Cardiac Catheterization

What is a Cardiac Catheterization?

A cardiac catheterization is considered an “invasive” procedure used to diagnose certain cardiac (heart) conditions.  This involves placing a small hollow plastic tube (a catheter) within a blood vessel (an artery).  Usually, an area of the upper leg (or groin) or an area of the inner arm below the bicep is used to access an artery.  This area is made numb by a local anesthetic.  The artery is then located by a needle.

A catheter is then placed within the artery and advanced toward the heart, following the natural course of the artery toward the heart.  An X-Ray camera follows the path of the catheter and allows the physician to visualize its location at all times during the procedure.  The catheter is used for multiple purposes.  It allows for measurement of blood pressure within the heart and blood oxygen levels at various locations within the heart chambers.  The catheter is also used to inject a dye (contrast agent) within the pumping chamber of the heart and within the coronary arteries – which supply the heart muscle with blood. 

Why is it ordered?

Typically, a cardiac catheterization is recommended in order to make a more definitive diagnosis of one or more specific cardiac conditions.  This “invasive” procedure is often the next step in evaluating a condition discovered by a previous “non-invasive” test. 

The most common condition requiring evaluation by cardiac catheterization is that of coronary artery disease – or blockage of the heart arteries by plaque.  Contrast injected directly into the coronary arteries may be visualized with the X-Ray camera, allowing for a precise look at flow within the coronary arteries.  This information will help to direct future management of your condition – which may include treatment with medications or improving blood flow mechanically via additional procedures such as angioplasty, stenting of coronary artery bypass surgery (CABG).

Cardiac catheterization is also a valuable diagnostic tool used in the evaluation of valvular heart disease, congenital heart disorders and cardiomyopathy. 

What can I expect on the day of my procedure?

  • You should not eat or drink for eight hours prior to the procedure.
  • You will receive sedation on the day of the procedure.
  • You will not be allowed to drive on the day of the procedure or for the first 48 hours following the procedure.
  • You may experience mild tenderness and possible bruising near the catheter entrance site.
  • Depending on the outcome of the procedure and whether additional invasive procedures are necessary, you may be discharged as early as the same day or you may be admitted to the hospital for a short stay.

Potential Risks of Cardiac Catheterization

As with all invasive procedures, there are potential risks involved with cardiac catheterization.  Each patient’s individual risk is dependent on one’s overall health at the time of the procedure, the level of acuity at the time of the procedure (emergency versus elective nature) and the presence of any of several medical conditions which may increase one’s risk. 

Possible complications of undergoing a cardiac catheterization include:

  • Stroke
  • Heart Attack
  • Blood clot formation
  • Irregularity of the heart rhythm
  • Blood vessel damage – requiring surgical intervention
  • Bleeding at the site of the catheterization
  • Death
  • Reaction to the dye material
  • Kidney failure

Your physician will review all of the above risks prior to the procedure and will provide you with his/her best estimate of your individual risk prior to proceeding with a diagnostic heart catheterization.  In the elective (non-emergent) setting, you will have a full discussion with your physician and will be encouraged to ask questions so that you fully understand the nature of the procedure, the potential benefits of the procedure and your individual risk for complications.