Cardiac catheterization is a medical procedure that cardiologists, or heart specialists, use to evaluate heart function and diagnose cardiovascular conditions.
During cardiac catheterization, a long narrow tube called a catheter is inserted into an artery or vein in your upper thigh, neck, or arm. This catheter is threaded through your blood vessel until it reaches your heart.
Once the catheter is in place, your doctor can use it to run diagnostic tests. For example, a dye can be injected through the catheter that allows your doctor to see the vessels and chambers of your heart using an X-ray machine.
Cardiac catheterization is usually performed in a hospital by a doctor who specializes in the procedure, with assistance from a team of medical professionals.
What to know about cardiac catheterization
- Cardiac catheterization is used to diagnose and treat problems with your heart or blood vessels.
- To do this, a doctor inserts a small tube called a catheter through your blood vessels and into your heart.
- It’s a common cardiac procedure, performed over
1 million timesevery year in the United States.
- The risk of serious complications is very low for most people. Serious problems happen less than 1 percent of the time.
There are several reasons why your doctor may request a cardiac catheterization procedure, including to:
- diagnose a suspected heart condition
- plan or carry out treatment after a heart attack
- help to determine what’s causing symptoms like chest pain, irregular heartbeat, or shortness of breath
- assess the condition of your heart before heart surgery or a heart transplant
- confirm a diagnosis of congenital heart disease (heart disease that you were born with)
During the procedure, your doctor can:
- check for narrow or blocked blood vessels
- look for problems with your heart’s valves
- take a sample (biopsy) of your heart tissue
- measure blood flow and blood pressure in your heart
- examine the arteries that go from your heart to your lungs to look for conditions like pulmonary embolism or pulmonary hypertension
Cardiac catheterization usually happens in a hospital or surgery center. Your doctor will be assisted by a team that may include other doctors, nurses, technicians, and other medical professionals.
Before starting the heart catheterization procedure, a nurse will place an intravenous (IV) line in your arm or hand. The IV line will deliver medication and fluids to you before, during, and after the procedure.
You’ll typically receive a medication called a sedative to help you relax, but you’ll remain alert enough to respond to instructions from doctors and nurses.
Usually, a nurse will use a local anesthetic to numb the area where the catheter will be inserted, also known as the access site. They may also use a small razor to shave off any hair from the access site, which may be on your upper thigh, arm, or neck.
Small discs called electrodes will be placed on your upper body. The electrodes are then connected to an electrocardiogram (EKG) machine, which allows the medical team to monitor your heart activity during the procedure.
Your doctor will insert a hollow, plastic tube called a sheath into the access site. To help place the sheath correctly, they may use a needle or a small incision. They may also use ultrasound imaging for additional guidance.
Your doctor will then insert the catheter through the sheath. You may feel pressure as the catheter is moved into position, but you shouldn’t feel pain.
Imaging devices, such as an X-ray machine, may be used to guide the catheter into place or to conduct tests during the procedure.
During the catheterization, you may be asked to:
- hold your breath
- take a deep breath
- move your head
This can help your doctor position the catheter or get a clearer image of your heart and arteries.
Once the catheter is in place, your doctor will proceed with the tests or procedures needed to diagnose or treat your condition.
When the procedure is complete, your doctor will remove the catheter and sheath. If necessary, the access site may be closed up with a suture, clip, or collagen plug.
In other cases, manual pressure is applied to the access site to help your body close up the access site. A bandage or dressing is applied after the site is closed up.
Procedures that use cardiac catheterization
To evaluate your heart function or diagnose a condition, your doctor may perform one of the following procedures:
- Coronary angiogram or arteriogram. With a coronary angiogram or arteriogram, a dye is injected through the catheter. Your doctor will use an X-ray machine to watch the dye as it flows through your heart and blood vessels.
- Heart biopsy. In a heart biopsy, your doctor can use a tool placed on the tip of the catheter to take a sample of heart tissue for further testing.
- Other tests. Other instruments can be placed on the tip of the catheter in order to:
- take blood samples from inside your heart
- measure blood pressure and blood oxygen in your blood vessels and different parts of your heart
- examine the inside of your blood vessels
Your doctor can also perform treatments during catheterization to help correct heart or blood vessel conditions. These procedures include:
- Ablation. To correct an irregular heartbeat, or arrhythmia, a doctor can apply heat or cold with a specialized catheter. This destroys heart tissue to stop the irregular heart rhythm.
- Angioplasty. During this procedure, a doctor inserts a tiny inflatable balloon into the artery. The balloon is then expanded to help widen a narrowed or blocked artery. This is also known as percutaneous coronary intervention.
