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What Actually is a Cardiac Cath and When Does a Doctor Recommend Them
A cardiac catheterization can help remedy blockages of the coronary arteries. Dr. Tim Wessel explains how this procedure works.
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Learn more about Timothy Wessel, MD
Timothy Wessel, MD
Timothy Wessel, MD is the Medical Director of Lake City Medical Center's Cardio Cath Lab.Learn more about Timothy Wessel, MD
Transcription:
Adam Ragusea (Host): Yes, heart problems are scary and so can be the procedures doctors use to fix them but not all procedures. There is something called a cardiac catheterization that doctors use to examine and fix blockages in the heart, and it is a surprisingly minor procedure. What’s it like? Is it right for you? Let’s ask cardiologist Tim Wessel at Lake City Medical Center.
This is Helmet of Health the podcast from Lake City Medical Center. I’m Adam Ragusea. Dr. Wessel, what is a cardiac catheterization?
Tim Wessel, MD (Guest): A cardiac catheterization is a procedure where we look directly for blockages in the coronary arteries of the heart. To do this, we insert a small tube called a catheter, it’s just a small flexible plastic tube. We put that in an artery either in the wrist or in the crease in the leg and go up from there to the heart. We put the tip of the tube at the coronary arteries, and inject some contrast dye, and take x-ray movie pictures of the heart while it’s beating to see if there’s any blockages in those arteries that supply the heart with blood.
Host: So what kind of blockages are we talking about here? Is this cholesterol? Is this my bacon catching up to me?
Tim: To some extent, yes. These are plaques that build up over time with inflammation and cholesterol deposits in them. So, cholesterol does play a role. They gradually build up over years until it can get to the point where they're significantly narrowing the artery to where it’s causing, you know, decreased blood flow to the heart muscle. Which can cause symptoms of chest discomfort or tightness, which we call angina or “an-jena.”
Host: So, obviously if I’m experiencing those kinds of symptoms, that tightness of the chest, I need to go see my doctor or maybe even the hospital. When I get there will they just go straight to the cardiac catheterization?
Tim: Usually, someone ends up with a catheterization. That’s often done as a result of having some symptoms that aren’t clearly severe or classic for heart attack or something like that, but just some symptoms that are concerning. That then leads to a stress test. So, a stress test is done to look for evidence that there may be blocked arteries to the heart by doing a treadmill or taking pictures of the heart with the nuclear stress test. So, if those are abnormal then that’s another common way that someone ends up having a heart catheterization because a screening test, like a stress test, has shown some abnormality that suggest there is a blockage.
Host: Okay, so I walk or run on treadmill with some wires hooked up to me, and my doctor does the stress test and on the basis of that test thinks I need a cardiac catheterization. What would that be like for me? You mentioned that it’s not an open-heart procedure or anything. You just go in through an artery in the arm or the leg.
Tim: Well, some people choose to have some IV sedation and kind of doze through the procedure. We don’t use general anesthesia or anything, but there can be some slight sedation. It actually is not a painful procedure except for just the initial kind of poke in the skin, just similar to getting an IV put in. So once we’re past that some people choose to stay awake and kind of look at the pictures. So, for the patient, they’re really just laying on an x-ray table underneath an x-ray camera with some drapes over them. Otherwise, it’s not a painful procedure. There’s no nerves inside the arteries of the heart to feel us taking pictures or putting the catheter in there. So, it’s actually a relatively comfortable procedure. Then as far as risks, go it’s less than 1% chance of any major complications. We do, obviously, monitor and watch for things. There can be complications that are serious, but it’s very rare. So, 99% of the time we have no major complications or problems.
Host: Okay, so let’s say that you get into my coronary artery and you do see a blockage, then what?
Tim: So, many blockages we can fix right through the catheters with a procedure called angioplasty. That’s where we thread a small wire and run a balloon up through the catheters to the artery where there’s a blockage. The balloon kind of pushes the plaque out of the way and then we leave a wire mesh tube called a stint behind to help keep that blocked section open. So, most significant blockages, nowadays, are actually fixed right through the catheters with the angioplasty and stinting procedure.
Host: Would you do that right then and there at the same time that you’re doing the initial test?
Tim: Yeah, many times that can be done. There are some factors that might make us delay actually fixing the blockage for various reasons, but often if we do it at the hospital, certainly in a setting where someone’s coming in with an urgent situation then we usually fix blockages right away at the same time.
