What is Cardiac Catheterization? Purpose, Procedure & Results

Cardiac catheterization is a medical procedure where your doctor inserts a thin, flexible tube called a catheter into your heart through a blood vessel. This minimally invasive technique allows doctors to see how well your heart is working and check for any problems with your coronary arteries or heart valves.

Think of it as giving your doctor a detailed roadmap of your heart's condition. The procedure helps diagnose heart problems and can even treat certain conditions right on the spot, making it both a diagnostic tool and a treatment option.

What is cardiac catheterization?

Cardiac catheterization is a procedure that lets doctors examine your heart and blood vessels from the inside. During the test, a cardiologist threads a thin catheter through a blood vessel in your arm, wrist, or groin and guides it to your heart.

The catheter acts like a tiny camera and toolkit combined. Once it reaches your heart, your doctor can inject contrast dye to make your coronary arteries visible on X-ray images. This creates detailed pictures that show exactly how blood flows through your heart.

There are two main types of cardiac catheterization. The first is diagnostic catheterization, which focuses on gathering information about your heart's condition. The second is interventional catheterization, where doctors can actually fix problems they find during the procedure.

Why is cardiac catheterization done?

Your doctor might recommend cardiac catheterization to get a clear picture of what's happening inside your heart. This procedure can diagnose conditions that other tests might miss or provide incomplete information about.

The most common reason is to check for coronary artery disease, which happens when the arteries that supply blood to your heart become narrowed or blocked. Your doctor can see exactly where blockages are located and how severe they are.

Here are some other important reasons why this procedure might be recommended:

• To evaluate chest pain that hasn't been explained by other tests
• To check how well your heart pumps blood throughout your body
• To examine heart valve problems and determine if they need repair
• To investigate abnormal heart rhythms or electrical problems
• To assess damage after a heart attack
• To evaluate congenital heart defects you were born with
• To measure pressure inside your heart chambers

Sometimes your doctor might also use this procedure to treat problems right away. This could include opening blocked arteries with a balloon or placing a small mesh tube called a stent to keep arteries open.

What is the procedure for cardiac catheterization?

The cardiac catheterization procedure typically takes between 30 minutes to several hours, depending on what your doctor needs to do. You'll be awake during the procedure, but you'll receive medication to help you relax and feel comfortable.

Your doctor will start by numbing the area where the catheter will be inserted, usually in your groin, wrist, or arm. You might feel a small pinch when the numbing medicine is injected, but you shouldn't feel pain during the actual catheter insertion.

Here's what happens step by step during the procedure:

1. You'll lie on an X-ray table and be connected to monitors that track your heart rhythm and blood pressure
2. Your doctor will clean and numb the insertion site
3. A small incision is made, and a thin tube called a sheath is inserted into your blood vessel
4. The catheter is threaded through the sheath and guided to your heart using X-ray guidance
5. Contrast dye is injected through the catheter to make your coronary arteries visible
6. X-ray images are taken from different angles to create a complete picture
7. If treatment is needed, it can be done through the same catheter
8. The catheter and sheath are removed, and pressure is applied to stop any bleeding

Throughout the procedure, your medical team will monitor you closely and keep you informed about what's happening. You might feel some pressure when the catheter is inserted, but most people find the procedure much more comfortable than they expected.

How to prepare for your cardiac catheterization?

Preparing for cardiac catheterization involves several important steps that help ensure your safety and the success of the procedure. Your doctor will give you specific instructions based on your individual situation, but there are some general guidelines that apply to most people.

The most important preparation step is fasting before the procedure. You'll typically need to avoid eating or drinking anything for 6 to 12 hours beforehand, though your doctor will give you exact timing based on when your procedure is scheduled.

Here are the key preparation steps you'll need to follow:

• Stop eating and drinking at the specified time before your procedure
• Take your regular medications unless your doctor tells you otherwise
• Arrange for someone to drive you home after the procedure
• Wear comfortable, loose-fitting clothing
• Remove jewelry, contact lenses, and dentures before the procedure
• Tell your doctor about any allergies, especially to contrast dye or iodine
• Inform your medical team about all medications and supplements you take
• Let your doctor know if you might be pregnant

Your doctor might also ask you to stop taking certain medications before the procedure, particularly blood thinners. However, never stop taking prescribed medications without first discussing it with your healthcare provider.

