Purpose of Examination

• To check for conditions in the left and right coronary arteries, determine the location of lesions, and assess the severity of narrowing.
• To evaluate heart failure by measuring right atrial pressure, right ventricular pressure, pulmonary artery pressure, and pulmonary capillary wedge pressure, as well as assess structural abnormalities of the heart.
• To conduct myocardial biopsy and pathological examination.
• To examine peripheral arteries and veins, including dialysis fistulas, pulmonary arteries, lower limb arteries, carotid arteries, subclavian arteries, renal arteries, and abdominal arteries.

Pre-Examination Precautions

• Sign the consent form.
• Perform blood tests (including hemoglobin and kidney function) and an electrocardiogram.
• Shave both sides of the groin area before the examination.
• Remove wigs, dentures, contact lenses, prosthetic limbs, money, jewelry, and other accessories before the examination.
• Avoid wearing makeup, lipstick, and nail polish to prevent misinterpretation of circulation status.
• If prescribed by a doctor, an intravenous catheter and infusion may be placed before the examination.
• No fasting is required on the examination day, but light meals are recommended. If certain condition, fasting may be required, please follow the instructions accordingly.
• Wear the provided surgical gown and remove underwear on the day of the examination.
• Empty bladder before the examination.

Examination Procedure

• Medical staff will assist you onto the examination table, where you will be instructed to lie down and adjust your position. Chest and knee restraints will be applied. Avoid moving, turning over, or bending your legs during the procedure.

• Electrodes will be placed on your chest, and a blood pressure cuff will be applied.
• Common vascular access sites include the radial artery and the common femoral artery. Depending on the examination needs, other access sites may include the common femoral vein, internal jugular vein, or popliteal artery.
• The skin at the groin, arm, wrist, neck, or popliteal region will be disinfected using an alcohol-based antiseptic, which may cause a burning or stinging sensation. Inform the medical staff if you experience discomfort. Please avoid touching the area.
• A sterile drape will be applied. Local anesthesia will be administered. A needle will be inserted into the artery, followed by a guidewire and then a catheter sheath.
• Under X-ray guidance, the catheter will be positioned at the coronary artery opening, peripheral artery/vein, or inside the heart chamber.
• Contrast media will be injected (or pressure measurements will be taken), and X-ray images or pressure recordings will be documented.
• Protective pads are placed on the examination table, so if you feel the need to urinate during the procedure, you can do so safely.

Post-Examination Precautions

For Femoral Artery/Vein (Groin) Access:

• After the procedure, the catheter sheath will be removed, and manual pressure will be applied to stop bleeding. A 2-kg sandbag will be placed over the site for 6-8 hours, and you must remain lying flat for 12 hours to prevent bleeding and hematoma formation. This helps the vascular wound heal.
• Remain lying flat without bending your legs or getting out of bed.
• During this period, nurses will monitor vital signs frequently, including blood pressure, pulse, skin temperature at the puncture site, and the symmetry and strength of the dorsalis pedis artery pulse.
• Monitor for swelling, pain, or bleeding at the puncture site.
• Use a bedpan or wear a diaper if needed. If you cannot urinate, medical staff may assist with catheterization.

For Radial Artery (Wrist) Access: 

• After catheter sheath removal, a two-layer adhesive dressing will be applied to stop bleeding, which will later be removed by a specialist.
• After a short period of bed rest, you may get up and move around if you feel well.
• Avoid lifting heavy objects or bending your wrist inward or twisting towels for three days to prevent internal bleeding and swelling.
• Observe for bleeding, changes in skin temperature, and discoloration of the fingers.
• Keep the puncture site clean and dry until the wound heals to prevent infection.

Important Notes

• You may eat after the examination and should drink plenty of water to help flush out the contrast media, unless you have fluid restrictions—follow your doctor’s instructions.
• Contact medical staff immediately if you experience any of the following symptoms after the procedure:
  • Chest tightness or pain
  • Difficulty breathing
  • A warm, moist feeling at the puncture site
  • Bleeding, pain, coldness, numbness, or tingling in the extremities

Possible Complications

• The risk of death from diagnostic cardiac catheterization is less than 0.001%. For coronary angioplasty (balloon dilation), the mortality rate is less than 0.01%.
• Other possible complications include:
  • Drug/contrast media allergy
  • Local bleeding, hematoma, or aneurysm
  • Arrhythmia
  • Low blood pressure
  • Angina
  • Shock
  • Acute kidney failure
  • Acute pulmonary edema
  • Coronary artery dissection
  • Vascular spasm
  • Acute myocardial infarction
  • Vascular or cardiac rupture
  • Aortic dissection
  • Stroke