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Cardiac Catheterization

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What is a Cardiac Catheterization?

What is a Cardiac Catheterization?

A cardiac catheterization is a procedure in which a doctor feeds a thin, flexible tube into the body to evaluate your heart. 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 pressure in the heart's chambers, measure oxygen levels in the blood, evaluate the heart arteries, or perform treatment procedures for certain heart conditions.

The following conditions can be diagnosed or treated by a cardiac catheterization:

  • Atherosclerosis a condition that occurs when fatty substances block or narrow the blood vessels affecting blood and oxygen flow to the heart. Coronary artery disease is caused by atherosclerosis. A cardiac catheterization can be used to evaluate blood flow in a diseased coronary artery to determine if it is preventing the heart from getting enough oxygen. During this procedure, doctors can then perform an angioplasty, which uses a tiny balloon to create more space within the artery to improve blood flow, or to place a stent to keep the artery open.
  • Heart valve disease. Valves regulate blood flow between the chambers of the heart. The heart valves can become narrowed (stenotic) or leaky (regurgitant). During a cardiac catheterization, a balloon can be used to open the valve with a procedure known as a valvuloplasty. Alternatively, the valve can be replaced through a large catheter in the groin.
  • Congenital heart disease is when someone is born with structural heart problems. These defects can affect how the heart functions. A cardiac catheterization can be used to further evaluate these patients.
  • Heart failure. A cardiac catheterization can be used to evaluate the heart pressures and the heart muscle’s ability to pump blood.
  • Heart cancer or infections. Doctors can perform a biopsy during heart catheterization. A biopsy involves taking tissue samples from the heart to detect cancerous cells, abnormal heart issue or infections.
     

Types of Cardiac Catheterization

Types

The two main types cardiac catheterization are:

  • Right heart catheterization (RHC). RHC involves inserting the catheter into a venous 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 an arterial blood vessel in the wrist, leg, or arm to reach the left side of the heart. 
     

How is a Cardiac Catheterization Procedure Performed?

Procedure

Typically, a Cardiac catheterization takes between 30 and 60 minutes and uses the following procedure:

  1. A nurse will clean and shave the area in which the catheter will be inserted. You may also be asked to remove jewelry.
  2. A sedative will be administered intravenously to help you relax during the procedure, though you will still be awake.
  3. You will be connected to ECG equipment so that heart rate, breathing rate, and blood pressure can be monitored throughout the procedure.
  4. A local anesthetic will be administered to numb the area in which the catheter will enter the body.
  5. 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.
  6. The catheter will be fed through the sheath into the blood vessel. X-Ray (Fluoroscopy) will be used to 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.
  7. 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, dye can be 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.
  8. X-ray videos are taken to view the blood vessels and heart while the dye flows through them.
  9. 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.
  10. The doctor will carefully remove the catheter and sheath and will close the insertion puncture using pressure, bandages, sutures, or collagen.
  11. 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.

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Complications and Risks to Consider

Risks

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:

  • Bleeding
  • Bruising
  • Blood Clots
  • Chest pain
  • Allergic reaction (contrast dye or other medication)
  • Damage to the heart or blood vessels
  • Heart attack
  • Infection
  • Arrhythmia
  • Stroke
  • Kidney damage

Preparing for a Cardiac Catheterization Procedure

Preparing

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 Cardiac Catheterization Procedure

What to Expect After a Cardiac Catheterization Procedure

After a cardiac 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 kidneys.

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.

FAQs

FAQs

A heart catheter is a very thin, flexible tube that is used to allow doctors to examine the heart pressures 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 right heart catheterization, this tube can assess pressures in the heart chambers. In the case of a left heart catheterization, the catheter can be used to assess the major heart vessels and can be used for certain procedures such as angioplasty and stent placement. 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 it can take longer depending on each patient’s anatomy. 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 cardiac 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 cardiac 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, heart failure, valve disease, congenital heart disease, or arrhythmias. A doctor may recommend a cardiac 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 the cardiac 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.

 

This content has been reviewed by the following medical editors.

Lauren Sharan Ranard, MD, MS

Ajay J. Kirtane, MD

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Other cardiac treatments and surgeries offered at NewYork-Presbyterian include biventricular pacing, heart transplantation, pacemaker implantations, coronary artery bypass surgery, and more.