What is Heart Catheterization?
Heart catheterization is a procedure in which a doctor feeds a thin, flexible tube through a blood vessel into the heart to evaluate heart function and structure. This tube called a catheter, is usually inserted into a large blood vessel in the neck, arm, or groin. Once it reaches the heart, doctors can measure blood pressure in the heart's chambers, measure oxygen levels in the blood, perform diagnostic tests, or perform treatment procedures for certain heart conditions.
The following conditions can be diagnosed or treated by heart catheterization:
- Atherosclerosis a condition that occurs when fatty substances block or narrow the blood vessels. During heart catheterization, irregularities in blood vessels can be detected using an intravascular ultrasound (IVUS), which uses sound waves to create real-time images of the blood vessels.
- Cardiomyopathy, or enlarged heart. This occurs when the heart's muscle walls thicken, and heart catheterization can be used to diagnose this.
- Heart valve disease. Valves regulate blood flow between the chambers of the heart. Heart catheterization can be used to widen a valve that is too narrow in a procedure known as a valvuloplasty.
- Coronary artery disease affects the blood vessels that bring blood and oxygen to the heart. Heart catheterization can be used to measure the blood flow in a diseased coronary artery to determine if it is preventing the heart from getting enough oxygen. Doctors can then use catheterization to perform an angioplasty, which uses a tiny balloon to create more space within the artery to improve blood flow. The catheter can even be used to place a stent to keep the artery open afterwards.
- Congenital heart disease, which involves heart defects that have been present since birth. These defects can be detected using heart catheterization.
- Heart failure. Since doctors can use heart catheterization to observe and measure heart activity, it can determine if heart failure occurs as a result of a weakened heart muscle that cannot pump blood properly throughout the body.
- Heart cancer or infections. Doctors perform a biopsy during heart catheterization. A biopsy involves taking tissue samples from the heart to detect cancerous cells or infections.
Types of Heart Catheterization
The two main types heart catheterization are:
- Right heart catheterization (RHC). RHC involves inserting the catheter into a blood vessel in the neck, leg, or arm to reach the right side of the heart.
- Left heart catheterization (LHC). LHC involves inserting the catheter into a blood vessel in the wrist, leg, or arm to reach the left side of the heart.
How is a Heart Catheterization Procedure Performed?
Heart catheterization takes between 30 and 60 minutes and uses the following procedure:
- A nurse will clean and shave the area in which the catheter will be inserted. You may also be asked to remove jewelry.
- A sedative will be administered intravenously to help you relax during the procedure, though you will still be awake.
- You will be connected to ECG equipment so that heart rate, breathing rate, and blood pressure can be monitored throughout the procedure.
- A local anesthetic will be administered to numb the area in which the catheter will enter the body.
- The doctor will make a small puncture through the numbed skin and insert a sheath (a small tube) through this puncture into the blood vessel.
- The catheter will be fed through the sheath into the blood vessel. Doctors can use X-rays or computer monitors to guide the catheter as it reaches either the left or right side of the heart. This should not be painful, though you may feel some pressure as the catheter is inserted.
- The doctor may ask you to cough, hold your breath, or move your head as the catheter is positioned. Once the catheter is in place, a dye is injected through the catheter to outline the shape of blood vessels, valves, and the heart's chambers. When the dye is inserted, some people feel flushed or nauseous, though this sensation will go away in a few moments.
- X-ray photos are taken to view the blood vessels and heart while the dye flows through them.
- If necessary, the doctor can also use the catheter to perform a biopsy, take measurements of oxygen levels and blood pressure, and perform diagnostic and treatment procedures.
- The doctor will carefully remove the catheter and sheath and will close the insertion puncture using pressure, bandages, sutures, or collagen.
- The medical staff will bring you to a recovery room. An arm guard and plastic band will be used to keep your arm stationary while you recover if the insertion site was in your arm. If the catheter was inserted in the groin, you will not be permitted to bend your leg for a few hours after the procedure.
Be sure to notify your doctor if you experience any nausea, dizziness, itching, burning, pain, heart palpitations, or difficulty breathing during the procedure.
Complications and Risks to Consider
As with most heart-related procedures, there are certain risks and complications to consider before undergoing heart catheterization. Major complications are rare, but possible risks of cardiac catheterization may include:
- Blood Clots
- Chest pain
- Allergic reaction (contrast dye or other medication)
- Damage to the heart or artery
- Heart attack
- Kidney damage
- Tear in the arterial lining
Preparing for a Cardiac Catheterization Procedure
In order to prepare for a cardiac catheterization procedure, there are certain guidelines that should be followed. Based on individual circumstances, your doctor may have additional, more specific instructions for you.
