Cardiac Catheterization: Is It Necessary for Your Health?

Q: Cardiac Catheterization: Is It Necessary for Your Health?

Hello： Based on your description, a 55-year-old female with a history of secondhand smoke exposure and no hypertension. <br>If there is no history of diabetes or high cholesterol, and no family history of cardiovascular disease, the likelihood of coronary artery disease is indeed

Cardiac catheterization

Hello Dr.
Huang,
I previously inquired with another physician about my family member's symptoms of rapid breathing and a sensation of being pricked.
My family member is 55 years old and has not yet reached menopause.
The physician I consulted earlier indicated that it is not angina, as the symptoms only include rapid breathing and a brief stabbing pain in the center of the chest.
Since my family member was quite worried, we eventually scheduled an appointment with a cardiologist.
After undergoing a stress test, electrocardiogram, and echocardiogram, the doctor mentioned that the reports indicated some blockage, but the actual condition can only be determined through a cardiac catheterization, which is now scheduled for next week.
My family member maintains a light diet (avoiding fried foods, low oil, and low salt), has low blood pressure (which has been the case for some time), takes fish oil, calcium, and B vitamins daily, and has a regular sleep schedule.
Due to work commitments, there is little time for exercise; however, the job primarily involves standing and physical labor (cleaning, taking out the trash), with only one day off.
There is a history of gastroesophageal reflux, and the weight is normal but slightly on the lighter side.
There is no smoking or alcohol consumption, so the likelihood of cardiovascular disease seems low.
Given that the symptoms do not appear severe based on previous consultations, it was unexpected to require a cardiac catheterization.
Is the cardiac catheterization necessary? Although I understand that the physician's recommendation implies it is essential, I am concerned about the risks involved.
I have seen cases where individuals with minimal symptoms ended up needing multiple stents, which has caused my family member significant anxiety.
Additionally, I have researched that the out-of-pocket costs for procedures can be significantly higher than those covered by insurance, making it difficult to manage if multiple stents are needed.
If covered by insurance, the effectiveness may not be as good as out-of-pocket options.
I have also looked into CT scans, but the costs are high, and it seems that a cardiac catheterization may still be required, leading to a substantial financial burden.
Could my family member's lack of exercise be a contributing factor, despite having a physically demanding job? My family member believes that previous exposure to secondhand smoke at work may be a factor.
Should there be any adjustments to the diet? Currently, they are on anticoagulant medication, and they may stop taking fish oil soon.
They have purchased unsweetened apple cider vinegar and plan to dilute a small amount in water after meals.
They also intend to switch to unsweetened oatmeal for breakfast.
Are there any other dietary or lifestyle changes I should consider?
After the cardiac catheterization, is it safe to lift heavy objects? My family member has heard from acquaintances that some people experience shortness of breath even when climbing stairs, and their job sometimes requires lifting items weighing over 10 kilograms.
Is it acceptable for them to work in the morning before the procedure, which is scheduled for later in the day? It is challenging for them to take leave from work, and they need to wait for the physician to notify them of the catheterization time on the same day.
I apologize for the lengthy message, but this is my family member's first time undergoing such a significant procedure, and they are understandably anxious.
I would like to know if there are any additional ways I can support them before and after the examination.
Thank you for taking the time to read this, and I appreciate your help.

