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Cardiac Catheterization

Cardiac Catheterization

Cardiac catheterization is a test which is performed to obtain certain diagnostic information about the heart. Patients may require this medical therapy rather than undergo angioplasty or bypass surgery when they suffer from rare or easily controlled episodes of angina. Alternatively, cardiac catheterization is not performed in patients who have infrequent episodes of angina and in whom angina can be easily controlled. When a patient has heart failure due to suspected coronary artery disease or there is suspected coronary artery disease, cardiac catheterization is conducted. Cardiac catheterization can help:

Measure blood pressure within heart.

Know the amount of oxygen in the blood.

Check the pumping ability of the heart muscle.

Check blood flow through the heart after surgery.

Collect blood samples from the heart.

Inject dye into the coronary arteries.

To provide treatment in certain types of heart conditions like congenital heart defects and how severe it is.

To find out a coronary artery disease and if found to pinpoint the size and location of fat and calcium deposits that have built up in coronary artery from atherosclerosis.

To determine whether the patient needs bypass surgery or angioplasty.

Examine the arteries of the heart with an x-ray technique called fluoroscopy.

The patient is asked not to drink or eat anything, except a small amount of water, for atleast 6 to 12 hours before the test. The patient is tested for allergy to iodine or other medications. Patients suffering from kidney disease or diabetes or bleeding disorders must keep the cardiologist informed. The cardiac catheterization test is performed in a cath lab by a cardiologist. The actual catheterization procedure takes about 15 - 30 minutes. The patient's electrocardiogram that continuously records the electrical activity of the heart is taken. A pulse oximeter device that measures the oxygen levels of the patients' blood is monitored. An intravenous needle is inserted into the patients' vein to give fluids or medicine during the catheterization procedure. A sedative is also given through this IV line which helps the patient to relax.

Cardiac catheterization procedure involves passing a catheter, a thin flexible tube, into the right or left side of the heart. The doctor inserts this thin plastic tube into the groin - femoral artery. Other places where in the catheter may be inserted are the elbow- brachial artery or the wrist - radial artery. From there it is slowly advanced into the chambers of the heart or into the coronary arteries. The doctor watches the progress of the catheter into the heart's vessels and chambers on the imaging screen. Pressures within the heart chambers are measured and the blood and tissue samples are also removed through the catheter. A small amount of dye is also injected through the catheter into the heart chamber or into one of the coronary arteries.

Therapeutic catheterization: Certain types of heart defects can be repaired using catheterization. For instance, if the coronary arteries are blocked, the cardiologist can use a catheter, guide wire and balloon to open and improve blood flow to the heart. This is termed as percutaneous coronary intervention (PCI).

Normal result indicate that there is no significant narrowing or blockage in the coronary arteries. Abnormal results may suggest that the heart does not pump blood normally or the valves in the heart may be weak. There may be leakage between heart chambers. There is a possibility of aortic aneurysm. Some complications with cardiac catheterization include heart attack or stroke, hematoma, puncture of the heart or arrhthmias.

Bladder Cancer

Bladder cancer is generally noticed in people over the age of 50. Quite often it is curable especially when it is found superficially on the surface of the bladder. At its more invasive and deeper stage, Bladder Cancer can be fatal. More instances of bladder cancer have been found in smokers, in particular those who have worked with PCB plastics or commercial dye industry.

This cancer occurs almost uniformly within the transitional cells of the bladder (the type of cell which lines the bladder wall). Transitional cell cancer is also found in the kidney and the ureter (the tube which connects the kidney to the bladder) although with much less frequency.

A urinalysis that shows an increased number of white blood cells without evidence of bacterial infection can lead to suspicion of bladder cancer. Urinalysis may also be remarkable for microscopic haematuria (blood in minute quantities). A cystoscopy allows the Urologist to look inside the bladder. This procedure is done under I.V. sedation or general anaesthesia. Cancer is detected with a biopsy or tissue sample. This is where a Pathologist can help in determining the extent of invasion of the cancer.

Chemotherapy agents are injected into the bladder through a catheter. These agents could include Adriamycin, BCG and other types of chemotherapy. If the bladder cancer is in an invasive stage, radical cystectomy may be required. This means a total surgical removal of the bladder. Radiation therapy which involves high doses of x-rays to localised body parts along with chemotherapy can be succesfully used to treat patients suffering from bladder cancer. When the bladder cancer has reached an advanced stage, it is generally incurable. A nutritious cancer diet is used to supplement the treatment.

Liver biopsy

Liver biopsy involves removal of a small piece of tissue from the liver to evaluate for damage or disease. This diagnostic test is usually suggested when blood tests reveal high levels of liver enzymes or excessive iron. An inflamed liver may also need to be examined with a liver biopsy. Cases of cirrhosis or hepatitis may require liver biopsy to diagnose the extent of liver damage. A patient scheduled for liver biopsy will need to keep the physician informed of various medications that are taken, such as anticoagulants, ibuprofen and aspirin. It is necessary to fast for about 8 hours prior to the liver biopsy procedure. The patient may be asked to stay in the hospital for a few hours to observe for any signs of bleeding or other complications as as peritonitis or puncture of the gallbladder.Liver biopsy is done in the following ways:

Percutaneous liver biopsy involves use of special needle to make an incision through the skin, taking care not to nick any other internal organs.

Laparoscopic liver biopsy involves use of laparoscope to make a small incision in the abdomen. This aids the physician in taking a biopsy from a specific part of the liver.

Transvenous liver biopsy involves insertion of a catheter into a vein in the neck and guiding it to the liver. The biopsy needle is fitted to the catheter.