Cardiac catheterization involves passing a thin flexible tube (catheter) into the right or left side of the heart, usually from the groin or the arm.
Catheterization - cardiac; Heart catheterization
How the test is performed
You will be given medicine before the test to help you relax.
The health care provider cleans a site on your arm, neck, or groin and inserts a line into one of your veins. This is called an intravenous (IV) line.
A larger plastic thin tube called a sheath is placed into a vein or artery in your leg or arm. Then longer plastic tubes called catheters are carefully moved up into the heart using live x-rays as a guide. Then the doctor can:
- Collect blood samples from the heart
- Measure pressure and blood flow in the heart's chambers and in the large arteries around the heart
- Measure the oxygen in different parts of your heart
- Examine the arteries of the heart
- Perform a biopsy on the heart muscle
If you have a blockage, you may have angioplasty and a stent placed during the procedure.
The test may last 30 - 60 minutes. If you also need special procedures, the test may take longer. 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.
You will be told how to take care of yourself when you go home after the procedure is done.
How to prepare for the test
You should not eat or drink for 6 - 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 checked into the hospital the morning of the procedure.
Your health care provider should explain the procedure and its risks. A witnessed, signed consent form for the procedure is required.
Tell your doctor if you:
- Are allergic to seafood or any medications
- Have had a bad reaction to contrast dye or iodine in the past
- Take any medicines, including Viagra or other drugs for erectile dysfunction
- Might be pregnant
How the test will feel
The study is done by trained cardiologists with the assistance of trained technicians and nurses.
You will be awake and able to follow instructions during the test.
You may feel some discomfort or pressure where the catheter is placed. Some people have some discomfort from lying still during the test or from lying flat on your back after the procedure.
Why the test is performed
In general, this procedure is done to get information about the heart or its blood vessels. It may also be done to treat certain types of heart conditions, or to find out if you need heart surgery.
Your doctor may perform cardiac catheterization to diagnose or evaluate:
- Cardiac amyloidosis
- Causes of congestive heart failure or cardiomyopathy
- Coronary artery disease
- Heart defects that are present at birth (congenital)
- High blood pressure in the lungs (pulmonary hypertension)
- Problems with the heart valves
The following procedures may also be done using cardiac catheterization:
- Repair of certain types of heart defects
- Open a narrowed (stenotic) heart valve
- Open blocked arteries or grafts in the heart (angioplasty with or without stenting)
What the risks are
Cardiac catheterization carries a slightly higher risk than other heart tests. However, it is very safe when performed by an experienced team.
The risks include:
- Cardiac tamponade
- Heart attack
- Injury to a coronary artery
- Irregular heartbeat
- Low blood pressure
- Reaction to the contrast dye
Possible complications of any type of catheterization include the following:
- Bleeding, infection, and pain at the IV or sheath insertion site
- Damage to the blood vessels
- Blood clots
- Kidney damage due to the contrast dye (more common in patients with diabetes or kidney problems)
Davidson CJ, Bonow RO. Cardiac catheterization. In: Bonow RO, Mann DL, Zipes DP, Libby P, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 9th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 20
Fraker TD Jr, Fihn SD, Gibbons RJ, Abrams J, Chatterjee K, Daley J et al. 2007 chronic angina focused update of the ACC/AHA 2002 Guidelines for the management of patients with chronic stable angina: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines Writing Group to develop the focused update of the 2002 Guidelines for the management of patients with chronic stable angina. Circulation. 2007;116:2762-2772.
Kern M. Catheterization and angiography. In: Goldman L, Schafer AI, eds. Cecil Medicine. 24th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 57.
Reviewed By: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; and Michael A. Chen, MD, PhD, Assistant Professor of Medicine, Division of Cardiology, Harborview Medical Center, University of Washington Medical School, Seattle, Washington. David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc.