What is cardiac catheterization?
Cardiac catheterization (cardiac catheterization or heart catheterization) is a procedure that tests how well the heart is working. Used to diagnose some heart problems. This is one of the most common heart surgeries performed in the United States.View cardiac catheterization diagram(link opens in new window).
Why do I undergo cardiac catheterization?
Cardiac catheters provide information about how well the heart is working, identify problems, and allow procedures such as angioplasty or stenting to open blocked arteries. During a cardiac catheterization, the medical team can:
- A contrast dye is injected through the catheter and x-rays are taken to check for narrowing or blockages in the coronary arteries. This is called coronary angiography or coronary angiography.
- Percutaneous coronary intervention (PCI), such as coronary angioplasty with stent placement, is performed to widen narrowed or blocked areas of the coronary arteries.
- Check the pressure in the four chambers of the heart.
- A blood sample is taken to measure the oxygen content in the four chambers of the heart.
- Evaluate the contractile capacity of the pump chamber.
- Look for defects in the valves or chambers of the heart.
- A small piece of heart tissue is removed (biopsy) and examined under a microscope.
Watch animation of angiogram
What are the risks of cardiac catheterization?
Cardiac catheterization is usually very safe. Serious complications are very rare. Minor risks include:
- Bruises where the catheter was inserted (puncture site).
- Bleeding at the puncture site.
- Response to contrast dyes.
- infection.
- Side effects of medications that help you relax or sleep, such as nausea and vomiting.
Other risks include:
- abnormal heart rhythm
- blood clot
- Blood vessel and heart damage caused by catheters
- heart attack
- Side effects of X-rays
- stroke
How do I prepare for a cardiac catheterization test?
- You will be given instructions on what to eat and drink 24 hours before your test.
- You will usually be asked not to eat or drink anything for 6 to 8 hours before surgery.
- Tell your health care team right away if you think you may be pregnant.
- Tell your health care team about the medicines you take (including over-the-counter medicines, herbs, and vitamins). You may be asked not to take them before your procedure.
- Tell your health care team if you are allergic to anything, especially to iodine, shellfish, latex or rubber products, X-ray dyes, or drugs such as penicillin.
- Arrange for someone to drive you home after your procedure.
- If you have hearing aids, you may be able to wear them during your surgery. If you wear glasses, please bring them with you to your appointment.
What happens during a cardiac catheterization?
A specially trained doctor performs the surgery along with a team of nurses and technicians. This procedure is done in a cardiac catheterization (catheterization) lab at a hospital or clinic.
- Before the catheterization procedure, a nurse will insert an IV (intravenous) line into a vein in your arm and give you medication (sedatives) to help you relax but remain awake and able to follow instructions during the procedure.
- The nurse cleans and shaves the area where the doctor will be working. This is usually located in the groin area.
- A local anesthetic is usually given to numb the puncture site.
- The doctor inserts a needle through the skin and into a large blood vessel. A small straw-sized tube (called a sheath) is inserted into the blood vessel. The doctor slowly guides the catheter (a long, thin tube) through the sheath and into the blood vessel. A video screen shows the position of the catheter as it travels through the major blood vessels to the heart. You may feel pressure in your groin area, but it should not be painful.
- Various instruments may be placed at the tip of the catheter. These include measuring the pressure of the blood in each heart chamber and the blood vessels connected to the heart, looking inside the blood vessels, taking blood samples from different parts of the heart, and collecting tissue from inside the heart. Contains equipment for collecting samples.
- When a catheter is used to inject a dye that can be seen on X-rays, the procedure is called angiography.
- When a catheter is used to remove a narrowed or blocked artery, the procedure is called angioplasty or percutaneous coronary intervention.
- When a catheter is used to widen the opening of a narrowed heart valve, the procedure is called valvuloplasty.
- The doctor will remove the catheter and sheath. The nurse will apply pressure to the area to prevent bleeding. In some cases, special closure devices may be used.
What happens after a cardiac catheterization?
You will be in the recovery room for several hours. You must lie down during this time.
- Pressure is applied to the puncture site to stop bleeding.
- You will be asked to keep your legs straight and will not be able to get out of bed.
- Your heart rate and other vital signs (pulse and blood pressure) will be checked during your recovery.
- Report any swelling, pain, or bleeding at the puncture site, or if you have chest pain.
- If you have additional procedures during your cardiac catheterization, you may have to spend the night in the hospital.
- You will receive written instructions on what to do at home before you are discharged from the hospital.
What happens after I get home?
Always follow your medical team’s instructions. It is important to take your medication as directed and make follow-up appointments before leaving the hospital. Depending on whether additional procedures were performed during cardiac catheterization, most people can return to normal activities the day after the procedure.
It is normal to have a small bruise at the puncture site. If the area starts to bleed, lie flat and press firmly on it for a few minutes. Then check again to see if the bleeding has stopped.
Contact your health care professional if:
- The foot with the puncture may feel numb or tingly, and the foot may become cold or blue.
- There will appear to be more bruising around the puncture site.
- The puncture site may swell and fluid may drain from it.
- Bleeding from the access site cannot be stopped even with strong pressure.
- You will experience:
- chest pain or shortness of breath
- dizzy
- heat
- irregular, very slow or fast heartbeat
Call 911 if:
- The puncture site will swell rapidly.
- Even if you press hard on the puncture site, the bleeding from the puncture site will not stop.