Host: That’s remarkable, thanks doc. Dr. Tim Wessel is a cardiologist at Lake City Medical Center. Thank you for listening to Helmet of Health. Go to lakecitymedical.com to get connected with Dr. Wessel or another provider. If you found this podcast helpful, please share it on your social channels. That would warm our coronary arteries. Be sure to check out all of our podcasts in the library.
Adam Ragusea (Host): Yes, heart problems are scary and so can be the procedures doctors use to fix them but not all procedures. There is something called a cardiac catheterization that doctors use to examine and fix blockages in the heart, and it is a surprisingly minor procedure. What’s it like? Is it right for you? Let’s ask cardiologist Tim Wessel at Lake City Medical Center.
This is Helmet of Health the podcast from Lake City Medical Center. I’m Adam Ragusea. Dr. Wessel, what is a cardiac catheterization?
Tim Wessel, MD (Guest): A cardiac catheterization is a procedure where we look directly for blockages in the coronary arteries of the heart. To do this, we insert a small tube called a catheter, it’s just a small flexible plastic tube. We put that in an artery either in the wrist or in the crease in the leg and go up from there to the heart. We put the tip of the tube at the coronary arteries, and inject some contrast dye, and take x-ray movie pictures of the heart while it’s beating to see if there’s any blockages in those arteries that supply the heart with blood.
Host: So what kind of blockages are we talking about here? Is this cholesterol? Is this my bacon catching up to me?
Tim: To some extent, yes. These are plaques that build up over time with inflammation and cholesterol deposits in them. So, cholesterol does play a role. They gradually build up over years until it can get to the point where they're significantly narrowing the artery to where it’s causing, you know, decreased blood flow to the heart muscle. Which can cause symptoms of chest discomfort or tightness, which we call angina or “an-jena.”
Host: So, obviously if I’m experiencing those kinds of symptoms, that tightness of the chest, I need to go see my doctor or maybe even the hospital. When I get there will they just go straight to the cardiac catheterization?
Tim: Usually, someone ends up with a catheterization. That’s often done as a result of having some symptoms that aren’t clearly severe or classic for heart attack or something like that, but just some symptoms that are concerning. That then leads to a stress test. So, a stress test is done to look for evidence that there may be blocked arteries to the heart by doing a treadmill or taking pictures of the heart with the nuclear stress test. So, if those are abnormal then that’s another common way that someone ends up having a heart catheterization because a screening test, like a stress test, has shown some abnormality that suggest there is a blockage.
Host: Okay, so I walk or run on treadmill with some wires hooked up to me, and my doctor does the stress test and on the basis of that test thinks I need a cardiac catheterization. What would that be like for me? You mentioned that it’s not an open-heart procedure or anything. You just go in through an artery in the arm or the leg.
Tim: Well, some people choose to have some IV sedation and kind of doze through the procedure. We don’t use general anesthesia or anything, but there can be some slight sedation. It actually is not a painful procedure except for just the initial kind of poke in the skin, just similar to getting an IV put in. So once we’re past that some people choose to stay awake and kind of look at the pictures. So, for the patient, they’re really just laying on an x-ray table underneath an x-ray camera with some drapes over them. Otherwise, it’s not a painful procedure. There’s no nerves inside the arteries of the heart to feel us taking pictures or putting the catheter in there. So, it’s actually a relatively comfortable procedure. Then as far as risks, go it’s less than 1% chance of any major complications. We do, obviously, monitor and watch for things. There can be complications that are serious, but it’s very rare. So, 99% of the time we have no major complications or problems.
Host: Okay, so let’s say that you get into my coronary artery and you do see a blockage, then what?
Tim: So, many blockages we can fix right through the catheters with a procedure called angioplasty. That’s where we thread a small wire and run a balloon up through the catheters to the artery where there’s a blockage. The balloon kind of pushes the plaque out of the way and then we leave a wire mesh tube called a stint behind to help keep that blocked section open. So, most significant blockages, nowadays, are actually fixed right through the catheters with the angioplasty and stinting procedure.
Host: Would you do that right then and there at the same time that you’re doing the initial test?
Tim: Yeah, many times that can be done. There are some factors that might make us delay actually fixing the blockage for various reasons, but often if we do it at the hospital, certainly in a setting where someone’s coming in with an urgent situation then we usually fix blockages right away at the same time.
Host: That’s remarkable, thanks doc. Dr. Tim Wessel is a cardiologist at Lake City Medical Center. Thank you for listening to Helmet of Health. Go to lakecitymedical.com to get connected with Dr. Wessel or another provider. If you found this podcast helpful, please share it on your social channels. That would warm our coronary arteries. Be sure to check out all of our podcasts in the library.