General guidelines may include:
- Fasting (not eating or drinking). Your doctor will ask you to not eat or drink for a specified period of time before the heart catheterization.
- Inform your doctor of any medications you are taking.
- Talk to your doctor about any previous heart conditions
- Inform your doctor of any allergies or sensitivities you may have, including any medications, anesthetics, iodine, contrast dyes, or latex.
- Tell your doctor if you have kidney problems. The dyes used during heart catheterization procedures may cause kidney damage in patients with poor kidney function.
- Inform your doctor of any bleeding disorders. A blood test may be recommended to check the rate at which your blood clots.
You will have the opportunity to speak with your doctor prior to undergoing the heart catheterization procedure. Based on your medical history and other related factors, your doctor will be able to determine any additional considerations or actions that need to be taken.
What to Expect After a Heart Catheterization Procedure
After a heart catheterization procedure has been completed, you will likely be placed on bed rest in the hospital for several hours to recover. A medical professional will monitor your vital signs as well as the insertion site. The specific amount of time that you will spend in recovery will vary depending on the individual as well as specific instructions from your doctor.
You may be prescribed medication for pain or discomfort felt around the insertion site. Unless told otherwise, you may resume your usual diet once the procedure is complete. It is common to feel the urge to urinate frequently due to the effects of the contrast dye. Drink plenty of fluids to flush the dye from your symptoms.
After being discharged from the hospital, it is important to monitor the insertion site for bleeding, swelling, and abnormal discoloration. Be sure to keep this site dry and clean. Your doctor may give you specific instructions for bathing or cleaning this area. If a closure device was used, you will be given guidance on how to care for this.
Any additional specific instructions that are necessary will be given to you by your doctor prior to being discharged. Be sure to contact your doctor if you experience any abnormal pain or excessive bleeding at the site of insertion. It is normal for this area to have a small bruise or feel sore for several days. You may also be told to avoid any strenuous activity for a specified period of time as well.
A heart catheter is a very thin, flexible tube that is used to allow doctors to examine the heart as well as its valves and major blood vessels. It is inserted through a small incision and then guided to the heart so that doctors can gather information and perform tests and provide treatments.
A catheter is small enough to be inserted into your body and can perform various functions. In the case of a heart catheterization, this tube is small enough to be passed through a blood vessel to reach the heart, allowing doctors to examine structures of the heart. The catheter can then be used for certain procedures, including stent placement, angioplasty, or collecting a heart tissue sample (biopsy).
The procedure itself usually takes 30 to 60 minutes. However, the time spent recovering in the hospital immediately afterwards may last several hours. Additional time in the hospital for recovery and observation may be recommended by your doctor depending on your individual care needs.
Your doctor may recommend avoiding certain activities after a heart catheterization such as heavy lifting, pushing or pulling for several days after the procedure. For instance, if the insertion site was in the groin, you should avoid straining yourself during bowel movements. It is important to consult your doctor about any medications you are taking, or that are prescribed as a result of the procedure to ensure you are familiar with the proper guidelines for taking them.
A heart catheterization is generally very safe and straight-forward. However, as with any procedure, there are some possible risks. Blood clots, bleeding, infection and in very rare instances, a heart attack or stroke may occur. This procedure takes place in a highly controlled and supervised setting and is performed by experienced medical professionals. As a result, complications are extremely rare.
Cardiac catheterization is a procedure commonly used by doctors to diagnose or treat patients with heart problems such as coronary artery disease, congenital heart disease, or arrhythmias. A doctor may recommend a heart catheterization if you are at risk of heart problems or are experiencing symptoms that may indicate an underlying heart issue.
Recovery time will vary depending on the patient and the reason for heart catheterization. Individuals who undergo this procedure should expect to stay in the hospital for several hours, and full recovery should take no more than one week.
Schedule an Appointment with a NewYork-Presbyterian Cardiologist
NewYork-Presbyterian's team of cardiologists are well-versed in a wide range of cardiac care treatments and procedures, including heart catheterization. Our medical care professionals can determine a patient's needs based on expert evaluation. Schedule an appointment for a consultation with one of our specialists to learn more.
Other cardiac treatments and surgeries offered at NewYork-Presbyterian include biventricular pacing, heart transplantation, pacemaker implantations, coronary artery bypass surgery, and more.