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 known as a myocardial biopsy.
A doctor often performs a myocardial biopsy during cardiac catheterization or other heart tests. However, you can also have this test on its own. The procedure usually occurs 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, your doctor will send the sample to a laboratory for analysis.
This procedure looks for disease or damage in the heart muscle. It can help diagnose:
- cardiomyopathy: deterioration of the heart muscle, which can be due to a number of conditions
- myocarditis: inflammation of the heart muscle
- rejection after a heart transplant: your immune system causes tissue damage that your doctor can see under a microscope
Your doctor will give you instructions on whether you can eat and drink before the biopsy. Typically, you shouldn’t consume food or liquid 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’re diabetic, your doctor may need to adjust your medications for the day of the biopsy. Let your doctor know about any allergies you may have.
You’ll probably enter 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’s over. You will not be able to drive yourself home.
You will receive a hospital gown to wear during the biopsy. A nurse will start an intravenous line in your hand or arm. This will deliver fluids to keep you hydrated. It can also deliver medication if your blood pressure drops or if your heartbeat becomes abnormal.
You will lie on a table with a large camera above you, along with several monitors. A surgeon will make an incision in your neck, arm, or groin, depending on whether you’re having another surgery. If you aren’t having another procedure, it will probably be in the neck. Location of the incision also depends on the part of the heart your doctor wants to sample.
You will receive a local anesthetic at the incision site. This will numb it, since you won’t be unconscious for the procedure. The surgeon will insert a hollow tube into your blood vessel to hold it open. You may feel some pressure or discomfort.
Once the tube is in place, the surgeon will insert the bioptome. They will thread it 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, the doctor will take a small sample of your heart muscle tissue. Then they’ll remove the bioptome and apply pressure to the insertion site. The whole procedure takes 30 to 60 minutes.
The medical staff will monitor your condition for a period of time after the procedure. The doctors will want to be sure you’re stable enough to be on your own. As you won’t be able to drive, someone else will need to take you home after the biopsy.
You’ll 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
- abnormal heart rhythm
- collapsed lung
- injury to the artery
- damage to the nerve that controls speech
- rupture of the heart (extremely rare)
The results of a myocardial biopsy will let your doctor know if there’s 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
- rejection of a heart transplant
If you do have heart muscle damage, treatment will vary depending on its cause.