Cardiac Catheterization

Creator: Dr. Shaqra Ekram
Published: 2022-05-02T18:38:52

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Cardiac catheterization is a procedure of guiding a flexible catheter into the heart's blood vessel. This article is an overview of cardiac catheterization.

Written by

Dr. Shaqra Ekram

Medically reviewed by

Dr. Sagar Ramesh Makode

May 2, 2022

October 6, 2022

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Contents

When Is Cardiac Catheterization Suggested?
How to Prepare for Cardiac Catheterization?
How Does It Feel During a Cardiac Catheterization?
How Is Cardiac Catheterization Performed?
What Are the Risks of Cardiac Catheterization?

Introduction

Cardiac catheterization is a medical procedure in which a fine and a ductile tube are directed into a cardiac vessel in order to evaluate or manage specific conditions of the heart and the cardiovascular system. These conditions vary in nature, for instance, arrhythmia or clots in arteries. The heart is divided into four chambers. Two upper sections are called the right and left atrium. The two lower chambers are called the right and left ventricles.

A cardiac catheterization is a diagnostic tool that provides the healthcare professional with in-depth information of the cardiac muscles, valves of the heart, heart chambers, and the entire structure of the heart. Cardiac catheterization can be used as a means for diagnosis as well as a treatment modality. Multiple tests are routinely done before the onset of cardiac catheterization. There are hardly any risks involved in this procedure. The patient is not under anesthesia and thus remains awake during the entire catheterization. Nevertheless, in case the patient is anxious, muscle relaxants or medications to calm the patient down may be administered intravenously.

When Is Cardiac Catheterization Suggested?

Cardiac catheterization is a standard cardiac procedure in an emergency setting as well as routine consultation. In addition, the healthcare provider may request a cardiac catheterization when there are high chances of an underlying cardiovascular disease. Mentioned below are some of the heart conditions that may need cardiac catheterization.

Coronary artery disease.
Heart failure.
Congenital heart disease.
Heart valve disease.
Microvascular heart disorder.
Chest pain.
Myocardial infarction.
Irregular heart rhythm.
Evaluating the hemodynamics of the heart chambers.
Measuring the ventricular function.
Evaluation of myocardial diseases.
Assessment of pericardial conditions.
Heart attack.
Constant shortness of breath.
Pain and discomfort in the shoulders.
Pressure in the jaw, neck, back, or arms.
Clogged arteries.
Abnormal stress test results.
High blood pressure.
Pulmonary embolism.
Abnormal enlargement of the heart.
Cardiomyopathy.
Pulmonary hypertension.
Congestive heart failure.

How to Prepare for Cardiac Catheterization?

The healthcare provider will inform all the necessary instructions before the procedure has to be started. Generally, patients are asked to stop eating or drinking for six to nine hours prior to the test. Cardiac catheterization only happens in a hospital setup and cannot be done at the comfort of one’s home. Patients may be asked to stay overnight so that the healthcare provider monitors the cardiovascular system before starting the procedure the next day. Patients are expected to inform the professionals about all the allergies they have. This includes allergies to products, foods, or any particular medication. Additionally, if the patient is pregnant or has plans to be, they must inform the same as well.

How Does It Feel During a Cardiac Catheterization?

Cardiac catheterization can be assumed to be a study, a diagnostic tool, or even a treatment modality. For whatever reason it is used, the procedure is not painful. The patient may be under general anesthesia after a request and consent form are filled out by the patient. In the majority of the cases, the individual is awake through the procedure with mild administration of muscles relaxants in order to keep the patient relaxed and calm. The patient lies flat throughout the course and is not expected to move. This may cause discomfort to some individuals. Slight pressure may be felt as the catheter moves within the blood vessel. Additionally, the catheter insertion site seldom causes irritation and minor pain.

How Is Cardiac Catheterization Performed?

The catheter is inserted at a selected site. The choices for insertion are the arm, neck, or groin. Veins receive the catheter, and thus cardiac catheterization is an intravenous procedure. A sheath made up of a plastic tube is placed into the selected vein. If the site is the arm or leg, it is inserted into arteries. This sheath pushes the catheter up into the heart. All this is guided under regular and live x-ray. Seldom a contrast dye is administered via the catheter for better visuals. The entire test lasts for up to sixty minutes. Patients are asked to stay flat so that there is no bleeding from the site of catheter insertion. During the presence of the catheter inside the vein or artery, the professional is able to do the following.

