What Is Cardiac Catheterization?

If you have coronary artery disease or you present suddenly with symptoms that could be a heart attack, you are likely to hear a cardiologist recommend a cardiac catheterization procedure. Or you will be rushed to a “cath lab” for the procedure if you have a cardiac emergency.

“Many patients are not familiar with cardiac catheterization until they actually need it,” said Paul Sapia, MD, Catholic Health Cardiologist. “It is a common minimally invasive cardiac procedure that measures heart function and blood flow to diagnose and treat heart conditions.”

If you are worried about your heart health, this article can help answer questions about cardiac catheterization and how cardiologists use it to diagnose and treat heart problems.

What happens during a cardiac catheterization?

During a cardiac catheterization, a cardiologist inserts a long, thin tube called a catheter into a blood vessel in your arm, groin, neck or upper thigh. This allows the delivery of medicine or the insertion of tools to examine heart valves or take blood or heart muscle samples.

There are two main types of cardiac catheterization: right heart catheterization (RHC) and left heart catheterization (LHC). The type of procedure determines which side of the heart the cardiologist will access. During the procedure, they may perform different tests and additional procedures, such as coronary angiography, coronary angioplasty or valvuloplasty, to evaluate and repair your heart function.

What additional procedures are common with cardiac catheterization?

A cardiologist may perform additional procedures depending on the type of catheterization.

Balloon angioplasty to open a narrowed artery in or near the heart
Balloon valvuloplasty to widen a narrowed heart valve
Cardiac ablation to correct heart rhythm problems
Coronary angiogram to check for blockages in the arteries leading to the heart
Heart valve replacement to remove a narrowed heart valve and replace it with an artificial one

A cardiologist may perform diagnostic tests using cardiac catheterization. They can measure blood pressure and oxygen levels in different parts of the heart. Measuring the amount of blood the heart pumps can help diagnose conditions like heart failure or high blood pressure.

What is the cardiac catheterization procedure like?

“Your cardiologist will discuss your specific procedure with you so you understand the risks, benefits and what to expect,” said Dr. Sapia. “Cardiac catheterization is a safe procedure for most people.”

The procedure takes 30 to 60 minutes, and you will stay awake the whole time. Your doctor will give you a sedative to help you relax. While you may feel pressure or warmth, you should not feel pain.

Cardiac catheterization is usually an outpatient procedure with no overnight hospitalization. You will need someone to drive you home afterward.

Before

Do not eat or drink anything for 6 to 8 hours before the procedure. Fasting reduces the risk of complications from the sedative. Additional instructions may include medications to stop taking before the procedure.

When you arrive, you will change into a hospital gown and sign consent forms. A nurse will take your vital signs. Be sure to tell them if you are allergic to anything.

During

The cardiologist will inject a numbing medicine underneath your skin with a small needle during the procedure. They will then insert a catheter into a blood vessel. Next, using an X-ray machine, they inject a contrast dye through the catheter and watch how it moves through the heart chambers, valves and vessels.

After

After the procedure, your cardiologist will remove the catheter, and you will move to a recovery room for monitoring. A nurse will check your vitals and look for signs of bleeding or grogginess from the sedative. You may feel sore at the insertion site after catheter removal. Depending on the location of the catheter, you can usually go home within a few hours.

The puncture site is bandaged if the catheter is inserted into your arm. You must keep the arm straight for at least an hour.

If the catheter is inserted into the groin area, sterile gauze is applied. Check the bandage regularly for infection. To prevent bleeding, you will need to lie flat and keep your leg straight for a couple of hours. Be sure to tell your cardiologist if your foot feels numb or tingles, as this can be a sign of injury.

Before you go home, your cardiologist will discuss future procedures, medications and follow-up appointments.

What is the recovery process for cardiac catheterization?

“Because a cardiac catheterization is a minimally invasive procedure, most patients recover quickly within a week or less,” said Dr. Sapia. “Check in with your cardiologist and make follow-up appointments to monitor your recovery and know when it is safe to resume normal activity.”

To aid the recovery process, be sure to: