A Glimpse into a Cardiac Cath lab

This is a guest blog by my friend and fellow nurse practitioner, Jenny Jin.

It is 7AM in the Kaiser Santa Clara Cardiac Procedure Unit. This is the place where people have Coronary Angiography. A scary sounding procedure that helps diagnose heart disease and look for clogging in the coronary arteries. These are the tiny blood vessels that bring oxygen and nutrients to the heart muscle. If they don’t work right, the heart doesn’t work right. 

During the test, if there’s life-threatening obstruction, we can intervene with various tools to dilate and open up arteries that may have been blocked, allowing more blood flow to the heart. The nurses are bustling to get their anxious patients ready for their upcoming procedures. This is where I come in, to help prepare patients and their families for the procedure. I wind my way through the unit, talking to each patient, obtaining a thorough history and then performing a physical exam. This is the time I can answer questions from the patients and their families. After a while, patients are relaxed enough to joke around a little bit, some even to call us “plumbers of the heart”. 

Often, you’ll find me in the Cath Lab, inserting the catheter into the patient’s femoral artery under the direct supervision of a physician. Before we start, we call a “time-out” to verify we have the right patient and the plan for this patient. During the procedure, patients are given a sedative, which keeps them relaxed and comfortable. They usually don’t recall what happens during the procedure. 

Next, a small amount of local anesthetic (similar to the novacaine that a dentist uses) is injected prior to my inserting the thicker IV cannula into an access site which is usually inserted into the groin area. About 10% of the time, we use the wrist or the inner elbow. Then very carefully, we thread the guide wire through the arteries up to the heart, followed by a catheter. Once the catheter is in place, x-ray dye is injected allowing the blood flow to appear on the x-ray. The guide wire and catheters are removed and replaced several times during angiogram. Within most people’s hearts, there are 3 arteries; 2 on the left which is connected to 1 large artery called the Left Main Artery, and 1 artery on the right side. 

Read part 2 on Saturday.