Talk:Cardiac catheterization

message: Problems can occur when having a cardiac catheterization done. In my own personal case,
I had it inserted in the groin area. Within 12 hours, my entire penis and testicles had turned purple and I had internal bleeding about two inches above 5 inches to the side of the insertion hole. 4 days later I can still hardly walk due to the blood build up in my groin area, it also hurts (badly) to sit down and stand up. 
I was given many flyers about the procedure, but NONE of them ever mentioned any of this being able to occur. I was quite suprised when this all happened and I had to goto my doctor to find out that this was fairly normal. I was told 1 of 4 people have a problem.
:Sounds like you were unlucky and got a bad hematoma.  Hematoma (bleeding) is a common complication.  I hope you have a speedy recovery.  Also, I hope that the cath told the docs what they wanted to know. 
:Feel free to edit the article... you could add a discussion about complications. Nephron 08:27, 18 March 2006 (UTC)
thread_title: complications

message: OK, from what I remember from what was done to me (both in the neck and in the groin), the radiocontrast as well as a local anesthetic were administered in the cath lab prior to the insertion of the guidewire and catheter. So "during" or "before" really depends on what you consider to be the actual procedure. I guess it comes down to semantics. --Kyoko 17:16, 29 November 2006 (UTC)
replies: text: Certainly not. Contrast is given during the procedure, through the catheter. And that's the way it is. --Ekko 13:28, 30 November 2006 (UTC)
replies: text: I'm sorry for my mistake, when you go through a whole rush of new (to me) procedures in a relatively short period of time, details can become a little hazy in the memory. Please forgive me. --Kyoko 13:50, 30 November 2006 (UTC)
thread_title:  timing of radiocontrast administration 

message: I've noticed that "catheterization" is occasionally spelled "catherization." I always assumed this was a misspelling, but it happens often enough -- even on respectable medical sites, and in one of the comments above -- that I've begun to wonder. Is "catherization" a misspelling, a valid alternate spelling, or something entirely different from "catheterization"? 38.115.185.2 18:38, 15 November 2007 (UTC)
thread_title:  Spelling? 

message: In cardiac catheterization (often called cardiac cath), a very small hollow tube, or catheter, is advanced from a blood vessel in the groin or arm through the aorta into the heart. Once the catheter is in place, several diagnostic techniques may be used. The tip of the catheter can be placed into various parts of the heart to measure the pressures within the chambers. The catheter can be advanced into the coronary arteries and a contrast dye injected into the arteries.
08:06, 10 January 2013 (UTC)
thread_title:  cardiac catheterization  

