What to expect in the cath lab and how to prepare for your procedure

Getting scheduled for a medical procedure can create some anxiety in the best of us. No matter how many times a hospital team has done the procedure, it’s new to you—and new means unknown.

“We see this often where cath lab procedures are concerned,” said Robert Jay Widmer, MD, PhD, interventional cardiologist on the medical staff at Baylor Scott & White Medical Center – Temple.

A cardiac catheterization lab, or cath lab, is a special room where doctors perform minimally invasive tests and procedures related to the heart. They’re often considered the “hub” of a hospital or clinic cardiac department.

“In the US alone, over one million angiograms and hundreds of thousands of other cath lab procedures happen every year,” Dr. Widmer said. “Our cath lab here in Temple has been in operation for nearly 40 years and we do about 2,500 procedures a year at this hospital alone.”

There’s a chance that at some point you or a loved one may be referred to a cath lab, so it’s important to address some of those “unknowns” to help make your experience as smooth as possible. Here’s everything you need to know about the cath lab.

What exactly is a cath lab?

A cath lab isn’t a lab at all, it’s simply a procedural area used to help examine certain heart issues. Instead of invasive, open surgical procedures, cardiologists perform procedures in a cath lab that use small wires and catheters to do things like measure pressures, take pictures of the heart/blood vessels, and even treat heart blockages, valve disease or reduced heart function.

Why might you be referred there?

Patients referred to the cath lab might have symptoms like chest pain from a blockage in one of the heart blood vessels or have shortness of breath from a poorly functioning valve or diminished heart function.

Other symptoms which could result in your doctor referring you to the cath lab include:

• Fatigue
• Pain in the chest/arm/shoulders when walking
• Shortness of breath
• Discomfort in the legs when walking
• Irregular heart rates/rhythms
• Swelling in the legs or abdomen

What types of procedures are done in a cath lab?

“There are multiple procedures performed in the cath lab on a daily basis,” Dr. Widmer said.

These include:

• Coronary angiography – taking pictures of the heart arteries
• Percutaneous coronary intervention – relieving blockages in the heart arteries using balloons and stents
• Right/left heart catheterization – measuring the pressures in various chambers of the heart at rest and sometimes with exercise or medications
• Valve replacement or repair – Using advanced techniques to replace diseased aortic valves (ex. TAVR) or reducing the leakage through the mitral/tricuspid valve (ex. MitraClip)
• PFO/ASD closure – closing congenital defects in the top chambers of the heart

How can you prepare for the cath lab?

“The best way to prepare for your visit is to make sure you talk to your doctor about what to do in advance and what to expect while you’re there,” Dr. Widmer said.

There are some really easy and manageable steps that you can take to prepare for a trip to the cath lab, including:

• Make sure you don’t eat the morning of the procedure.
• Take medications as instructed on the morning of the procedure.
• Bring along another person to drive you to and from the procedure.
• Bring an overnight bag just in case you need to stay an extra night.

Things to know while you’re here:

• Patients and family members are taken to a prep room beforehand, and family can wait there for you until after the procedure.
• The procedure rooms can be cold, but there are blankets and warmers available.
• You will be given medications that help make you sleepy and reduce discomfort.

Dr. Widmer also pointed out that the rooms can be loud and busy with all of the work to prepare, perform and then clean up after the procedure.

What to expect after the procedure?

The procedures generally take 30 minutes but can last a bit longer depending on the type of intervention. Some people experience a bit of soreness or discomfort at the procedure site, which can be managed with over-the-counter pain relievers.

In most cases, we are able to have a specialist meet with the patient and our team after a procedure to explain findings and next steps, so everyone is on the same page at the end of your visit. Don’t be afraid to ask questions at any point.

“Cath lab visits are really important for helping us deliver the best care for our patients, but we understand the experience itself can feel daunting,” Dr. Widmer said. “We encourage our patients to ask for explanations on any activity going on around them, whether that’s asking about what’s happening in the room or even revisiting expectations for how long the procedure should take while you’re there. We welcome any questions that can help you feel more at ease.”

Learn more about your heart care options today.