Dai jia ren wen, 50~59 year old female. Ask Date: 2020/07/31

Dr. Huang Yinghe reply Cardiology

Hello: Based on your description, a 55-year-old female with a history of secondhand smoke exposure and no hypertension.
If there is no history of diabetes or high cholesterol, and no family history of cardiovascular disease, the likelihood of coronary artery disease is indeed low given the atypical symptoms.
Conducting an exercise electrocardiogram or nuclear medicine tests for cardiac ischemia in this situation is similar to the concept of widespread COVID-19 testing in Taiwan, where false positives may be more common.
However, without personally examining the patient, we must respect the clinical judgment of the physician; if the physician believes that a cardiac catheterization is necessary, that is acceptable.
In fact, cardiac catheterization procedures are quite safe nowadays, and the economic burden under health insurance is not high.
The benefit of the procedure is to confirm whether there is any narrowing of the coronary arteries.
Generally, there are no special activity restrictions before the procedure, but basic tests such as an electrocardiogram and blood tests are usually performed during hospitalization.
If there are issues found during the vascular examination, immediate treatment can be done with balloon angioplasty or stent placement, and it is recommended to avoid vigorous exercise for one to two weeks.
If the vascular examination shows no issues, most patients can be discharged on the same day or the next day, and their daily activities or work will not be affected.
Dietary recommendations can follow the principles of the DASH diet, which emphasizes more fruits and vegetables and less fat.
If there are indeed vascular issues or a stent is placed, long-term medication will be necessary.
In summary, cardiac catheterization can confirm whether there is any narrowing of the vessels and assist in subsequent medication decisions.
If there are still concerns, it is advisable to discuss further with your physician.

Reply Date: 2020/07/31

More Info

Cardiac catheterization is a critical diagnostic procedure used to assess the condition of the heart and its blood vessels. It is often necessary when there are indications of coronary artery disease (CAD) or other cardiac conditions that require further evaluation. Based on the information provided, it appears that your family member has undergone various preliminary tests, including a treadmill test, electrocardiogram (ECG), and echocardiogram, which have raised concerns about potential blockages in the coronary arteries. The physician's recommendation for cardiac catheterization is likely based on these findings, as it provides a more definitive assessment of the coronary arteries.

Understanding the Need for Cardiac Catheterization
1. Indications for the Procedure: Cardiac catheterization is typically indicated when there are symptoms of angina (chest pain), shortness of breath, or other signs of heart disease, especially if non-invasive tests suggest the possibility of significant coronary artery blockages. In your family member's case, the reports indicating some level of blockage necessitate a closer look to determine the severity and exact location of any obstructions.

2. Risks vs. Benefits: While it is natural to be concerned about the risks associated with cardiac catheterization, it is essential to weigh these against the potential benefits. The procedure is generally safe, but like any medical intervention, it carries some risks, including bleeding, infection, or adverse reactions to the contrast dye used during the procedure. However, the information gained from catheterization can be invaluable in guiding treatment decisions, such as whether angioplasty or stenting is needed.

3. Lifestyle Factors: Your family member's lifestyle, including their work and dietary habits, can influence heart health. While they have a physically demanding job, which can provide some level of exercise, it is crucial to incorporate regular cardiovascular exercise into their routine. Additionally, a heart-healthy diet low in saturated fats, cholesterol, and sodium can help manage heart disease risk factors. The inclusion of omega-3 fatty acids from fish oil is beneficial, but it is wise to consult with a healthcare provider about continuing or adjusting this supplement, especially if they are on anticoagulant medications.

4. Post-Procedure Considerations: After cardiac catheterization, patients are typically advised to avoid heavy lifting or strenuous activities for a short period, usually 24 to 48 hours, to allow for proper healing. It is essential to follow the physician's recommendations regarding activity levels post-procedure. If your family member has a physically demanding job, they should discuss their work schedule with their healthcare provider to ensure they do not overexert themselves during recovery.

5. Monitoring Symptoms: It is crucial to monitor any symptoms that may arise before and after the procedure. If your family member experiences increased chest pain, shortness of breath, or any new symptoms, they should seek medical attention promptly.
6. Nutritional Adjustments: The introduction of apple cider vinegar and unsweetened oatmeal can be part of a healthy diet, but it is essential to ensure that these changes are balanced with other nutritional needs. Consulting with a dietitian can provide personalized dietary advice that aligns with their health goals.

7. Emotional Support: Finally, it is important to provide emotional support to your family member during this time. Anxiety about medical procedures is common, and having a supportive family member can help alleviate some of that stress.

In conclusion, while cardiac catheterization may seem daunting, it is a necessary step in accurately diagnosing and managing potential heart disease. Following the physician's advice and maintaining a healthy lifestyle can significantly impact your family member's overall heart health.

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