:confused: My cardiologist says I need a heart cath because I had an "abnormal stress test." A good friend of mine said what exactly does that mean? I started thinking about it and now I am wondering myself...what was abnormal about it? I have some palpitations...I would love to have peace of mind so are these heart caths dangerous...what do I need to know? My friend now has me confused, she said the procedure is serious and I should be asking a second opinion because he didn't give me specifics...he did say he didn't think it was anything serious but that he wanted to be sure...and that women sometime have false positives? What the heck does that mean? Well I am rambling now...I just need some help here.....

Well, heart catheterization procedures are very safe and very routine, so don't worry too much about that. But you should definitely find out more specifics about what exactly was abnormal about your stress test, and why he thinks you need a cath.

AND....ask who is going to do this Cath and how many times he has done them AND, discuss before hand if he sees something will be just go ahead and stent an area without you knowing it and or discussing it before hand.

I have had three Caths with 3 different doctors. The last Cath doc by far was the best and most professional to me and my hubby who was waiting outside the cath Lab. He also was the oldest of the others and has done these things in his sleep and will not do anything he thinks does not need attention now. I have had 2 unnecessary stents.(second cath) .. :rolleyes:

Ask a lot of questions. Don't let any doctor intimidate you.

Good Luck.

Abnormal stress test almost always indicates a coronary blockage of an artery.

The test is invasive and as such does carry some risk, and usually is the last procedure to determine exact area of blockage by injecting a colored substance into the blood stream and the placement of a stent if necessary and possible (complete blockage may require a bypass). Also, internal heart pressures can be measured.

Prior to the procedure you will be given a shot to deaden the area of the groan or arm in prep for the penetration of a probe to explore the coronary arteries. You will also be given a drug through an IV to keep you calm and cooperative. You will be in a hospital setting and relased after a day or two.

A cath is a painless procedure. They always scared me, but eventually I needed one and it wasn't bad at all. I think it is very safe too, if done by a good cardiologist.
Mine showed blockages and the bypass surgery was done two days later after discussion with my doctor.
I also had a cath on my carotid arteries and this too was fine. I needed to be wide awake for this procedure because you can't swallow when they take the pictures, but it was painless also and did show where the blockages were and the extent.
I think that I fell asleep during the heart cath as thry give you sedatives. I don't remember much about it at all.

have had 2 unnecessary stents.(second cath) .. :rolleyes:


Caroliz,
What exactly do you mean by unnecessary stents? Did they insert those two stents without your consent? Did they do the senting when the lesions were not big enough for angioplasty? Or did they do the work but you were not feeling better afterwards? :nono:

Caroliz,
What exactly do you mean by unnecessary stents? Did they insert those two stents without your consent? Did they do the senting when the lesions were not big enough for angioplasty? Or did they do the work but you were not feeling better afterwards? :nono:
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HI Brian, I had two stents placed and was told there were no blockages but the pressures were a lil off. I was livid.. and while doing this they nicked an artery, sent me home and I ended up in the ER room 2 days later with elevated Heart Enzymes. Just be darn sure you know who is doing your cath and it is not some Cardiac Fellow being trained on you. Stay awake if all possible...I was asleep. Let them tell you what they are doing and why they are doing this and that. It is your body. What I went throu was not routine/the norm. Make sure there is a nurse standing right by you at all times for good communication.

I do want to add that there are some excellent Heart Cath doctors out there and also some excellent Stent doctors.

QUOTE: I think that I fell asleep during the heart cath as thry give you sedatives. I don't remember much about it at all.

You can be assured one does not fall asleep during a cath. Your cooperation is needed to move, hold your breath, do not swallow, etc....It is not unusual to not remember because of the medication.

There is not much danger of a doctor going ahead with stents during the cath without consent. There may be a problem of not remembering giving consent when medicated. It happened in my case. I don't remember much from my time in ER and the completion of stent placement. But I do remember a bypass was not an option due to an EF 13% and a stent was the best option.

As Caroliz states there is a danger of rupturing the artery during a cath. It is an invasive procedure and requires an awake patient! Damage to an artery is my concern with a cath and should not be taken lightly. Be sure the doc doing the cath has done at least 1000 recent procedures without any problems. One's confidence in the doctor is a great help to get through the unpleasant experience.

