Cardiac Catheterization: What to Expect

Cardiac catheterization is one of the most common methods doctors use to diagnose heart conditions. It sounds scary, but this test can help your doctor evaluate certain cardiac symptoms to create a treatment plan that will be as effective as possible.

If you're scheduled for this test, you probably have many questions. Getting answers can help you relax and feel more confident about having the procedure.

What Is Cardiac Catheterization?

This test is a specialized medical procedure that helps your doctor diagnose and treat certain heart conditions. Your doctor may recommend this procedure if you have chest pain, if you've recently had a heart attack, or if another type of diagnostic test (a stress test, for example) suggests you have heart disease. Also, this procedure can help identify specific heart defects and allow your doctor to better plan for any heart surgery you may require.

The procedure itself involves passing a thin, flexible tube called a catheter into a large blood vessel in your arm, upper thigh, or neck. The catheter is threaded through the blood vessel to your heart, where it's used to take X-ray images, check the pressures inside the chambers of your heart, and look for defects in the heart muscle itself. Depending on your specific symptoms, your doctor can also use the catheter to take blood and heart tissue samples or evaluate your heart's pumping effectiveness.

How Should You Prepare?

Preparing for a cardiac catheterization is simple. You'll need to ask someone to drive you home after the procedure. Your doctor will give you instructions about what you can and cannot eat and drink in the 24 hours before your test. You should also discuss all the medications you take with your doctor, including over-the-counter medications and supplements. Your doctor also needs to know about any allergies you have, especially if you're allergic to iodine, shellfish, latex or rubber, penicillin, or X-ray dye.

What Happens During the Procedure?

This test is performed in a hospital. You are awake throughout the entire test, but you will receive medication to help you relax. That way, you can follow your doctor's instructions during the procedure.

First, you'll receive numbing medication at the catheter insertion site to help prevent any pain. Then your doctor makes a small hole in your skin to allow access to your blood vessel. Your doctor will place a thin, plastic tube, called a sheath, into your blood vessel.

The catheter is threaded through the sheath into your blood vessel, all the way to your heart. During this time, X-ray films are taken to ensure the catheter is correctly placed. When the catheter reaches your heart, more X-rays help your doctor with diagnostic examinations or evaluations of your heart muscle.

The procedure usually takes 30 to 60 minutes. However, if your doctor performs any other diagnostic tests while the catheter is in place, it may take longer.

What Is Recovery Like?

Most people recover well from cardiac catheterization, but your recovery will depend on where the catheter was placed and what — if any — other diagnostic procedures were performed. Recovery takes place in the hospital under the watch of specially trained nurses. Patients recovering from this test must limit their movement to help prevent bleeding from the catheter insertion site.

Depending on where the catheter was placed, you may be able to leave recovery after a few hours. If the catheter was placed in your upper thigh area (groin), you will be required to stay in the hospital for several hours — maybe even overnight. You may notice a bruise where the catheter was inserted, and the area may be sore for about a week.

You should let your doctor know immediately if you have the following problems after your procedure:

• Unusual pain, swelling, or redness at the catheter insertion site
• Constant or large amounts of bleeding at the catheter insertion site

Procedure Risks

Although most people tolerate the procedure extremely well, the procedure does carry certain risks. These may include:

• Heart attack
• Irregular heartbeat
• Coronary artery injury
• Low blood pressure
• Allergic reaction to contrast dye
• Stroke
• Bleeding
• Infection
• Blood clots

Talk with a doctor about any concerns you may have before the procedure. They can help you identify your risk by examining your personal medical history.

Cardiac catheterization is an effective method for diagnosing a variety of heart problems. The knowledge your doctor gains during the procedure can help guide treatment decisions and determine which options may work best for you.