What is cardiac catheterization?

Cardiac catheterization, also known as a cardiac cath or heart cath, is a cardiac procedure that is used to diagnose and/or treat coronary artery disease. During a cardiac catheterization, a catheter, a long, thin, flexible tube, is inserted in a blood vessel and threaded to your heart. Your doctor can perform various tests and treatments on your heart during a cardiac catheterization.

Who is a candidate for cardiac catheterization?

Your doctor may order a cardiac catheterization if you are exhibiting signs of heart disease such as:

  • Chest pain
  • Shortness of breath
  • Pain or pressure in the shoulders
  • Pressure or pain in the shoulders, arms, jaw, neck or back

Other reasons why your doctor may recommend a cardiac catheterization include:

  • Evaluate chest pain on a patient recovering from a recent heart attack
  • Evaluate severe heart attack that caused major tissue damage
  • Evaluate abnormal electrocardiogram results that indicate heart disease
  • To look for problems with heart valves
  • To view the shape of your heart and the heart chambers inside it to identify heart defects prior to heart surgery
  • To measure oxygen and blood flow in the heart as well as evaluate how artificial heart valves are functioning 

A cardiac catheterization may be used in emergency cases to treat a heart attack. When used in conjunction with a percutaneous coronary intervention (PCI), your doctor will open a blocked artery. A PCI is a non-surgical procedure that involves using an inflated balloon and stent to widen a narrowed artery. 

Risks associated with cardiac catheterization

Although major complications associated with a cardiac catheterization are uncommon, complications can occur. Risks are greater as you age and/or if you have conditions such as diabetes or chronic kidney disease. 

Complications may include:

  • Bruising, bleeding, pain or infection at the catheter insertion site
  • Damage or tear in the artery that the catheter was inserted into 
  • Reaction to dye used in the procedure
  • Heart attack
  • Stroke
  • Arrhythmias - irregular heart beat
  • Kidney damage 
  • Blood clots
  • Low blood pressure
  • Buildup of blood or fluid in the sac around the heart 

What to expect during cardiac catheterization

Prior to the procedure, your doctor will outline what to do leading up to the procedure, including:

  • Whether or not you should stop taking any medications 
  • When to stop eating or drinking before the procedure. Typically, your doctor will require you stop eating within six hours of the procedure.
  • Bring your medications to the appointment to ensure your doctor knows the exact medications and dosages you are taking.

A cardiac catheterization is performed in Mercy Health’s cardiac catheterization lab, also known as the cath lab. You will be sedated but will be awake throughout the procedure.

During the procedure, your doctor will puncture your skin to insert a catheter into a blood vessel, typically in the groin or wrist. Your doctor will guide the catheter into the heart using a medical dye that will enable your blood vessels to show up on an x-ray machine. The x-ray will indicate if you have a blocked or narrowed artery. If your doctor finds a blockage, he or she may perform an angioplasty immediately. The angioplasty will open the blockage to allow the blood to flow and prevent further heart damage.

Other uses of a cardiac catheterization include:

  • Measure the blood flow and pressure in the right side of the heart. During this procedure, your doctor will insert the catheter into the neck or groin. 
  • Obtain a sample of heart tissue to evaluate in a lab. During this procedure, the catheter will be inserted into a vein the neck.
  • Repair heart defects such as a heart valve leak. 
  • Open narrowed heart valves with a balloon valvuloplasty. 
  • Replace a valve that is narrowed or leaking. 
  • Ablate tissue that is causing abnormal heartbeats in a heart ablation.

Recovery from cardiac catheterization

After the cardiac catheterization, you will be moved to a special care unit in the hospital where you will be monitored while the anesthesia wears off. Your care team will ensure you stay still during this period to avoid serious complications and to allow the artery to heal. The team also will closely monitor your heart rate, blood pressure and other vital signs.  

Depending on the results of the cardiac catheterization, you will either go home that day or be admitted to the hospital. 

After discharge, follow your doctor’s discharge instructions closely. You should avoid lifting anything heavy for a few days after the procedure and should continue blood-thinning medication. You will also be given instructions on when to follow up with your physician for your results or treatment plan.

Although it is normal to feel sore for a week or develop bruising around the catheter insertion site, unusual pain, swelling, redness are signs of infection. If you experience these symptoms, call your doctor right away.

Results from cardiac catheterization

If your doctor performed the cardiac cath as a diagnostic test, your doctor will review your results with you after the sedation wears off.  

If the procedure reveals you have a narrowed or blocked artery, you may need an immediate PCI with or without a stent placement. If there are multiple blockages, you may need open-heart surgery. If your doctor suspects you may need an emergency procedure during your cardiac catheterization, he or she will discuss the various options with you before the procedure begins.

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