Cardiac catheterization (a.k.a. “cath” or “heart cath”) is the process of passing a flexible tube through the vascular system into the heart or the blood vessels that surround it. The process can be used to both diagnose and treat a variety of heart conditions. If you are scheduled for a cardiac cath, here are the people who will be taking care of you.
An interventional cardiologist is a physician who has undergone specialty training to gain the skills for cardiac catheterization. This individual will have completed a minimum of three years of medical residency followed by three years of cardiac fellowship to specialize in the heart and then another 12-month fellowship dedicated specifically to catheterization. That means your physician has a minimum of seven years of training on top of the four years (minimum) he or she spent in medical school. Electorphysiologists (EPs) are “super specialists” who deal only with the electrical activity in the heart. They attend an additional year of fellowship, bringing the total minimum training to eight years.
Depending on where your catheterization is performed, the attending cardiologist may be assisted by one or more fellows. That simply means that the head cardiologist will be teaching the next generation of physicians how to perform a cath. Fellows are always supervised by an experienced cardiologist.
In a limited number of cases an interventional radiologist may carry out the catheterization. Interventional radiologists undergo a minimum of one year of general medical training, four years of radiology residency, and one year of interventional radiology fellowship in addition to medical school. In most hospitals, like St. Elizabeth, cardiologists carry out all heart catheterizations and interventional radiologists carry out catheterization procedures that do not involve the heart.
Cardiac caths are carried out in a sterile setting, which means that anyone who will be touching the patient or the instruments must be in sterile clothing, including gloves and a mask. The scrub nurse is responsible for keeping the instruments and materials that will be used in the catheterization procedure clean and organized. His or her job is one of extreme importance because it involves the oversight of sterility both for the instruments and the personnel in the room. The scrub nurse must be vigilant to ensure that the sterile field is never broken. Becoming a scrub nurse requires specialized training beyond the RN degree.
The circulating nurse is responsible for moving items from storage to the sterile field using approved sterile techniques. This individual also helps to control access to the room to ensure sterility and answers pages and phone calls for anyone who is “scrubbed in” and thus sterile. The circulating nurse may be an RN or LPN.
General anesthesia may or may not be necessary for a cardiac cath. In most cases, local anesthetics are used along with simple general agents that do not render a patient completely unconscious. If full sedation is required, an anesthesiologist or certified registered nurse anesthetist (CRNA) will be present to administer medication and monitor the patient’s condition.
Meeting Your Team
Chances are good that you will meet your cardiologist in the weeks and months before your procedure and that you’ll meet the circulating nurse the day of the procedure. You may or may not meet fellows who will be assisting and you likely won’t meet the scrub nurse. If you require anesthesia, the anesthetist will speak with you the day of your operation. If you want to meet all the members of your team, don’t hesitate to ask.