Should I Be Scared of a Cath?

I see many posts about people fearing a heart catheterization, so as someone who has had several, I want to help put the collective mind at ease. Keep in mind that I am not a doctor; this is simply a patient’s perspective of the experience.

What is a cath and why would you get one?

To start, what is a catheterization (cath) and why would a doctor want to perform one? Per the Mayo Clinic, a “long thin tube called a catheter is inserted in an artery or vein in your groin, neck or arm and threaded through your blood vessels to your heart.”¹

From there, ultrasound and contrast dyes are used so that your doctor can “see” the coronary vessel and other structures of your heart. Interventions such as stents can be placed during a catheterization if they need to be.

To further sum up the potential uses of a catheterization, during this procedure a doctor can:¹

• Locate narrowing or blockages in your blood vessels that could cause chest pain (angiogram)
• Measure pressure and oxygen levels in different parts of your heart (hemodynamic assessment)
• Check the pumping function of your heart (right or left ventriculogram)
• Take a sample of tissue from your heart (biopsy)
• Diagnose heart defects present from birth (congenital heart defects)
• Inspect heart valves

Risks and information

This is a low-risk procedure; however, it is clearly not a risk-free procedure. As always, you need to listen to your medical team about the risk and benefits of this procedure for you. It is important to ask questions and be informed. Why are they recommending a cath for you? What are they expecting to find, or hoping to learn? What are the anticipated risks and outcomes? 

I would never advise turning towards social media for something as serious as your cardiac testing. It is important you ask questions of your medical team and you are fully informed by professionals.

Operation prep

So, what does this procedure entail? Once you arrive at the hospital you are taken into pre-op. Depending on where they access your vein (groin, neck, or arm) a nurse might shave your groin. You can always ask for a nurse of a specific gender.

They will take your vitals, hook you up to monitors, give you an IV, and review the consent form. Keep in mind that pain medications and a sedative are usually part of this, and you can talk to your anesthesia team about giving these early if you are particularly nervous.

Into the cath lab

Once pre-op needs are done and the room is ready, you will be taken into the cath lab. This is admittedly jarring as it looks nothing like any other part of the hospital. You lie on a cold procedure table and many providers such as nurses, techs, and the cardiology team are milling around you. Do not expect anyone to be chatty, as they are going through their own checklists to be sure everything is done correctly.

They drape you, cover you with more electrodes and hook you up to more monitors. The team will tell you when they are ready to start, and the anesthesiologist will put you in "twilight", which means you are given medications to make you feel relaxed and assure you are not in pain.

The best way I can describe this is that it feels like you are “half there,” and I remember drifting in and out. There were a few times I felt pain, and/or I heard the doctors discuss blocked arteries; a conversation that understandably stressed me out. Each time I muttered, someone was by my head immediately. I recall them asking what was going on and I said “pain,” and they responded by titrating my medications right away. I never for a moment felt unmonitored. I was never alone.

Post-op

Once the team is finished you are taken to postop to be monitored. You will feel groggy. The doctor might come in, and you will see your loved one/companion at this point. You will probably stay in the hospital for a few hours.

Every catheterization I have gone through has been through my groin, and the worst part for me in the days following has been the bruising and soreness. However, I also have 6 stents and am on dual antiplatelet therapy, so I bruise easily. The last time I was sore for several days and walking was tough. However, this was not that bad and the data and information my doctor gained from the procedure was invaluable. I hope this helps!