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Cardiac Catheterization

What Is Heart Catheterization?

Heart catheterization involves putting a catheter into the right or left side of the heart to measure pressures. Right heart catheters are called pulmonary artery (PA) catheters. They’re used to find out how well the heart and its blood vessels are working and to treat heart disease. PA catheters are mainly used in cardiac catheterization laboratories, intensive care units (ICUs), and operating rooms. Left heart catheterization is done by putting a catheter across the aortic valve into the left ventricle. Left and right heart catheterization can be done simultaneously.

Heart catheterization and coronary angiography, a different procedure, are often done together. In coronary angiography, a special dye (contrast material) is put into the catheter, and x-rays are taken to see how blood flows through the heart. Coronary angiography is also used to diagnose coronary artery disease.

Who Needs Heart Catheterization?

People have heart catheterization for diagnosis of different heart and valve disorders and coronary artery diseases.

People shouldn’t have heart catheterization if they have severe uncontrolled high blood pressure, certain abnormal heart rhythms (arrhythmias), acute stroke, severe anemia or bleeding, heart failure, and infections.

How Is Heart Catheterization Done?

Avoiding eating or drinking for 6–8 hours before the test is needed. A mild sedative is given before the test to help people relax. The health care provider puts a sheath into a blood vessel in the arm, leg, or groin, usually the femoral, internal jugular, or subclavian vein. A catheter and guide wire are then placed into the sheath. From there, it’s threaded into the heart or coronary arteries. This takes a few seconds and there is no pain since blood vessels have no pain nerves. Once the catheter is in place, the guide wire is removed. Once the catheter is in place, dye is injected and pictures (angiograms) are taken to show narrowing of the arteries. In some cases, interventional procedures (angioplasty and stenting) may be done right away to improve blood flow.

People are awake and can follow instructions during the test. The test may last 1 to several hours. Some discomfort at the spot where the catheter is placed is possible. After the test, the catheter is removed. If it was put into the groin, lying flat on the back for a few hours after the test is needed to avoid bleeding.

What Are Risks of Heart Catheterization?

Heart catheterization is very safe when done by an experienced team. Risks include arrhythmias (abnormal heartbeat), heart attack, bleeding from the catheter insertion site, low blood pressure, allergic reactions to contrast dye, blood clots, stroke, injuries to blood vessels, chest pain, infections, kidney failure, and, rarely, death.

The rare complication with the highest death rate is bursting of a PA because the balloon at the catheter tip is inflated too much or because of trauma to the PA.

DOs and DON’Ts in Managing Heart Catheterization:
  • DO understand the risks. Talk to your health care provider about the test and about heart health. Take medication as instructed.
  • DO tell your health care provider if you’re allergic to contrast material, iodine, or shellfish or if you might be pregnant.
  • DO be heart healthy: have your blood pressure and cholesterol levels checked regularly. Eat low-fat foods (fruits and vegetables). Lose weight if you’re overweight. Exercise, such as walking, if your health care provider says it’s OK.
  • DON’T forget to avoiding eating or drinking for 6–8 hours before the test.
  • DON’T forget to tell your health care provider about any medications you take, including over-the-counter medications, herbs, and supplements.
  • DON’T forget to arrange for an adult to take you home after the procedure.

Contact the following sources:

  • American Heart Association
    Tel: (800) 242-8721
  • American College of Cardiology
    Tel: (800) 253-4636

Copyright © 2016 by Saunders, an imprint of Elsevier, Inc.

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