Cardiac catheterization is a medical procedure used by cardiologists or cardiologists to evaluate heart function and diagnose cardiovascular disease.
During cardiac catheterization, a long narrow tube called a catheter is inserted into an artery or vein in the groin, neck, or arm. This catheter is passed through your blood vessels until it reaches your heart. Once the catheter is in place, your doctor can use it to perform diagnostic tests. For example, a dye can be injected through the catheter that allows your doctor to examine the vessels and chambers of the heart using a special X-ray machine.
Why is a cardiac catheterization required?
Your doctor may ask you to have a cardiac catheterization to diagnose a heart problem or to identify a possible cause of your chest pain.
During the procedure, your doctor can:
- Confirmation of a congenital heart defect (a defect present at birth)
- Check for narrowed or blocked blood vessels that may cause chest pain
- Look for problems with your heart valves
- Measuring the amount of oxygen in your heart (hemodynamic assessment)
- Measure the pressure inside your heart
- A biopsy of your heart tissue
- Assessment and determination of the need for further treatment
How to prepare for cardiac catheterization
Your doctor will tell you if you can eat or drink before procedure. In most cases, you won’t be able to eat or drink anything from midnight on the day of the procedure. Eating food and fluids in your stomach during the procedure can increase the risk of complications. You may need to reschedule if you are not able to fast.
Before the catheterization begins, you will be asked to undress and put on a hospital gown. You’ll then lie down and the nurse will start an intravenous (IV) line. A vein, usually placed in your arm or hand, will deliver medications and fluids to you before, during and after the procedure.
The nurse may need to shave the hair around where the catheter was inserted. You may also receive an injection of anesthetic to help numb the area before the catheter is inserted.
What are the stages of the procedure?
The catheter is guided by a short, hollow plastic cap called a sheath. Once the catheter is in place, your doctor will continue the tests needed to diagnose your condition.
Depending on what they’re looking for, your doctor may do one of the following?
1. Coronary angiography
In this procedure, a contrast material or dye is injected through the catheter, and your doctor will use an X-ray machine to monitor the dye as it travels through the arteries, heart chambers, valves, and vessels to check for blockages or narrowing in the arteries.
2. Heart biopsy
In this procedure, your doctor will take a sample of the heart tissue for further testing.
Your doctor may perform an additional procedure if they discover a potentially life-threatening problem with the catheter. These procedures include:
3. Eradication
This procedure corrects an irregular heartbeat (arrhythmia). Doctors use energy in the form of heat (radio frequency energy) or cold (nitrous oxide or laser) to destroy heart tissue and stop an irregular heartbeat.
4. Catheters
During this procedure, doctors insert a small, inflatable balloon into an artery. The balloon is then expanded to help widen the narrowed or blocked artery. Angioplasty can be combined with a stent a small metal coil placed in a blocked or blocked artery to help prevent any future stenosis problems.
5. Balloon valvuloplasty
In this procedure, doctors inflate a balloon-tipped catheter into the narrowed heart valves to help open the narrowed space.
6. Thrombectomy (treatment of blood clots)
Doctors use a catheter in this procedure to remove blood clots that can break off and travel to organs or tissues.
You will be sedated during the catheterization, but you will remain alert enough to respond to the instructions of the doctors and nurses.
During the catheterization, you may also be asked to:
- hold your breath
- Take a deep breath
- cough
- Put your arms in different positions
This will help your health care team get a better picture of your heart and arteries.
What are the benefits of the procedure?
Cardiac catheterization can help your doctor diagnose and treat problems that may be causing more problems, such as a heart attack or stroke. You may be able to prevent a heart attack or stop a stroke in the future if your doctor is able to correct any problems discovered during the procedure.
What are the risks of treatment?
Any procedure that involves your heart comes with a certain set of risks. Cardiac catheterization is relatively low risk, and very few people have any problems. The risk of complications, although rare, increases if you have diabetes or kidney disease, or if you are 75 or older.
The risks associated with catheters include:
- Allergic reaction to contrast materials or medicines used during the procedure
- Bleeding, infection, and the bruising at the catheter insertion site
- Blood clots that could lead to a heart attack, stroke, or other serious problem
- Damage to the artery where the catheter was inserted, or the damage to the arteries as the catheter travels through your body
- arrhythmia (arrhythmia)
- Kidney damage caused by contrast
- low blood pressure
- torn heart tissue
What do you expect after treatment?
Cardiac catheterization is generally a quick procedure and usually takes less than an hour. Although it is performed fairly quickly, you will need several hours to recover.
Once the procedure is completed, you will be taken to a recovery room where you will rest while the sedatives wear off. The catheter insertion site may be closed with a suture or “plug” made of a material that works with your body to form a normal clot in the artery.