Unless you develop complications, you’ll probably be moved from the coronary care unit to a step-down unit, or intermediate care, within a day or two. Your heart will continue to be monitored for rhythm abnormalities and other problems. The last step in the hospital phase of your treatment is evaluating your risk of having another heart attack. This involves several different types of tests. For example, you may undergo a less strenuous form of the conventional treadmill stress test to evaluate your heart’s performance at different levels of exertion. This information will also help determine how much activity you can safely do at home. If the test reveals no problems, you’ll be able to go home.
If the test indicates that parts of your heart are at risk for further damage, your doctor may suggest cardiac catheterization to find out whether angioplasty or bypass surgery might improve blood flow and reduce your chances of another heart attack.
Cardiac catheterization is performed in a hospital. You will be awake for the procedure, but receive local anesthesia and will get medication that will help you relax. A nurse or aide will clean and shave the area of your arm or leg where the catheter will be inserted. You will lie on a flat table under a large x-ray machine. Several electrocardiogram electrodes will be placed on your arms and legs. An intravenous line will be inserted into a vein in your arm to deliver fluids and medications.
After the catheter site is cleaned with antiseptic solution, the doctor will numb your skin and then make a small cut in it to reach a large blood vessel under the skin surface. Next, he or she will insert the catheter into the blood vessel and guide it though your circulatory system toward the heart. By using x-rays, the doctor can watch the catheter’s progress on a nearby monitor. Once the catheter is in your heart, it will measure pressures inside the heart, take blood samples, inject x-ray dye, or perform other functions.
After all the tests are finished, the catheter will be removed, and the insertion site will be closed. A special pressure dressing may be applied. Although the catheterization itself usually takes an hour or less, medical personnel must keep you under observation for several hours after the procedure to monitor your vital signs and check for bleeding where the catheter was inserted.
If a leg vessel was the point of entry, depending on the technique used to enter the artery, you may need to lie down for several hours. Medical personnel will also monitor the pulse, color, and temperature of the arm or leg in which the catheter was inserted. If you don’t have angina, internal bleeding, or other complications, you may be able to go home later that day.
After your cardiac catheterization, you will need to avoid strenuous activity for at least 24 to 48 hours. Your doctor will likely want to see you soon in the office for a checkup.