QUOTE: I think that I fell asleep during the heart cath as thry give you sedatives. I don't remember much about it at all.

I do think I slept or "twilight slept" during the heart cath. I only remember them opening the groin area and then afterward when the nurse was appying pressure to the same area to stop the bleeding.
I was awake during the carotid cath because there were certain times I couldn't swallow and had to remain very still so they could take pictures.
To be truthful, I didn't think the procedures were particualrly unpleasant. A little scary because I didn't know what would happen, but not painful at all. The nurses and the cardiologist talked me through both times and I felt fairly calm.

Caroliz,
It is sad indeed to know invasive cardiologists sometimes do the wrong procedure when the in the paperst they give at discharge say you have "exellent results" through "successful procedures" et cetra.

Agree with Kenkeith that the guy whom you are going to entrust your heart with should have done atleast 1000 similiar procedures. My family doctor had putforth that as a condition while selecting a cardiologist for me.

I remember most of the things happened in the cathlab. The cameras, the beeps, voices, anxiety in the face of nurses.. the doctor had advised me earlier that he would perform an angioplasty and stenting if there is a major lesion.. so when he told the nurse "gimme guide wires" I felt like sky had fallen off.. since earlier they told excercise tests often go wrong and since then I was praying for a negative result in cath test..

Cath is painless and experienced doctor can perform it right. Excercise test show false positives on an average of 15 out of hundred they say.. lets hope for the good..

Brian,

False positve at 15% is high. There is a judgement call to err on the side of caution for borderline cases; a 15% false negative could prove problematic for proper and timely treatment as well as less revenue. ;)

There should have been a surgical/cardio doc with the angioplasty procedure in the event there is a rupture or some other problem that would require prompt surgical attention!! :eek: If possible it should be a surgeon of the patient's choice.

I am getting so darn educated into these things that I do not think the docs like me too welll. :yawn: Too darn bad. After what I went thru twice (third time was a great doctor) I will never let them put me out again. The first Cath, the doc was training a fellow on me. I was in and out of awakeness. When I heard them anxious becuz the "kid" was running into trouble, I became anxious and asked what was happeneing to me. I heard them call for a surgeon. I was praying hard and talking until the Cath doctor got up off his chair and got in my face and told me to "shut my *&%^%& mouth" and act like an adult and pumped me with more fentynal. I will never forget this jerk.

I did survive this and no surgical procedures. The next cath I asked that no "kid on the block" be trained on me. They promised there would not be one. There was. AND, someone nicked the artery and no one said a word then.....I am paying for this now.

We ALL have to be aware of procedures. I hate having to get in someone's face to make them understand but so many just do not want to hear what we have to say. BUT, we sign papers and view Patient's Rights and these rights are violated at times. I can attest to this. I see that day in my nightmare's over and over again.

I am in contact now with some great heart centers to see what my next step is.

God Bless All Those Suffering.

Thanks for all the advice...cath is scheduled for 9-8-05. I have a cardiologist with a good rep, and will be going to a great hospital...not the one in town (its a first aid station). I don't really feel nervous....yet. I am so thankful for this board its important to talk to patients...gives you a great ideal of whats to come, what to look for, and questions to ask the doctor. I really do appreciate all your thoughts and concerns with this matter.

Connie

Good luck Saggy.

I had my first angiogram in March and just had local anaesthetic for the groin entry. I did not have sedation although it was on offer if I had wanted. The whole procedure was comfortable and relaxed, staff were super. I actually enjoyed it - watched it all on the monitors. I could diagnose myself when I saw the arteries - whopping blockages that were clear as day. I found it quite awesome and fascinating, one of the really amazing experiences of my life. I wouldn't have missed it for anything!

I went on to have an angioplasty 3 weeks later followed by another angiogram and again the experiences were fine. They had music on the cath lab radio and it was quite surreal to watch my heart beating and the arteries jigging about in time with the music! I was actually laughing out loud (gently!!!) at one point.

It really is an OK experience. Just relax and hand over to the docs. How lucky we are to have this wonderful technology. I am like a new woman after my angioplasty (3 stents). No chest pain whatsoever since then. Brilliant. Best of luck to you in Sept..