message: Hello, we are a group of medical students editing this page as part of our class assignment. We have compiled a list of suggestions to improve this article and would appreciate community feedback before we proceed with these edits. Here is a list of our suggestions:
1. “In cardiac catheterization, radial access is not associated with an increased risk of stroke over femoral access. Sirker, Alex; Kwok, Chun Shing; Kotronias, Rafail; Bagur, Rodrigo; Bertrand, Olivier; Butler, Robert; Berry, Colin; Nolan, James; Oldroyd, Keith (November 2016). "Influence of access site choice for cardiac catheterization on risk of adverse neurological events: A systematic review and meta-analysis". American Heart Journal. 181: 107–119. doi:10.1016/j.ahj.2016.06.027. ISSN 1097-6744. ."
2. We propose to add a section focusing on conditions of patients at higher risk for complications of catheterization. We would like to add the following, “ Individuals with certain comorbidities are at a higher risk during the cardiac catheterization procedure. These comorbidities include aortic aneurysm, aortic stenosis, diabetes, obesity, renal insufficiency, unstable angina, uncontrolled hypertension and extensive three-vessel coronary artery disease.
3. Outline the normal dose of radiation exposure and the precautions put in place to limit this exposure in the cath lab. We propose to add the following in the Procedure section after the introduction of fluoroscopy: “Patients are constantly exposed to low doses of ionizing radiation during procedures. Ideal table positioning between the x-ray source and receiver, and radiation monitoring via thermoluminescent dosimetry, are two main ways of reducing patient exposure to radiation. Christopoulos, Georgios; Makke, Lorenza; Christakopoulos, Georgios; Kotsia, Anna; Rangan, Bavana V.; Roesle, Michele; Haagen, Donald; Kumbhani, Dharam J.; Chambers, Charles E. (2016-02-01). "Optimizing Radiation Safety in the Cardiac Catheterization Laboratory: A Practical Approach". Catheterization and Cardiovascular Interventions: Official Journal of the Society for Cardiac Angiography & Interventions. 87 (2): 291–301. doi:10.1002/ccd.25959. ISSN 1522-726X. ."
4. We propose to correct the following error made in the left heart catheterization subheading under the procedure section of the article. The current version states: “At this point, the wire can be maneuvered into the coronary ostia and into the coronary arteries. A catheter is guided over the wire and enters either the left or right coronary artery.” This is incorrect, as the wire does not enter the coronary arteries. It is the catheter tube, and its shape, that enters and engages the coronary artery during the procedure. The wire is removed, out of the aorta, before the catheter engages the coronaries.  We thus propose the following replace the above two sentences currently on the page: “At this point, a catheter is guided over the wire into the ascending aorta, where it can be maneuvered into the coronary arteries through the coronary ostia."
5. We propose to add a section focusing on the importance of the cardiac catheterization as an interventional procedure to provide a better clinical context (as opposed to a purely procedural focus). In particular, we would like to use a reference on superior survival outcome after out of hospital cardiac arrest, since this condition represents the majority of clinical cases where cardiac catheterization is used as a direct intervention (as opposed to a diagnostic procedure). We thus propose to add the following: “Cardiac catheterization can be used as part of a therapeutic regimen to improve outcomes for survivors of out-of-hospital cardiac arrest.Camuglia, Anthony C.; Randhawa, Varinder K.; Lavi, Shahar; Walters, Darren L. (November 2014). "Cardiac catheterization is associated with superior outcomes for survivors of out of hospital cardiac arrest: review and meta-analysis". Resuscitation. 85 (11): 1533–1540. doi:10.1016/j.resuscitation.2014.08.025. ISSN 1873-1570. ."
6. We propose to remove reference # 6 as it is from 2008. Consequently, we propose to remove the sentence(s) associated with this reference in Cardiac Catheterization#Catheterization of chambers and valves that currently reads: “It has the ability to measure the pressure gradient across a valve and derive valve area from it. Thereby, it can assist in diagnosis of, for example, aortic stenosis.” We propose to replace the above sentences with the following: “Cardiac catheterization can be used to diagnose or assess severity of valvular stenosis by measuring elevated pressure gradients across cardiac valves. Grossman & Baim's cardiac catheterization, angiography, and intervention. Moscucci, Mauro, (Eighth edition). Philadelphia. p. 272. ISBN 9781451127409. OCLC 829739969.”
7. We noticed the information stated in the history section is not referenced. We therefore propose to cite the information stated in these sentences: "Clinical application of cardiac catheterization begins with Werner Forssmann in the 1930s, who inserted a catheter into the vein of his own forearm, guided it fluoroscopically into his right atrium, and took an X-ray picture of it. Forssmann won the Nobel Prize in Physiology or Medicine for this achievement, though hospital administrators removed him from his position owing to his unorthodox methods."
Huge thank you to the Wikipedia community. We appreciate your time and welcome any feedback or suggestions you may have!
Ryee5 (talk) 03:15, 8 November 2017 (UTC)
replies: text: that's all great by me.  the only thing i would ask is that you template the refs.  there is a tool in the toolbar right above the editing window that helps you do that.  See WP:MEDHOW. Thanks! Jytdog (talk) 03:27, 8 November 2017 (UTC)
replies: text: Refs #2 and #4 are duplicates [since fixed]. If to the same pages, use the method that allows repeat use of same ref. If not to same pages add page numbers to each ref. All the book citations have "Edition ed." I think this is because when you add a number for edition the template automatically adds "ed." For your History section, are there any significant, referenceable milestones between 1930s and present? For your CardCath as improving survival, can you explain what CardCath is achieving, and from that meta-analysis a percentage improved survival? For #3, Wikipedia prefers "people" over "patients" (even when they are patients). For #1, your non-medical readers will not know what radial or femoral means. In general, try to write for a person who does not have a medical education. David notMD (talk) 04:49, 8 November 2017 (UTC)
replies: text: Thanks to everyone who gave feedback! We have found it very useful and plan on making the following changes: Based on the comments made from the Wikipedia community, we have formatted the references according to the appropriate template, and the duplicates have been removed. We will do further research into citations for the rest of the history section, from 1930 onwards. Notable milestones found from credible sources will be added to the article. The meta-analysis examining cardiac catheterization survival investigated angiography and percutaneous coronary intervention. The results are as follows: Overall survival in the early angiography group was 58.8% versus 30.9% in the conservative management group (Odds ratio 2.77, 95% CI 2.06-3.72). Survival with good neurological outcome in the acute angiography group was 58% versus 35.8% in the conservative management group (Odds ratio 2.20, 95% CI 1.46-3.32). The key takeaway highlighted in this paper is the benefit of early imaging and stenting if necessary. We will ensure that our writing takes on a tone more suited to our audience by focusing on "people" rather than "patients" and using layman’s vocabulary so that non-medical readers will understand. For example, instead of just using the words radial and femoral, in the actual edit we will describe where on the body these access locations are. Thanks again and feedback is always welcome! Ryee5 (talk) 22:53, 13 November 2017 (UTC)
replies: text: Thanks for the comments . Great job with your suggestions so far. Please be sure to add all these changes and any new text you propose to add to the article into your list of suggested changes above. This will allow us to preview exactly what you wish to insert into the article before it goes live in the actual article. Once again, great work so far! JenOttawa (talk) 23:03, 13 November 2017 (UTC)

text: Removed duplication of sentence about Forssmann. The text after Forssmann is not in chronological sequence and not referenced. Steadmanns' founding of the PA concept not germane to this article. Need to make clear that Forssmann And Cournand were co-winners of the Nobel. David notMD (talk) 00:41, 16 November 2017 (UTC)
replies: text: Hello and thank you for your feedback! We have edited the history section to clarify that Forssmann and Cournand were co-recipients of the Nobel Prize. The parts of this section that are not referenced were present before we began are edits, and so we did not feel comfortable removing them. We have also made changes 1 and 4 (can be seen above). Thanks! Ryee5 (talk) 15:51, 21 November 2017 (UTC)

text: We have also added change #5.Ryee5 (talk) 16:39, 21 November 2017 (UTC)
replies: text: We have just made changes #1 and 2, thanks! Ryee5 (talk) 14:23, 22 November 2017 (UTC)
thread_title:  Potential Changes