The next gap I want to address pertains to cardiac catheterization. It’s not always clear, but there are two different specialists who can do the procedure. And as you may have learned on Sesame Street way back when, “One of these things is not like the others.”
- What is a cardiac catheterization
- Why you’d need it
- Mind the gap!
- Diagnostic vs interventional cardiologist
- What it means for you
- What you can do
So what’s a cardiac catheterization (“cardiac cath”)? It’s a minimally invasive procedure where the cardiologist will run a small catheter up through an artery in your wrist (the radial artery) or your groin (the femoral artery) if they can’t use the wrist for some reason. They migrate the cath up toward your heart and look into the arteries of your heart. Very straightforward, right?
You’d need a cardiac cath if your cardiologist thinks you have issues with your coronary arteries, the small blood vessels of the heart, or heart failure.
During the procedure the doctor can check for clots, take samples, look for narrowed and/or blocked blood vessels, and depending on the cardiologist, they can open the blockages up for you.
Whoops! Did you see the gap there?
“Depending on the cardiologist…”
Mind the gap!
Cardiologists who are able to perform cardiac caths do so to diagnose those issues. But in that moment that’s all that some of them can do: diagnose. If those cardiologists have you on the table and find a blockage, they are not able to fix it right then and there. These cardiologists are not considered interventional cardiologists. At least not where I worked. The definitions may have wiggle room depending on the practice.
An interventional cardiologist, as I’m describing them, is able to perform the diagnostic cath as described above, but they are also able to get in there and fix the problem when they see it. That is to say, when they diagnose the problem, they are also able to intervene. Immediately.
What does this mean for you?
I have seen patients go to the cardiac cath lab and get a diagnostic cath, only to be closed back up, lay flat for hours while their groin site heals, and then have to go through it all again so that an interventionist can fix their problem.
Often those diagnosticians have a working relationship with an interventional cardiologist who may be in the next cath lab room over. If that interventionist is free, you may have to wait a bit while they finish what they’re doing and scrub in, with your artery still open, so they can come and perform the intervention. If that interventional cardiologist is performing a cath for their own patients, you may wait on the table longer, or your doctor may close you back up and you’ll have to schedule another cath with an interventionist at a later date. Essentially, going through the whole process all over again… sounds fun, huh?
Just so we’re clear, you’re awake on the table. They give you meds to keep you calm and they numb the site, but you’re awake and staring at the ceiling waiting.
So what can you do?
If you’re recommended to have a heart cath, confirm the person performing the cardiac cath can also open up a blockage if they find one. If not and you still want to use your cardiologist, confirm that an interventional cardiologist (someone who can intervene if they find a blockage) will be available at the time of your procedure if they are needed. Get it in writing.
If it’s the latter case, it’s still not 100% guaranteed. Emergencies will happen and the interventional cardiologist may have to take another case while you’re on the table with the diagnostician. If you don’t want to risk that, go with someone who can intervene when they find the problem.
I personally wouldn’t pay a plumber to come look at my pipes and tell me I’ve got a clogged drain only to shake my hand and tell me a different plumber will have to come out and fix it!
Ideally, I’d make sure I was working with an interventionist from the beginning.
Thank you for reading! Please share this site with anyone you think could benefit from it! What questions do you have? Do you have any suggestions? Or did this bring up any stories you want to share? Reach out to me through the contact page, or leave a comment below. I’d love to hear from you!
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