In cardiac catheterization (often called cardiac cath), a very small, flexible, hollow tube called a catheter is put into a blood vessel in the groin, arm or neck and advanced through the vessel into the aorta and into the heart. Once the catheter is in place, several tests may be done. The tip of the catheter can be placed into various parts of the heart to measure the pressures within the heart chambers.
The catheter can also be guided into the coronary arteries and a contrast dye can be injected to check blood flow through them. (The coronary arteries are the vessels that carry blood to the heart muscle.)
Fluoroscopy, a special type of X-ray, can be used to find any blockages in the coronary arteries as the contrast dye moves through them.
A cardiac cath may be used to help diagnosis these heart conditions:
If a screening exam, such as an ECG or stress test, suggests there may be a heart condition that needs to be explored further, a cardiac cath may be needed. Another reason for a cath procedure is to evaluate blood flow to the heart muscle if chest pain occurs after the following:
Procedures that may be done during or after a cardiac cath include:
- Angioplasty: a tiny balloon used to press plaque buildup against the artery wall and improve blood flow through the artery
- Stent placement: tiny metal coils or tubes placed inside an artery to keep it open
- Fractional flow reserve: a pressure management technique to determine the severity of an artery blockage
- Intravascular ultrasound: a technique that uses ultrasonic sound waves to create images of the blood vessels
- A heart tissue biopsy
What to Expect
A cardiac cath can be done on an outpatient basis or as part of a hospital stay. The patient receives a sedative medication through an IV to help relax, but stays awake during the procedure. A local anesthetic is injected into the skin where the catheter will be put in, typically in the groin area, but sometimes the wrist, inside the elbow or the neck.
A sheath, or introducer, is put into the blood vessel. A catheter is threaded into the blood vessel and advanced through the aorta to the left side of the heart. Fluoroscopy is used to help guide the catheter. Once the catheter is in place, contrast dye is injected to visualize the heart and the coronary arteries. After the contrast dye is injected, a series of rapid X-ray images of the heart and coronary arteries are made.
Once the procedure is done, the catheter is removed and the insertion site closed. The patient is then taken to the recovery area, where their vitals are monitored closely. Bedrest will last until the introducer is removed, anywhere from 4 to 12 hours. After the recovery period, the patient is discharged home unless their doctor decides otherwise.