What is Cardiac Catheterization?

Cardiac catheterization is a common, relatively painless, nonsurgical procedure that can help your physician diagnose a heart problem. In some cases, catherization can be used to treat heart disease, as well. To perform the the procedure, the cardiologist inserts a long, flexible tube called a catheter into a blood vessel and gently guides it toward your heart. Once the catheter is in place, x-rays and other tests are done to help your doctor evaluate how well your heart is working.

Why is Cardiac Catherization Done?

You may have had shortness of breath, angina, dizziness, palpitations, or other symptoms of heart trouble. Or, your doctor may have found signs of heart problems during a physicial exam. You've probably been through a number of tests already, such as a treadmill test, an echocardiogram, and perhaps a nuclear scan. The next step may be cardiac catheterization, which can help your doctor identify a heart problem more precisely. Cardiac catherization can show:

• If the blood vessels in your heart are clogged.

• If your heart is pumping normally and blood is flowing correctly.

• If you were born with any heart problems.

Understanding the Risks

The risks of catherization are farily low. They are usually outweighed by the benefit of knowing the exact condition of your heart. Your doctor will discuss any risks and side effects with you. Possible risks include:

• Bleeding or clotting

• Perforation of the heart muscle or blood vessel

• Arrhythmia (abnormal heartbeat)

• Allergic reaction to the x-ray-sensitive liquid

• Heart attack or stroke

Before the Procedure

The night before the catherization, you may be asked not to eat or drink anything after midnight. You will probably be admitted to the hospital on the day of the procedure. Before cateterization begins, you may be given medication to help you relax. The skin where the catheter will be inserted may be shaved. Then you'll be taken to the catherization laboratory.

During the Procedure

Cardiac catheterization usually takes an hour or less. The area where the catheter is inserted is numbed with a local anesthetic. You remain awake during the procedure, because your cooperation is needed from time to time. A local anesthetic is given by injection so you won't feel pain at the insertion site. The most common insertion site is a blood vessel in your groin or arm. The injection feels like a bee sting and is probably the most uncomfortable part of the procedure. An introducing sheath is inserted into a blood vessel. You may feel a little pressure when it is inserted, but this sensation should pass quickly. The diagnositc catheter is inserted throught the introducing sheath. While watching the catheter's progresson an x-ray video monitor, your doctor gently guides it toward the heart. You should feel no pain as the catheter moves through your body and into your heart.

To conduct different tests in your heart and coronary arteries, your doctor inserts new catheters or changes the position of the catheter or x-ray equipment. During angiography and ventriculography, x-ray contrast fluid is injected into your blood vessels or heart chamber. You may be asked to hold your breath, and you may feel a hot flush all over your body for about 10 seconds. Your doctor will probably ask you to cough to help move the liquid through your heart. After the tests are finished, the doctor removes the catheter and introducing sheath.

After the Procedure

After the catheterization, you will need to remain lying down for 4 to 6 hours. If the catheter was inserted in your groin, you will be asked not to move your leg to prevent bleeding. Most people have no pain after the procedure. Many patients go home from the hospital the same day, while others may stay overnight.