The usual quote is a 1% risk of a serious side effect on angiography.
My esperience was an almost total involvement and full interest on my part. I saw the complete blockage and was AMAZED as the catheter was pushed through the goo.

It was one of the more positive experiences of my life...being totally aware the whole time was a plus.
My procedure (angiography/angioplasty/stent placement) was done by one of the best cardiologists in the US. I judge this a BIG plus!

I had a heart cath last week and it really wasn't a big deal, I'm 55....I was more stressed in the two weeks waiting to have it. I had to have it done because I flunked my stress test again. Though, last month during my echo, it was found out that I have MVP. So, that is my reason for having shortness of breath at times.
Luckily, I have no blockages and my heart is in very good shape. My cardio said I have no restrictions on my treadmill. :bouncing: (I guess all my years of exercising paid off)

Hi Allison,
Good for you on no blockages...sorry about the MVP, but for most people it's symptomless and never causes a problem.

Just curious, do you fit this standard?
The mitral valve prolapse (MVP) syndrome has a strong hereditary tendency, although the exact cause is unknown. Affected family members are often tall, thin, with long arms and fingers, and straight backs.

Quote: The usual quote is a 1% risk of a serious side effect on angiography.

Lenin, are you sure it is one in a hundred!? I thought it was 1 in thousand or .001. Pushing through the "goo". Was that an artherioectomy (sp?)? I asked my doc about that procedure, he stated it was almost as risky as bypass and it required at least a small opening for a wire to pass otherwise there is a risk of rupturing the artery wall. Is that the .01% risk?

I have the long arms and fingers and am basically a small bone structure but am taller than most women my age. My father died at 42 of a heart attack and he and his relatives, who also had heart disease, were very tall and thin with long arms and finger too. My oldest son is built the same way. I worry about him because he has the high colestorol which also runs in the family. My daughter is built more like my husband, but has very high cholestorol. They both are on statins.
They both exercise too and don't smoke, so I guess they aew doing all they can. I only pray they don't inherit my diabetes.

"The mitral valve prolapse (MVP) syndrome has a strong hereditary tendency, although the exact cause is unknown. Affected family members are often tall, thin, with long arms and fingers, and straight backs."

Unfortunately, my parents died when I was 26 & 30 and I never spoke to them about heart conditions. As far as I know, neither had heart problems.
My sister (62) just found out she has a slight heart murmur. Maybe it is MVP.
She never had a echo, and her cardio found the heart murmur through a stresstest.

I can't say I am amongst the average people having MVP. My cardio does not feel it is a serious problem.

:confused: My friend now has me confused, she said the procedure is serious and I should be asking a second opinion because he didn't give me specifics...he did say he didn't think it was anything serious but that he wanted to be sure...and that women sometime have false positives? What the heck does that mean? Well I am rambling now...I just need some help here.....

The statistics for a cath procedure is 2 in 1000 or .002 for heart attack, death and stroke. The statistical numbers increase with age. A cardiac interventionalist with at least 900 successful procedures renders it relatively safe with patient's general health taken into consideration.

Unfortunately, if you include the risk of dangerous internal arterial bleeds the odds go higher. There is also the risk of a clot forming at the tip of the catheter that can migrate to legs, lungs, bowwel, brain, and
can be life threatening and/or involve immediate serious surgical intervention.
A clot can also form at the arterial enrty site in the groin that can migrate.
There are also people who show extreme allergy to the contrast material.

Then there's also the small but not inconsequential chance that you'll have a kidney removed by mistake, you get one of those untreatable bugs that lives only in hospitals, or the anaesthesiologist will kill you with the wrong anesthetic.

That's why I'm fond of the 1% figure for "life threatening side effects."

... inconsequential chance that you'll have a kidney removed by mistake, you get one of those untreatable bugs that lives only in hospitals, or the anaesthesiologist will kill you with the wrong anesthetic.

That's why I'm fond of the 1% figure for "life threatening side effects."

huh! :confused: You have to be joking. :eek:

Heart catherizations are no big deal, they are just like any other safe procedure, they take a piece of your heart and your all done,, no big deal, I have them done all the time!