La cateterización cardíaca proporciona información más precisa y detallada sobre el funcionamiento de su corazón que otras pruebas diagnósticas. Ayuda a los médicos a diagnosticar su problema con precisión y les permite elegir el mejor tratamiento para usted.
¿Qué es la cateterización cardíaca?
During cardiac catheterization, doctors insert a long, thin, flexible tube, called a catheter, into the body. The catheter is inserted into a blood vessel and is guided toward the heart. The procedure allows doctors to study how well your heart pumps blood and to examine the coronary arteries (the vessels that supply blood to the heart muscle) and the heart valves. Other terms used to describe cardiac catheterization include coronary angiography, angiogram, cardiac cath, and heart cath.
Why perform a cardiac catheterization
This test provides the most accurate and detailed information about how your heart is working.
In general, cardiac catheterization is done for one or more of the following reasons:
- evaluar o confirmar la enfermedad cardíaca coronaria (por ejemplo, en pacientes con dolor en el pecho y/o una prueba de esfuerzo anormal
- determinar si el tratamiento (con angioplastia con balón o cirugía de derivación) puede ayudar a un paciente diagnosticado con enfermedad cardíaca coronaria.
- ver qué tan bien fluye la sangre a través de las arterias coronarias después de la angioplastia o la cirugía de bypass
- determinar si existe una enfermedad significativa de las válvulas cardíacas que podría requerir cirugía
- determinar si existe un defecto cardíaco congénito y evaluar su gravedad
Preparación para la cateterización
A menos que ya esté en el hospital, es muy probable que se le pida que llegue por la mañana el día de su cateterismo. Es posible que se le realicen varias pruebas de rutina, como un ECG, radiografías y análisis de sangre. (Estas pruebas pueden realizarse unos días antes del procedimiento). El médico revisará su historial médico y le examinará. (Es posible que vea al médico en la consulta varios días antes del procedimiento). El médico o la enfermera hablarán con usted sobre el procedimiento, su propósito, beneficios y riesgos. Este es un buen momento para hacer preguntas y, lo más importante, para compartir cualquier inquietud que pueda tener. Después, se le pedirá que firme un formulario de consentimiento. Una enfermera afeitará y limpiará la zona donde se insertarán los catéteres. Por lo general, esto se hace en la ingle (el pliegue entre el muslo y el abdomen). En algunos casos, puede ser en la muñeca o el brazo. El afeitado y la limpieza facilitan la inserción de los catéteres y ayudan a prevenir infecciones. Se insertará una vía intravenosa (IV) en una vena de su brazo. Esta vía permite inyectar medicamentos directamente en la vena, si es necesario. Para ayudarle a relajarse, se le administrará un sedante. Si lleva prótesis dentales, audífonos o gafas, es muy probable que se le permita mantenerlas puestas.
Antes de su cateterismo
Generally, you will be asked not to eat or drink anything for 6 to 8 hours before the procedure. This helps prevent nausea. You may have small sips of water to take your medications. Check with your doctor several days before the procedure. You may be asked to stop some medications (such as aspirin or anticoagulants) for a few days before your catheterization. Make arrangements with a friend or family member to drive you to and from the hospital. You will not be permitted to drive home after the procedure, since you may be sedated. Pack a small bag in case your doctor decides to keep you in the hospital overnight. You may want to include a robe, slippers, pajamas or nightgown, and toiletries. Bring a list of the names and dosages of all the medications you are taking. Tell the doctor or nurse if you have had any allergic reactions to medications or X-ray dye (contrast), iodine or seafood, or if you have a history of bleeding problems. For your comfort, empty your bladder as much as possible before the procedure begins. There will also be a bedpan or a urinal, should you need it during the procedure.
Durante la cateterización cardíaca
Cardiac catheterization is performed in a specially equipped X-ray room called a cardiac catheterization laboratory, or simply, cath lab. You will be taken to the cath lab in a wheelchair or on a movable bed. Then you will be helped onto an X-ray table. The table has a large X-ray camera above it and television screens close by. There also are heart monitors and other instruments. The cath lab team generally includes a cardiologist, an assistant, nurses, and technologists. Once you are positioned on the X-ray table, you will be connected to several monitors and then covered with sterile sheets. The staff will be wearing sterile gowns, gloves, and possibly masks.
¿Qué sucede durante el procedimiento?
The site where the catheters will be inserted is usually in the groin. Sometimes it is in the wrist or arm. The site is cleansed thoroughly. A local anesthetic is injected into the skin with a tiny needle to numb the area. This may cause a stinging sensation. A small incision is made in the skin, and a needle is used to puncture the blood vessel (usually an artery). A guidewire (a soft and flexible wire) is threaded into the artery. A short plastic tube, called a sheath, is then slipped over the guidewire and into the artery. The guidewire is then removed. Once the sheath is in place, doctors can insert and remove several different catheters without having to use a needle each time. The catheter is inserted into the artery and guided toward the heart, while the staff watches its progress on a television screen. The catheter may be removed and replaced several times. This is done to reach each of the heart chambers or coronary arteries. Once the catheter is inside the heart, the doctors can measure the pressures in the left ventricle (the main pumping chamber) and take pictures of the coronary arteries and left ventricle. If you are also having a right-heart catheterization, a special catheter is inserted into a vein and is guided to the right side of the heart. This is usually done to measure the pressures inside the right heart chambers and in the lungs, especially in people who have a weakened heart.
Lo que puedes esperar
You will be given medication to help you relax and make you drowsy. You may be awake, or you may sleep through part or all of the procedure. The staff will be monitoring you at all times. You may be asked to take a deep breath and hold it, to keep the pictures from blurring. You may also be asked to cough forcefully several times, to help move the dye through the heart. The procedure generally is not painful, although you may feel some pressure as the catheters are inserted. You will not feel the catheters as they move through the blood vessels and into your heart. For many, the most difficult part of the procedure is having to lie still for a long time on a hard table. As X-ray contrast is injected into the heart, you may feel a warm sensation ("hot flash") through your body, lasting for 20 to 30 seconds. You may also feel nausea, chest discomfort, or a mild headache. A complete cardiac catheterization procedure usually takes from one to two hours. If you feel pain or discomfort at any time during the procedure, let the staff know.
¿Qué muestra la cateterización?
La cateterización cardíaca permite a los médicos medir las presiones dentro del corazón, estudiar qué tan bien el corazón está bombeando sangre y tomar imágenes de las arterias coronarias y las cámaras del corazón.
