(Narrator) Hi. You or your family member have been scheduled for cardiac catheterization
procedure at St. Michael's Hospital. We want things to go as smoothly and as
comfortably as possible. This video is to help you prepare for the procedure, and
let you know what to expect on your day with us at the Cardiac Investigation Unit.
Welcome to St. Michael's Hospital. St. Michael's is the provincial hub for
the most complex cardiac and cardiovascular care. As a patient, you may also
be given an opportunity to participate in clinical research evaluating
tomorrow's treatments. You will meet not just your heart doctor but a team of
highly-qualified professionals during your stay, including registered nurses,
specialized in cardiac medicine, resident physicians in advanced specialty
training, medical X-ray and cardiac technologists. Your cardiologist has
referred you to ask for a catheter-based procedure, either a cardiac angiogram for
diagnosis or a coronary angioplasty or stent for treatment.
A cardiac catheterization is a diagnostic procedure to see if there are any
blockages in your heart arteries, or problems with the valves or pump. A fluid
called contrast or dye is injected through a catheter into your heart
arteries (or heart chambers.) X-ray movies are taken during these injections to
show the inside of your heart. The most common treatment done in the cardiac
catheterization laboratory is a coronary angioplasty, a procedure done to treat
important narrowings that obstruct blood flow to major heart arteries.
>> Hi, my name is Dr. Wassef. I'm an interventional cardiology fellow at St. Michael's Hospital.
The two most common places to get access are in the femoral artery,
which is in the upper part of the thigh here where we'll put an introducer sheath
like this into it, into the upper part of the thigh. This will allow us to advance
the catheters to your heart. The other place is in the upper part of the wrist,
just below the thumb here where a catheter will be inserted.
(Narrator) >> One of our staff members from the Cardiac Investigation Unit will contact
you on the phone to schedule your cardiac catheterization test.
The first thing you need to do is get a set of blood tests and ECG tests at a lab near
your home. Your heart test may be delayed if we do
not have your blood and ECG test results. Please call your case manager if you do
not have the requested tests done before the date of your procedure. You will need
to arrange for someone to drive you home after the heart test. You are strongly
advised not to take public transportation, and you are not allowed
to drive for 48 hours after your heart test.
Clear your schedule: be ready to spend all day with our team in the hospital.
Emergency cases may push your test to a later time slot of the day. You may
wait anywhere from one to six hours for the test from your scheduled appointment time.
What to do the night before your heart test. Step 1: take out and write
down all the medications you are currently taking on the medication
information form. Step 2: pack your bag with your health card, all
of your medications you are currently taking, completed medication list
instruction letter and information packet from the case manager.
Step 3: stay hydrated by drinking a lot of low sugar, non-caffeinated beverages. Plain water
is the best option. In the morning of your heart test, it is important to take
all your usual heart and blood pressure medications unless your doctor and case
manager told you to stop. Before you leave your house, make sure to bring the
bag you packed the night before, and ensure that you have a ride home. There are (three)
entrances to the hospital. We recommend you enter through the Queen St. entrance.
The Cardiac Investigation Unit, also
known as CIU, is located on the 7th floor Cardinal Carter wing.
Take the north elevators. When you step off the elevator
on the 7th floor Cardinal Carter wing, you will be directed to wait in the
patient and visitor waiting area outside the Cardiac Investigation Unit.
The nurse will ask you questions about your health history, take your vital
signs and review the medications you are taking. Remember to bring all your
medications, as well as the list of medications you are currently taking.
The nurse will then disinfect and clean the skin, and insert an intravenous into your arm.
The doctor will talk to you and get your consent for the procedure while
you're waiting in the CIU. A nurse from the procedure room will
come and take you on a stretcher into the room. Once you are in the room, you
will lie flat on a narrow table under an X-ray camera. When you are comfortable on
the table, you will be asked not to move any parts of your body unless asked by
the doctor or other staff in the room. The team in the room will use a cold and
wet solution to clean the areas where the test equipment enters your body.
These areas could include top of your leg and your wrist. The team will put a
sterile drape over your body. Before the test begins, the nurse will give you
medications and IV to help with any anxiety or pain you may experience.
However, you will be awake during the procedure. Once you are prepared, the
doctor will enter the procedure room. The doctor will begin by putting a local
anesthetic to numb the area where a long thin tube is placed inside an artery.
The tube allows access for other equipment to be guided into your heart.
The freezing medicine, so you do not feel any pain or discomfort. After the test is
done, the CIU team will help you move to a stretcher. If the test was done through
the wrist, the doctor will take the tube out in the procedure room and put a
tight clamp around your wrist to stop the bleeding.
>>Hi I'm Dr. Buller. I thought I'd come and introduce myself to you, and make sure that we've answered any
of your questions. Naturally we can't put catheters into
the heart without some small risks, and there are some small risks to this procedure.
For healthy people the risks are pretty tiny, but they do include the
risk of major heart attack, the risk of stroke, which can be very serious, and of
course a tiny but definite risk of death. And sometimes the X-ray contrast we use
can be difficult with respect to kidney injury,
and sometimes people have allergic reactions to the medicines and to
the contrast that we use. But we're prepared to handle that, and this is a
very experienced centre. The team is all very experienced, and if we do encounter
a complication, we know how to deal with it promptly. Sometime before you go home,
either the fellow or I will come and have a conversation with you and your
family, make sure you understand the results of the tests, whether any other
tests or appointments are necessary as a result of it. And we're going to give you
a diagram that shows where the blockages in your heart are and we'll go over that
with you and suggest that you keep that with you for your future medical
appointments with your specialists and with your family doctor.
(Narrator) >> Thank you for taking the time to prepare for your procedure. We hope this video has helped.
The CIU team at St. Michael's Hospital has a strong commitment to comprehensive
patient care, and look forward to meeting you on the day of your procedure.