From Baptist Health South Florida
Science
5 min. read
Millions of cardiac catheterization procedures are performed every year in the U.S. to confirm suspected coronary artery disease and/or other related cardiovascular disorders.
Known more commonly as Cath Labs, Cardiac Catheterization Labs – such as the one at Baptist Health Miami Cardiac & Vascular Institute -- are equipped with the latest technology and a diverse team of interventional specialists. Cath Labs serve critical roles as a stopover on the road to recovery from a heart attack or blockages in the arteries or structural problems with the heart’s valves.
Marcus St. John, M.D., interventional cardiologist and medical director of Baptist Health Miami Cardiac & Vascular Institute‘s Cardiac Catheterization Lab (Cath Lab).
As a diagnostic procedure, the interventionalist at a Cath Lab guides a catheter into a blood vessel, via the wrist or groin, and injects contrast dye to visualize blood flow in the coronary arteries that carry blood to the heart muscle, explains Marcus St. John, M.D., an interventional cardiologist, the medical director of the Cath Lab at Baptist Health Miami Cardiac & Vascular Institute. This diagnostic procedure is called a coronary angiography.
Minimally invasive procedures can be done during or after a “cardiac cath,” including an angioplasty in which a tiny balloon is inflated at the tip of the catheter to push plaque buildup against the artery wall and improve blood flow. In a stent placement procedure, the interventionalist expands a tiny metal mesh coil or tube at the end of the catheter inside an artery to keep it open.
“The combination of symptoms, plus an abnormal diagnostic non-invasive test, is probably the ideal scenario that should then lead to an elective, more invasive evaluation with an interventional cardiologist,” explains Dr. St. John. “And then that evaluation involves the cardiac catheterization with the coronary angiography, which is just the taking of pictures. Then we confirm what is or isn't there. And then that provides the key information upon which to base whatever treatment therapy or surgery is needed.”
A cardiac cath can also lead to a referral to a cardiac surgeon for coronary artery bypass surgery or to a structural heart specialist to treat valvular defects.
Emergency Cases and Elective Outpatient Referrals
Usually, two types of cases make their way to the Cath Lab, said Dr. St. John. Many involve urgent cases where patients are transported from the ER with potentially life-threatening, cardiac-related events.
Dr. St. John emphasizes that no one should ignore telltale symptoms of a heart attack, such as chest pain or pressure, shortness of breath, nausea or vomiting, profuse sweating, dizziness, or fainting.
“It’s not that every time you get a discomfort in your chest you need to run to the emergency department,” said Dr. St. John. “But discomforts that are severe, that are associated with shortness of breath, nausea, vomiting, sweatiness, and that don't go away quickly -- they really do warrant urgent attention. And if you are in doubt about whether this could be a heart attack, going to the emergency room is really the best strategy.”
The other types of Cath Lab cases are elective outpatient referrals, typically patients with symptoms or with irregular findings from non-invasive testing, including electrocardiograms (ECGs or EKGs), calcium scores, stress tests or other evaluations.
“If they are referred to us, then they have had a number of risk factors that led to an evaluation and/or symptoms, like chest pain or shortness of breath,” explains Dr. St. John. “Sometimes, there are no symptoms, but there’s been a change in an EKG or a diagnostic test such as a calcium score, for example, that leads to additional testing. Often, it’s a coronary CT (computerized tomography) angiogram or a stress test that earns someone a referral to the Cath Lab.”
Many patients don’t realize that the Cath Lab procedures have evolved so much in recent years that most are performed on an outpatient basis.
“Most people who come in for a cardiac catheterization now expect to go home the same day,” said Dr. St. John. “It used to be that if you get a cath and a stent as an outpatient, you then spent the night. And we realized over the last decade or so that spending the night really is not adding a lot of value, especially as cath techniques have evolved.”
What to Expect During Cardiac Catheterization
Here's the general process for a typical cardiac cath followed by a stent placement, as described by Dr. St. John:
February 28, 2023
3 min. read
February 24, 2023
4 min. read