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(Narrator) Hi. You or your family member have been
scheduled for cardiac catheterization procedure at St. Michael’s Hospital.
We want things to go as smoothly and as comfortably as possible. This video is to
help you prepare for the procedure, and let you know what to expect on your day
with us at the Cardiac Investigation Unit. Welcome to St. Michael’s Hospital.
St. Michael’s is the provincial hub for the most complex cardiac and
cardiovascular care. As a patient, you may also be given an opportunity to participate
in clinical research evaluating tomorrow’s treatments. You will meet not
just your heart doctor but a team of highly-qualified professionals during
your stay, including registered nurses, specialized in cardiac medicine, resident
physicians in advanced specialty training, medical X-ray and cardiac
technologists. Your cardiologist has referred you to ask for a catheter-based
procedure, either a cardiac angiogram for diagnosis or a coronary angioplasty or
stent for treatment. A cardiac catheterization is a diagnostic
procedure to see if there are any blockages in your heart arteries, or
problems with the valves or pump. A fluid called contrast or dye is injected
through a catheter into your heart arteries (or heart chambers.) X-ray movies
are taken during these injections to show the inside of your heart. The most
common treatment done in the cardiac catheterization laboratory is a coronary
angioplasty, a procedure done to treat important narrowings that obstruct blood
flow to major heart arteries.>>Hi, my name is Dr. Wassef. I’m an interventional cardiology fellow at St. Michael’s Hospital. The two most common places
to get access are in the femoral artery, which is in the upper part of the thigh
here where we’ll put an introducer sheath like this into it, into the upper part of
the thigh. This will allow us to advance the catheters to your heart. The other
place is in the upper part of the wrist, just below the thumb here where a
catheter will be inserted. (Narrator)>>One of our staff members from the
Cardiac Investigation Unit will contact you on the phone to schedule your
cardiac catheterization test. The first thing you need to do is get a set of
blood tests and ECG tests at a lab near your home. Your heart test
may be delayed if we do not have your blood and ECG test results.
Please call your case manager if you do not have the requested tests done before
the date of your procedure. You will need to arrange for someone to drive you home
after the heart test. You are strongly advised not to take public
transportation, and you are not allowed to drive for 48 hours
after your heart test. Clear your schedule: be ready to spend
all day with our team in the hospital. Emergency cases may push your test to a
later time slot of the day. You may wait anywhere from one to six hours for the
test from your scheduled appointment time. What to do the night before your
heart test. Step 1: take out and write down all the medications you are
currently taking on the medication information form. Step 2:
pack your bag with your health card, all of your medications you are currently
taking, completed medication list instruction letter and information
packet from the case manager. Step 3: stay hydrated by drinking a lot of low
sugar, non-caffeinated beverages. Plain water is the best option. In the morning of
your heart test, it is important to take all your usual heart and blood pressure
medications unless your doctor and case manager told you to stop. Before you
leave your house, make sure to bring the bag you packed the night before, and ensure
that you have a ride home. There are (three) entrances to the hospital. We recommend
you enter through the Queen St. entrance. The Cardiac Investigation Unit, also known as CIU, is located on the 7th
floor Cardinal Carter wing. Take the north elevators.
When you step off the elevator on the 7th floor Cardinal Carter
wing, you will be directed to wait in the patient and visitor waiting area outside
the Cardiac Investigation Unit. The nurse will ask you questions about
your health history, take your vital signs and review the medications you are
taking. Remember to bring all your medications, as well as the list of
medications you are currently taking. The nurse will then disinfect and clean the
skin, and insert an intravenous into your arm. The doctor will talk to you and get
your consent for the procedure while you’re waiting in the CIU.
A nurse from the procedure room will come and take you on a stretcher into
the room. Once you are in the room, you will lie flat on a narrow table under an
X-ray camera. When you are comfortable on the table, you will be asked not to move
any parts of your body unless asked by the doctor or other staff in the room.
The team in the room will use a cold and wet solution to clean the areas where
the test equipment enters your body. These areas could include top of your
leg and your wrist. The team will put a sterile drape over your body. Before the
test begins, the nurse will give you medications and IV to help with any
anxiety or pain you may experience. However, you will be awake during the
procedure. Once you are prepared, the doctor will enter the procedure room. The
doctor will begin by putting a local anesthetic to numb the area where a long
thin tube is placed inside an artery. The tube allows access for other equipment
to be guided into your heart. The freezing medicine, so you do not feel any
pain or discomfort. After the test is done, the CIU team will help you move to
a stretcher. If the test was done through the wrist, the doctor will take the tube
out in the procedure room and put a tight clamp around your wrist to stop
the bleeding.>>Hi I’m Dr. Buller. I thought I’d come and introduce myself to you, and make sure that we’ve answered any of your questions.
Naturally we can’t put catheters into the heart without some small risks, and
there are some small risks to this procedure. For healthy people the risks
are pretty tiny, but they do include the risk of major heart attack, the risk of
stroke, which can be very serious, and of course a tiny but definite risk of death.
And sometimes the X-ray contrast we use can be difficult with respect to kidney injury, and sometimes people have allergic
reactions to the medicines and to the contrast that we use. But we’re
prepared to handle that, and this is a very experienced centre. The team is all
very experienced, and if we do encounter a complication, we know how to deal with
it promptly. Sometime before you go home, either the fellow or I will come and
have a conversation with you and your family, make sure you understand the
results of the tests, whether any other tests or appointments are necessary as a
result of it. And we’re going to give you a diagram that shows where the blockages
in your heart are and we’ll go over that with you and suggest that you keep that
with you for your future medical appointments with your specialists and
with your family doctor. (Narrator)>>Thank you for taking the time to prepare for your procedure. We hope this video has helped. The CIU team at St. Michael’s Hospital
has a strong commitment to comprehensive patient care, and look forward to meeting
you on the day of your procedure.

Reynold King

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