin, arm, or wrist) will be clipped and washed with an antiseptic soap. You will receive a sedative medication in your IV before the procedure to help you relax. The pulses in your feet will be checked and the location where the pulses are felt will be marked on the skin with a marker. This is done in order to be able to compare the strength of these pulses after the procedure.

You will lie flat on your back during the entire procedure. There will be several monitor screens in the room, showing your vital signs (EKG, heart rate, blood pressure, breathing rate, and oxygen level), the images of the catheter being moved through the body into the heart, and the structures of the heart as the dye is injected.

The cath lab is a sterile area, so everyone in the room will wear gowns, masks, and caps. The physician and assistants actually performing the procedure will also wear sterile gloves. A large x-ray camera will be above the table to make pictures of the procedure.

The cath site (groin or arm) will be cleansed again with antiseptic soap, and then sterile towels and a sheet will be placed around this area. A numbing medication (lidocaine, or xylocaine) will be injected into the cath site.

Once the numbing medication has taken effect, the physician will insert a catheter into the artery or vein and advance it into the heart. It will be very important for you to remain still during the procedure so that the catheter placement is not disturbed and to keep from causing damage to the insertion site.

The catheter is inserted into the blood vessel. The physician advances the catheter through the blood vessels into the heart. This is done by watching the catheter on the monitor and guiding it into the proper structures. The catheter may be advanced into either the right or left side of the heart, or both sides, depending on what the physician is looking for.

Pressures are obtained at various locations within the heart structures. Blood samples may be withdrawn to assess oxygen levels at various places in the heart. Dye may be injected into one or more of the heart's chambers to assess blood flow and the heart's structure. When the dye is injected, you may notice a feeling of warmth or even a hot flash. This sensation will last for only a few seconds. The catheter may be advanced to the coronary arteries, where dye is injected to determine if there are any blockages and where the blockages, if any, are located.

At certain points during the procedure, you may be asked to take in a deep breath and hold it for a few seconds. You may also be asked to cough during the procedure. If you notice any discomfort or pain, such as chest pain, neck or jaw pain, back pain, arm pain, shortness of breath, or breathing difficulty, let the physician know.

Once the physician has obtained the information, the catheter will be removed from the insertion site.

The physician or an assistant will hold pressure on the insertion site for about 15 to 20 minutes, so that the blood can begin to form a clot at the site and stop the bleeding. Once the physician or assistant is satisfied that the bleeding has stopped, a bandage will be placed on the site.