It's also helpful to prepare mentally for the procedure. Ask your doctor any questions you have beforehand, and remember that this is a common, safe procedure that helps doctors take better care of your heart.

How to read your cardiac catheterization results?

Understanding your cardiac catheterization results helps you make informed decisions about your heart health. Your doctor will explain the findings in detail, but knowing what to expect can help you better understand the conversation.

The main thing your doctor looks for is how well blood flows through your coronary arteries. Normal arteries should be smooth and wide open, allowing blood to flow freely to nourish your heart muscle.

Your results will typically include information about several key areas:

• Coronary artery blockages and their severity (measured as percentages)
• How well your heart muscle contracts and pumps blood
• Pressure measurements inside your heart chambers
• The condition of your heart valves
• Overall heart function and blood flow patterns

If blockages are found, they're usually described as percentages. A blockage of less than 50% is generally considered mild, while blockages of 70% or more are considered significant and may need treatment.

Your doctor will also evaluate your ejection fraction, which measures how much blood your heart pumps out with each beat. A normal ejection fraction is typically between 55% and 70%, though this can vary based on your individual situation.

What are the risk factors for needing cardiac catheterization?

Several factors can increase your likelihood of needing cardiac catheterization, though having risk factors doesn't mean you'll definitely need the procedure. Understanding these factors can help you take steps to protect your heart health.

The most significant risk factors are related to coronary artery disease, which is the most common reason for cardiac catheterization. These include both factors you can control and ones you cannot.

Here are the main risk factors that might lead to needing this procedure:

• High blood pressure that isn't well controlled
• High cholesterol levels, especially LDL (bad) cholesterol
• Diabetes or prediabetes
• Smoking or using tobacco products
• Family history of heart disease
• Being overweight or obese
• Leading a sedentary lifestyle
• Chronic stress or depression
• Age (risk increases with age, especially after 45 for men and 55 for women)

Some less common risk factors include having had rheumatic fever, certain autoimmune diseases, or previous radiation therapy to the chest. People with congenital heart defects may also need cardiac catheterization at various points in their lives.

The good news is that many of these risk factors can be modified through lifestyle changes and medical treatment. Working with your healthcare provider to manage these factors can help protect your heart health.

What are the possible complications of cardiac catheterization?

While cardiac catheterization is generally very safe, like any medical procedure, it does carry some risks. The vast majority of people have no complications, but it's important to understand what could potentially happen.

Most complications are minor and temporary. The most common issues are related to the insertion site where the catheter was placed, such as bruising or mild bleeding.

Here are the possible complications, starting with the most common:

• Bruising or small hematoma at the insertion site
• Minor bleeding that stops with pressure
• Temporary irregular heartbeat during the procedure
• Allergic reaction to the contrast dye (usually mild)
• Temporary kidney problems from the contrast dye
• Infection at the insertion site
• Damage to the blood vessel used for catheter insertion
• Blood clots forming on the catheter

Serious complications are rare but can include heart attack, stroke, or significant bleeding. These occur in less than 1% of procedures and are more likely in people who already have severe heart disease.

Your medical team takes many precautions to minimize these risks, including careful monitoring throughout the procedure and choosing the safest approach for your individual situation. They'll also discuss your specific risk factors beforehand.

When should I see a doctor after cardiac catheterization?

After your cardiac catheterization, you'll receive specific instructions about when to contact your doctor. Most people recover quickly, but it's important to know what symptoms might signal a problem.

You should contact your doctor immediately if you experience any signs of complications at the insertion site or elsewhere in your body. While most post-procedure symptoms are normal, some require prompt medical attention.

Call your doctor right away if you notice any of these symptoms:

• Excessive bleeding from the insertion site that doesn't stop with pressure
• Signs of infection like fever, redness, or warmth at the insertion site
• Severe pain or swelling at the insertion site
• Chest pain or shortness of breath that's new or worsening
• Numbness or tingling in the arm or leg where the catheter was inserted
• Changes in color or temperature of the limb used for catheter insertion
• Dizziness or fainting
• Nausea or vomiting that persists

You should also schedule a follow-up appointment with your cardiologist to discuss your results and any treatment recommendations. This usually happens within a few days to a week after the procedure.

Remember that some mild discomfort, bruising, or fatigue is normal after the procedure. However, when in doubt, it's always better to contact your healthcare provider with any concerns.