Cardiac Catheterization

Cardiac catheterization is a procedure used to check for many cardiovascular conditions, especially blockages in the arteries to your heart that could cause heart attack. During cardiac catheterization, a long thin tube called a catheter is inserted in an artery or vein in your groin or arm and threaded through your blood vessels to your heart. Using this catheter, doctors can then do diagnostic tests as part of a cardiac catheterization.

Why it’s done:

Cardiac catheterization is done to see if you have a heart problem.
If you’re having cardiac catheterization as a test for heart disease, your doctor can:

  • Locate narrowing or blockages in your blood vessels
  • Find out the amount of oxygen in your heart
  • Test the pressure inside your heart
  • Look for problems with your heart valves

Risks:
As with most procedures done on your heart and blood vessels, cardiac catheterization has some risks. Major complications are rare, though.

Risks of cardiac catheterization are:

  • Bruising
  • Bleeding
  • Heart attack
  • Stroke
  • Damage to the artery where the catheter was inserted
  • Irregular heart rhythms (arrhythmias)
  • Allergic reactions to the dye or medication
  • Tearing the tissue of your heart or artery
  • Infection
  • Blood clots

If you are either pregnant or planning to become pregnant, tell your doctor before having cardiac catheterization performed.

How you prepare:
Cardiac catheterization is usually performed in the hospital. The test requires some preparations. To prepare for your test:

  • Don’t eat or drink anything for eight to 12 hours before your test. Having food or drink in your stomach can make your test results inaccurate. Cardiac catheterization tests are often scheduled for the morning, so you can have something to eat and drink soon after your test.
  • Take all your medications and supplements with you to the test. It’s best if you take the original bottles so that your doctor will know the exact dose you take.

At the hospital, you’ll have your blood pressure, pulse and body temperature checked. You’ll be asked to use the toilet to empty your bladder. You’ll be asked to remove dentures and may need to remove jewelry, especially necklaces that could interfere with pictures of your heart. You’ll wait in a room until it’s time for your procedure – you can often have someone wait there with you.

Read complete instructions on preparing for your cardiac catheterization here.

What You Can Expect

During the procedure:
Cardiac catheterization is often done in a special operating room called a catheterization lab. The catheterization lab has special X-ray and imaging machines that normal operating rooms don’t have. Cardiac catheterization is usually performed while you’re awake, but sedated. An intravenous (IV) line will be inserted in your arm, and will be used to give you any additional medication you might need during your procedure. You will also have monitors (electrodes) placed on your chest to check your heartbeat during the test. Just before the procedure, a nurse or technician will shave the hair from the site where the catheter will be inserted. Before the catheter is inserted in your artery, you’ll be given a shot of anesthetic to numb the area. You may feel a quick stinging pain before the numbness sets in. After you feel numb, the catheter will be inserted. A small cut is made, usually in your leg, to access an artery. A plastic sheath will be inserted to allow your doctor to insert the catheter.

What happens next depends on why you’re having a cardiac catheterization:

  • Coronary angiogram: If you’re having this test to check for blockages in the arteries leading to your heart, contrast will be injected through the catheter, and X-ray images of your heart arteries will be taken. In a coronary angiogram, the catheter is usually placed in the artery in your groin or wrist.
  • Right heart catheterization. This procedure checks the pressure and blood flow in the right side of your heart. For this procedure, the catheter is inserted in the artery in your neck or groin. The catheter has special sensors in it to measure the pressure and blood flow in your heart.

Although you may be sedated, you’ll be awake during this procedure so that you can follow instructions. Throughout the procedure you may be asked to take deep breaths, hold your breath, cough or place your arms in various positions. Your table may be tilted at times.

Threading the catheter is not painful, and you will not feel it moving through your body. Tell your health care team if you do experience discomfort.

After the procedure:
It usually takes several hours to recover from a cardiac catheterization. After your procedure is finished, you’ll be taken on a gurney to a recovery room while the sedation wears off. This usually takes about thirty minutes. The plastic sheath inserted in your groin or arm will be removed. It’s very important not to move the limb that your catheter’s been inserted in, or to lift your head if your catheter is in your neck, so as not to cause serious bleeding. After your catheter has been removed, the technician or nurse who has removed your sheath will apply pressure to the insertion sites, and you’ll need to lie flat for four to six hours after the procedure to avoid serious bleeding and to allow the artery to heal. You’ll be able to eat and drink after the procedure. The length of your stay in the hospital will depend on your condition. You may be able to go home the same day or you may need to stay overnight or longer.

Results:
If you’re having cardiac catheterization, your doctor will explain the results to you. Your results may show that you need medication, surgery or a stent to correct the problem.