Cardiac catheterization is a medical procedure used to diagnose and treat various heart conditions. During this procedure, a thin, flexible tube called a catheter is inserted into a blood vessel and guided to the heart. This allows doctors to assess blood flow, detect narrowed or blocked arteries, and perform interventions such as balloon angioplasty to open blocked arteries. It is commonly used for conditions like clogged arteries and irregular heartbeats. Overall, cardiac catheterization is a minimally invasive technique that provides valuable information about heart health and can lead to effective treatments.

1. CARDIAC
CATHETERIZATION

2. CARDIAC CATHETERIZATION
• It is an extremely valuable diagnostic tool for obtaining
detailed information about the structure and function of
the cardiac chambers, valves and coronary arteries
• It involves study of the right side of the heart, left side
of the heart, coronary arteries .

3. CLIENT PREPARATION
• Assessment of the client’s physical and psychosocial
readiness and knowledge level is an important aspect of
client preparation because many clients have anxiety
and fear about cardiac catheterization.
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4. • To advice anxiety
• Review the purpose of the procedure.
• Inform the client about the length of the procedure.
• State who will be present.
• Describe the appearance of the catheterization
laboratory.
• Inform about the sensations that may be experienced
during the procedure.
• Such as palpitations, feeling of heat or a hot flash ,a
desire to cough.
• Written materials may be used.
• Risk
CLIENT PREPARATION (contd..)

5. RIGHT SIDED CARDIAC CATHETERIZATION
• INDICATION
– Congenital heart disease
– Valve disorders
– To obtain cardiac biopsy
– Blood samples, pressure readings, cine radiographs
of right chambers of heart and pulmonary arterial
circulation.

6. PROCEDURE
• Physician inserts catheter via cut down or
percutaneously into a large vein. (Medial cubital,
brachial, internal jugular.)
• Catheter then threaded with use of fluoroscopy into
superior venacava, right atrium, rt ventricle, pulmonary
artery, arterioles.
• When catheter passes through various chambers and
vessels , blood samples are taken to know O2 content
and saturation.

7. PROCEDURE (contd…)
• B.P. is recorded. Pressure is highest in right ventricle.
Normally PAP is 25/10mm Hg.
• Elevation in chamber pressure such as an elevated right
aortic pressure can indicate valvular problems or
possible right ventricular failure.

8. LEFT SIDED HEART CATHETERIZATION
• INDICATION:-
– Evaluate pressures on the left side of the heart,
valvular competency and LVF.
• PROCEDURE:-
– A catheter is passed into the aorta from either
brachial or femoral artery with use of fluoroscopy.
– After reaching the aorta, the catheter is
manipulated around the aorta area, down ascending
aorta and through aortic valve into left ventricle.

9. PROCEDURE (CONTD…)
• Pressure gradient measurements are obtained to detect
pressure change across the valves.
• Ventricular angiography may be performed during left
sided heart catheterization.
• This involves the injection of contrast material into the
ventricle while radiographs are taken.
• Selective coronary arteriography may be performed .

10. • The catheter is threaded to the aortic root, tip of the
catheter is advanced to right (i.e.) left coronary
arterial.
• Contrast medium is injected into each coronary artery
outlines entire coronary circulation, cineangiographic
films are taken to monitor progression of dye.
PROCEDURE (CONTD…)

11. • Introduction of the dye may temporarily displace blood
flow in the coronary arteries and may produce transient
ischemia and chest pain.
• Sublingual NG administered to reduce discomfort.
• In addition Isosorbide may be given.
• Injection of contrast material into the right coronary
artery may suppress SA node producing Brady
dysrhythmias.
PROCEDURE (CONTD…)

12. PRE PROCEDURE PREPARATION
• Provide information about the procedure
• Include family in the patient teaching.
• Ask the patient concerning history of allergy especially
to Iodine, shellfish.
• Administer mild sedative before procedure and
antibiotic as ordered.
• Assess the presence and quality of peripheral pulses
and marks them before the test.

13. DURING PROCEURE
• The patient may experience a warm, flushing sensation
for approximately 30 seconds as the contrast medium is
injected.

14. POST PROCEDURAL CARE
• Many patients prefer to rest or sleep after the
examination.
• Monitor the patients pulse and blood pressure every 15
min for 1 hour and then every 30 min for 3 hours.
• If femoral approach was used, patient is initially placed
on bed rest and monitor for signs for bleeding,
inflammation, tenderness or edema at insertion site.
l & Research Institute

15. – Apply external compression with sand bag.
– If Brachial site used bleeding occurs the nurse
applies firm pressure directly over site.
– I/O monitored.
– Hypertension may develop
POST PROCEDURAL CARE (CONTD….)

16. COMPLICATIONS
• Ventricular fibrillation.
• Tachycardia or dysrhythmia has to be reported.

17. CONTRAST ANGIOGRAPHY

18. CONTRAST ANGIOGRAPHY
• INDICATION
– Evaluation of peripheral vascular disease.
– Has great risk for patient.
– For diagnosis of arterial emboli arterial trauma,
aneurysm, buerger’s disease .
– Reevaluation of patency of arteries after grafting.

19. NURSING CARE
• A pressure dressing may be plated at the insertion site
after the procedure.

20. COMPLICATIONS
• Thrombi.
• Perforation of vessel.
• Emboli.
• Renal Failure.
• Pseudo aneurysms.

21. Thank you!