- Balloon valvuloplasty. Similar to angioplasty, a doctor can inflate a balloon-tipped catheter into narrowed heart valves to help open up the space.
- Stent placement. A doctor can use the catheter to place a small metal coil inside a blocked or clogged artery. This helps to improve blood flow.
Cardiac catheterization can help your doctor diagnose and treat problems in your heart and blood vessels that might otherwise cause larger issues, such as a heart attack or stroke.
With a more accurate diagnosis and treatment plan from your doctor, you may be able to prevent a heart attack or stroke from happening.
Any procedure that involves your heart comes with some risks. Overall, cardiac catheterization is considered low risk, and very few people have any serious problems.
The risk is higher for people who have a serious heart condition or kidney disease. It’s important to talk with your doctor to ensure you understand the potential risks.
The risks associated with catheterization include:
- an allergic reaction to dye used during the procedure
- bleeding or bruising at the access site
- irregular, fast, or slow heartbeat, which is usually temporary
Rarer and more serious complications include:
- damage to your blood vessels, heart tissue, or heart valves
- kidney damage caused by dye used during the procedure
- radiation injury due to X-ray exposure during a long catheterization procedure
- a blocked blood vessel if plaque is relased by the procedure (cholesterol embolism)
- heart attack
Though it’s uncommon, heart surgery is sometimes needed to treat serious problems caused by cardiac catheterization.
A doctor will help you prepare for cardiac catheterization. They will ask you about your medical history, any allergies you may have, and any medications or supplements you’re taking.
They’ll also perform a physical exam to determine whether cardiac catheterization is appropriate for you.
Before cardiac catheterization, your doctor will usually request several tests. These can include:
- an EKG
- a blood pressure reading
- blood tests
- imaging tests, such as an ultrasound, X-ray, CT scan, or MRI scan
Your doctor will also give you instructions on how to prepare for the day of the procedure. They may instruct you to:
- restrict what you eat or drink
- stop or start specific medications
- arrange for someone to help you get home after the procedure
- bring personal items, like your toothbrush, if your doctor expects that you’ll need to stay in the hospital overnight
Cardiac catheterization is a generally quick procedure and usually lasts less than an hour. Even though it’s performed rather quickly, you’ll still need several hours to recover.
Once the procedure is finished, you’ll be taken to a recovery room where you’ll rest while the sedative wears off. If needed, pressure will continue to be applied to the access site to help stop bleeding.
A doctor or nurse will check your access site and monitor your heart rate and blood pressure.
They may ask you to lie flat for several hours if your incision site was in your upper thigh (groin).
When can you go home?
In most cases, you can go home the same day. An overnight stay may be required if you have an additional procedure, such as angioplasty or ablation, during the catheterization.
Your doctor will provide you with instructions for home care after the procedure. You’ll likely need to rest at home for several days to prevent serious bleeding and allow the blood vessel to heal completely.
Your doctor may recommend that you avoid lifting heavy objects while you are healing.
Most people will recover well at home. But if you notice unusual changes, it’s important to call your doctor. Reasons to call your doctor include:
- swelling, pain, or yellow or green drainage at the access site
- bleeding at the access site that does not stop with firm pressure
- numbness, weakness, or a cold or pale limb around the access site
- shortness of breath
- fast, slow, or irregular heartbeat
When to get emergency help
Although it’s rare, a heart attack or stroke can happen after cardiac catheterization.
According to the
National Heart, Lung, and Blood Institute, it’s important to get immediate help if you notice certain symptoms after your procedure.
Heart attack symptoms include:
- pain or discomfort in your chest or upper abdomen
- nausea or vomiting
- lightheadedness or fainting
- cold sweats
- shortness of breath
- discomfort in one or both arms, back, neck, jaw, or upper stomach
To check for signs of a stroke, use the FAST test:
- Face: When the person tries to smile, does one side of their face droop?
- Arms: When the person raises both arms, does one drift down?
- Speech: When you ask the person to say something, does it sound slurred?
- Time: Act quickly if you notice signs of a stroke.
If you suspect a heart attack or stroke, it’s important to call your local emergency services or get help to go to the nearest emergency room.
Cardiac catheterization is a quick procedure that is usually low risk. In many cases, you’ll be able to go home the same day.
It’s important to follow your doctor’s instructions to prepare for the procedure and to care for yourself afterward. If you have any questions or unusual symptoms, be sure to tell your doctor.
Your doctor will often be able to discuss the results of your catheterization with you soon after it’s completed. If you had a biopsy, the results may take a little longer. Depending on the findings, your doctor may recommend future treatment or procedures.