Why Cardiac Catheterization #2?

May 9, 2012 8:06 AM

YANMyMom'sDoctor, but why would a second/follow up cardiac catheterization be performed? She has been receiving pulmonary rehab but seems unlikely to be able to reverse heart and lung damage; Rehab seems to be to maintain quality of life. Snowflake details below.

My mom was diagnosed with emphysema, vascular disease and emphysema related heart failure (cor pulmonale) in 12/11. She had a cardiac cath procedure done then which told us the extent of the various vascular blockages she had. Since then, she's been on supplemental oxygen 24/7 and done some pulmonary rehab. There is a second catheterization scheduled in a few weeks. What is the purpose of a second one? Does the mere act of scheduling it mean anything, prognosis-wise?

After the last cath, the doc who performed it said things were pretty seriously blocked up (so much so that they avoided putting instents/recommending bypass, as the biggest blockage is in a risky area). Mom won't tell me details about her health status, only to be "on standby just in case" during the cath procedure. I can't ask her about "why" the procedure is being done because she is evasive or pleads ignorance. She's a nurse so I know she knows what's going on; I am aware of the emotional aspects of why she might not be processing this stuff with me, but I just want technical information. Thanks in advance.

posted by ShadePlant to Health & Fitness (4 answers total)

It is hard to do anything more than speculate given what you have said. If they didn't want to put a stent in they may have seen a blockage in the left main coronary artery, which is usually treated with surgery. Given her overall condition, though, surgery may be very risky for her and so after discussing it they may have decided to go ahead with the stent. Another possibility is that they may want to give her a trial of therapies to reduce her pulmonary hypertension, such as nitric oxide. This is often done in the cath lab, where the pulmonary blood pressure can be measured directly and can require special equipment or personnel in addition to the normal cath lab staff and so is not typically done during a routine cath looking for coronary artery disease or valve disease. As I said, this is just speculation on my part, there might be other things going on as well. I hope things go smoothly for her.
posted by TedW at 8:22 AM on May 9, 2012 [2 favorites]

FWIW my mom was a nurse, and had various heart problems (valve). She was afraid of invasive procedures, and often fluffed them off as something she could do later "if it gets serious". Perhaps your mom doesn't want to talk about the details for similar reasons. I do know someone who does want to talk about details; her cardiologist. Suggest a family meeting to him/her because you are interested in providing support for your mum. BTW who is her healthcare proxy?
posted by Gungho at 9:17 AM on May 9, 2012

Response by poster: I appreciate the responses so far. Follow up details: I've tried to weasel my way into meetings; trouble is I have no releases of info. signed and I live 6 hours away. I asked if I could come to this procedure, (as I learned more from the doc with the first one in 10 minutes than I learned from anyone in 6 months,) but my mom said she just wanted me to be "ready to come to [her city] if something happens." She does not have a healthcare directive, afaik. I'm a social worker; I know those are important but I can't make her do one. If she has a healthcare proxy, I don't know about it.
posted by ShadePlant at 10:06 AM on May 9, 2012

I asked if I could come to this procedure, (as I learned more from the doc with the first one in 10 minutes than I learned from anyone in 6 months,) but my mom said she just wanted me to be "ready to come to [her city] if something happens."

I would really try to be there, especially if you live so far away. It is just easier to plan ahead to be there rather than make last-minute plans if there is a problem. Will she have anyone with her while she is in the hospital?
posted by TedW at 10:41 AM on May 9, 2012