Cardiac catheterization
Definition
Cardiac catheterization involves passing a catheter (a thin flexible tube) into the right or left side of the heart.
Alternative Names
How the Test is Performed
You will be given a mild sedative prior to the test to help you relax. An intravenous (IV) line is inserted into one of the blood vessels in your arm, neck, or groin after the site has been cleansed and numbed with a local anesthetic.
A catheter is then inserted through the IV and into your blood vessel. The catheter is carefully threaded into the heart using an x-ray machine that produces real-time pictures (fluoroscopy). Once the catheter is in place, contrast material is injected and pictures are taken.
How to Prepare for the Test
If possible, you will be asked not to eat or drink for 6 to 8 hours before the test. The test takes place in a hospital and you will be asked to wear a hospital gown. Sometimes, you will need to spend the night before the test in the hospital. Otherwise, you will be admitted as an outpatient or an inpatient the morning of the procedure.
Your health care provider should explain the procedure and its risks. A witnessed, signed consent for the procedure is required.
Tell your doctor if you are allergic to seafood, if you have had a bad reaction to contrast material or iodine in the past, if you are taking Viagra, or if you might be pregnant.
How the Test Will Feel
The study is done by a trained cardiologist or radiologist and technicians or nurses.
You will be awake and able to follow instructions during the test. A mild sedative is usually given 30 minutes before the test to help you relax. The test may last from 1 to several hours.
You may feel some discomfort at the site where the catheter is placed. Local anesthesia will be used to numb the site, so the only sensation should be one of pressure at the site. You may experience some discomfort from having to remain still for a long time.
After the test, the catheter is removed. You might feel a firm pressure, used to prevent bleeding, at the insertion site. If the catheter is placed in your groin, you will usually be asked to lie flat on your back for a few hours after the test to avoid bleeding. This may cause some mild back discomfort.
Why the Test is Performed
In general, this procedure is done to get information about the heart or its blood vessels or to provide treatment in certain types of heart conditions. It may also be used to determine the need for heart surgery.
Therapeutic catheterization may be used to repair certain types of heart defects, open a stuck (stenotic) heart valve, and open blocked arteries or grafts in the heart.
Cardiac catheterization can be used to:
- collect blood samples from the heart
- determine pressure and blood flow in the heart's chambers
- examine the arteries of the heart with an x-ray technique called fluoroscopy (which gives immediate, "real-time," pictures of the x-ray images on a screen and provides a permanent record of the procedure)
- evaluate heart abnormalities in a newborn
- evaluate heart valves and function
What Abnormal Results Mean
The procedure can identify heart defects or disease, such as coronary artery disease, valve problems, ventricular aneurysms, or heart enlargement.
The procedure also may be performed for the following:
Risks
Cardiac catheterization carries a slightly higher risk than other heart tests, but is very safe when performed by an experienced team.
Generally, the risks include the following:
- Cardiac arrhythmias
- Cardiac tamponade
- Heart attack
- Hemorrhage
- Low blood pressure
- Reaction to the contrast medium
- Stroke
- Trauma to the artery caused by hematoma
Possible complications of any type of catheterization include the following:
- A risk of bleeding, infection, and pain at the IV site.
- A very small risk that the soft plastic catheters could actually damage the blood vessels.
- Blood clots could form on the catheters and later block blood vessels elsewhere in the body.
- The contrast material could damage the kidneys (particularly in patients with diabetes).
Considerations
Cardiac catheterization may include coronary angiography.
References
Reviewed By: Larry A. Weinrauch, MD, Assistant Professor of Medicine, Harvard Medical School, Cardiovascular Disease and Clinical Outcomes Research, Watertown, MA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