Collect samples of blood directly from the heart.
Measure the pressure of different heart chambers.
Measure flow of blood into the heart.
Evaluate the condition of large arteries in the heart.
Measure the amount of oxygen in different heart sections.
Perform a biopsy of any cardiac muscle.
Angioplasty.
Stent placement.
Assess the amount of blockage in the heart vessels.
Assess the amount of plaque accumulation in the heart vessels.

What Are the Risks of Cardiac Catheterization?

Generally, there are no risks involved in cardiac catheterization if the process is done smoothly. However, rarely there may be some complications that crop up during or after the procedure. Mentioned below are some of the difficulties that may pose a risk to the patient.

Cardiac tamponade.
Heart attack.
Low blood pressure.
Reaction to the contrast dye.
Stroke.
Irregular heartbeat.
Injury to the coronary artery.
Bleeding at the site.
Infection.
Pain due to intravenous insertion.
Blood clots.
Kidney damage due to the contrast dye.

Conclusion

Cardiac catheterization is a procedure that may require a multidisciplinary approach of a cardiologist, anesthetist, radiologist, gynecologist, and general practitioner. Cardiac catheterization is a safe procedure if it is performed by a highly qualified and experienced team of professionals. The possibility of risks is very low. Nevertheless, in rare situations, infections or pain and bleeding at the site of catheter insertion may pose some problems. The healthcare professional will have a detailed analysis of the patient’s total cardiovascular system post cardiac catheterization. This will help in diagnosis or treatment planning. There is no change in the patient’s quality of life, and the patient may continue with regular activities after a week.

Frequently Asked Questions

1. When Is Cardiac Catheterization Indicated?

Cardiac catheterization is a procedure used to diagnose the following conditions:
- Heart attack.
- Irregular heartbeat.
- Heart valve problems.
- Chest pain.
- Coronary heart disease.
- Cardiomyopathy.
- Clogged arteries, etc.

2. How Is a Heart Catheterization Done and How Long Does It Take?

The patient is asked to lie flat during the cardiac catheterization, and the doctor gives medications to relax the patient’s muscles, and the patient may stay awake during the procedure. Next, a blood vessel in the arm, leg, or neck is selected to insert a small flexible tube called a catheter. The catheter passes through the blood vessel to the heart, visualizing it through a live X-ray. It takes about 60 minutes for the whole procedure, and during this process, the doctor may evaluate or treat the heart’s condition.

3. Is Cardiac Catheterization a Major Surgery?

No, cardiac catheterization, also known as cardiac cath, is not major surgery. No large incisions are made, and the doctor inserts a small and flexible tube and a contrast agent into the blood vessel to assess various heart disorders. The procedure takes 30 to 60 minutes to complete, and the patient may stay awake during it. The recovery takes place quickly, and the risk is also low. It also aids in placing stents and in other procedures like angioplasty.

4. Is Cardiac Catheterization Serious?

Cardiac catheterization is a diagnostic procedure that aids in evaluating any defects in heart muscles, valves, and chambers. But, the doctor may discuss the following risks with the patients before the procedure, and it includes:
- Infection.
- Bleeding at the insertion site.
- Injury to the blood vessel.
- Blood clot.
- Irregular heartbeat.
- Heart attack.

5. How Many Types of Cardiac Catheterization Are There?

The cardiac specialist uses cardiac catheterization to diagnose and treat various heart conditions. It is of two types, and they are:
- Right heart catheterization - The cardiologist inserts the catheter through the blood vessel in the neck or leg to visualize the right side of the heart. The oxygen level and blood pressure are also assessed.
- Left heart catheterization is inserted into the arm’s or leg’s blood vessel to assess the left side of the heart and visualize the artery blockage.

6. When Can I Recover Completely From a Heart Catheterization?

The heart catheterization procedure allows the cardiac specialist to visualize the heart’s valves and muscles. It is a less invasive procedure and takes 30 to 60 minutes. It is done under general anesthesia for a few patients, but mostly the doctor may give medications to keep the patient relaxed during the procedure. It takes a week to recover from the procedure. The individual may feel weak and tired for the first two days after the procedure. Therefore, the doctor may advise not to participate in vigorous physical activities for one or two weeks. It is better to discuss the diet and medications to be followed after the procedure with the cardiologist.

