Myocardial Biopsy

Written by Jaime Herndon | Published on June 6, 2012
Medically Reviewed by George Krucik, MD

What Is a Myocardial Biopsy?

The heart muscle is known as the myocardium. If your doctor suspects a problem with your heart muscle, you may need a biopsy. This involves removing a small piece of tissue for examination. A heart biopsy is called a myocardial biopsy.

A myocardial biopsy is often performed during cardiac catheterization or other heart tests. However, the test can also be performed on its own. It is usually performed in a hospital.

This biopsy uses a small catheter called a bioptome to remove a small piece of heart tissue. This is a special type of catheter used to take a biopsy. It has jaws on the end that can remove a piece of tissue.

After the biopsy is performed, the sample is sent to a laboratory for analysis.

Why Is this Procedure Done?

This procedure is performed to look for disease or damage in the heart muscle. It can be used to diagnose:

  • cardiomyopathy: deterioration of the heart muscle, which can be caused by a number of conditions
  • myocarditis: an inflammation of the heart muscle
  • rejection after a heart transplant: your immune system causes tissue damage that can be seen under a microscope

How Do I Prepare for the Biopsy?

Your doctor will give you instructions on whether you are able to eat and drink before the biopsy. Typically, no food or liquid is allowed for six to eight hours before the test.

If you take any medications or supplements, ask your doctor whether you should stop them before the procedure. If you are diabetic, your medications may need to be adjusted the day of the biopsy. Let your doctor know about any allergies you may have.

You will probably be admitted to the hospital the morning of your biopsy. In rare cases, you may need to go to the hospital the night before.

Bring someone with you to the procedure or have a car service send a car for you after it is over. You will not be allowed to drive yourself home.

What Does the Procedure Involve?

You will be given a hospital gown to wear during the biopsy. An intravenous line will be started. This will deliver fluids to keep you hydrated. It can also deliver medication if your blood pressure drops or heartbeat becomes abnormal.

You will lie on a table with a large camera above you, along with several monitors. An incision will be made in your neck, arm, or groin, depending on whether you are having another surgery. If you are not having another procedure, it will probably be in the neck. Location of the incision also depends on what part of the heart your doctor wants to sample.

A local anesthetic is applied to the incision site. This will numb it, since you will not be unconscious for the procedure. A hollow tube will be inserted into your blood vessel to hold it open. You may feel some pressure or discomfort.

Once the tube is in place, the bioptome will be inserted. It will be threaded through your blood vessels until it reaches your heart. The doctor will guide it there using a special type of moving X-ray called fluoroscopy.

Once in the correct location, a small sample of your heart muscle will be taken. Then the bioptome will be removed and pressure will be applied to the insertion site. The whole procedure takes 30 to 60 minutes.

You will be monitored for a period of time after the procedure. The doctors will want to be sure you are stable enough to be on your own. As you will not be allowed to drive, someone else will need to take you home after the biopsy.

Are There Any Risks?

You will need to sign a consent form prior to the procedure that will outline the risks of the biopsy. A myocardial biopsy may seem scary. However, with an experienced doctor, complications are rare.

Some potential risks include:

  • blood clots
  • bleeding
  • abnormal heart rhythm
  • infection
  • collapsed lung
  • injury to the artery
  • damage to the nerve that controls speech
  • rupture of the heart (extremely rare)

What Do the Results Show?

The results of a myocardial biopsy will let your doctor know if there is any damage to your heart muscle. A number of conditions can cause an abnormal biopsy, including:

  • heart damage from long-term alcohol use
  • cardiac amyloidosis: a disease where amyloid protein builds up in the heart
  • various types of cardiomyopathy
  • myocarditis
  • rejection of a heart transplant

If you do have heart muscle damage, treatment will vary depending on its cause.

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