7. Can I Return Home After Cardiac Catheterization?

Cardiac catheterization is a less invasive procedure, but it has its limitations. It involves the insertion of a fine tube called a catheter into your blood vessel to monitor the heart’s condition. The patient usually stays awake the whole procedure. After it is done, the cardiologist removes the catheter and covers the insertion site with a bandage. Then, the doctor takes the necessary steps to control bleeding if present. Depending on your health condition and the procedure (stent placement), the doctor may suggest you to stay a few hours or a night in the hospital before going home. The doctor also discusses the measures to be followed after you return home.

8. Do I Stay Awake During a Cardiac Catheterization?

Cardiac catheterization is a less invasive procedure, and the doctor may use muscle relaxants to keep you calm and relaxed during the procedure. You may stay awake for the whole procedure. It almost takes 30 to 60 minutes for cardiac catheterization. The doctor visualizes the heart condition during the process and may plan for surgery if required based on the procedural results. You may return home a few hours or the next day after the procedure. Discuss with the cardiologist about the diet and medications to be followed.

9. Do a Heart Cath and a Stent Mean the Same?

Here is the difference between heart catheterization and stent:
- A cardiac stent is used in heart conditions like coronary heart disease, where the artery is blocked, and the blood flow is blocked. The doctor may use a catheter to pass through the blocked artery, and it is inflated to allow the placement of a stent. Then the doctor removes the catheter while the stent remains in place to prevent the narrowing of the artery.
- Heart catheterization - A diagnostic procedure where the catheter is inserted into the blood vessel to assess heart conditions. It is a minimally invasive procedure.

10. Does Cardiac Catheterization Cause Complications?

The following complications may occur after a cardiac catheterization procedure:
- Bleeding (most common).
- Blood clots.
- Infection.
- Irregular heart rhythm.
- Heart attack.
- Pain at the insertion site.
- Chest pain.

11. Which Medications Should I Stop Before Cardiac Catheterization?

Before the cardiac catheterization, the doctor may advise you to stop the following medications:
- Blood thinners like Warfarin, etc.
- Aspirin.
- The cardiologist may alter the anti-diabetic medications’ dosage.
It is essential to discuss if you have any drug or specific allergy with your cardiologist.

12. What Are the Suggested Medications for Cardiac Catheterization?

The following is the list of medications for cardiac catheterization:
- Before the procedure - The doctor may advise you to stop anticoagulants several days before catheterization.
- The cardiologist may use medications like Midazolam for mild sedation during the procedure.
- After the procedure, the cardiologist may suggest anti-platelet medications and beta-blockers prevent narrowing the artery.

13. Can Cardiac Catheterization Clear Blockage?

Cardiac catheterization is a diagnostic procedure used to evaluate any blockage or other conditions in the heart. A thin catheter is passed through the blood vessel, and it is visualized via live X-ray to identify any heart valve defects. If the doctor finds any valve blockage during the procedure, they might plan a surgery to clear it. First, a stent is placed in the blocked artery with the help of a catheter with a small balloon fitted at its end. Next, the catheter goes through the blocked artery, and the small balloon is inflated, then a stent is placed inside the artery to prevent its narrowing. The doctor then removes the catheter, and the stent remains in place, thus clearing the blockage.

14. What Should I do After Cardiac Catheterization?

The cardiologist may give the below-listed suggestions after the cardiac catheterization:
- Stay hydrated.
- Keep the catheter insertion site dry and clean.
- Do not engage yourself in strenuous activities for one week after the procedure.
- Gentle walking is allowed.
- Diet and medications are to be followed as per the specialist’s advice.

15. Can I Take Tylenol Before Heart Catheterization?

Heart catheterization involves the insertion of a fine and flexible tube (catheter) into the blood vessel of the arm, leg, or neck to visualize the heart’s valve, chamber, and muscle condition. Before the procedure, the cardiologist may suggest you to stop certain medications to avoid further complications during cardiac catheterization. However, if you have a rise in body temperature or pain, you can take Tylenol under the doctor’s advice before the procedure.

16. Does Cardiac Catheterization Cause Pain?

Cardiac catheterization is not painful. It is usually not done under general anesthesia, but the specialist may administer mild sedatives to make you feel drowsy during the procedure. You may feel the pressure when the catheter and contrast agent are passed through your blood vessel, and it will not cause pain. Your cardiologist may complete the procedure within 30 to 60 minutes, but if you feel any pain during it, inform the specialist immediately to avoid complications.

Sources

Dr. Sagar Ramesh Makode

Cardiology

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