What is heart catheterization?

Heart (cardiac) catheterization is a procedure in which a narrow, flexible tube is inserted through a blood vessel and into the arteries or the chambers of your heart. The tube is called a catheter. It is usually inserted through a blood vessel in the arm, groin, or neck.

A heart catheterization can:

• show the chambers of the heart and major blood vessels and help your doctor see how well the heart valves are working

• record the blood pressure in chambers of the heart and blood vessels

• measure blood flow and oxygen content within the heart and lungs.

• take a tissue sample (biopsy) of the heart muscle.

When is it used?

If your heart is not working normally, heart catheterization can help determine the condition of your coronary arteries and how well your heart muscle and heart valves are working. If a biopsy is taken, the tissue sample is useful for such purposes as showing inflammation of the heart muscle or checking for rejection of a transplanted heart.

Examples of alternatives include:

• having an echocardiogram, a procedure that uses ultrasound waves to produce pictures

• choosing not to have treatment, recognizing the risks of your condition.

You should ask your doctor about these choices.

How do I prepare for heart catheterization?

Follow any instructions your doctor may give you. No special preparation is needed for local anesthesia.

What happens during the procedure?

The doctor may give you a sedative to help you relax and then put a local anesthetic into your groin. The local anesthetic should keep you from feeling pain during the catheterization.

The doctor will put a needle into the blood vessel where the catheter will be inserted. If the doctor cannot insert the needle into a blood vessel near the skin, he or she may make a cut in your groin to expose a blood vessel big enough for the needle. This cut may need two or three stitches when the procedure is finished.

The doctor can use the catheter to inject a special dye that shows the blood vessels or the chambers of your heart on x- rays. This procedure with dye is called coronary angiography. The doctor may also measure blood pressure and oxygen levels.

When the procedure is finished, the doctor will remove the catheter and apply pressure over the area where the needle was inserted to control any bleeding.

What happens after the procedure?

You will remain under observation for at least 6 hours to ensure that the wound is no longer bleeding. You should avoid strenuous activity for the rest of the day. You may have nausea and vomiting or a fever. Your leg may be swollen and blue for a day. It may feel cool, even though your circulation is OK. A swollen bruise might appear near the puncture site and be uncomfortable for a few days.

Ask your doctor if you should take any precautions after the procedure, what symptoms to watch for, and when you should come back for a checkup.

What are the benefits of this procedure?

This procedure is considered the most accurate way to gather the information your doctor needs to diagnose and treat heart problems.

What are the risks associated with this procedure?

• A local anesthesia may not numb the area quite enough where the needle is inserted, and you may feel some minor discomfort. Also, in rare cases, you may have an allergic reaction to the drug used in the anesthesia.

• The procedure can result in irregular heart rhythms, which could require treatment.

• If the catheter is placed in an artery, some blood may form a clot around it where it entered. The doctor may give you a blood thinner and keep you in the hospital for a few days to help dissolve the clot.

• You could have an allergic reaction to the dye and become nauseated or flushed. This can be treated with medication.

• The catheter may puncture the artery and cause internal bleeding.

• Rarely, you may have a seizure during the procedure.

• While it is not common, heart catheterization can trigger a heart attack.

You should ask your doctor how these risks apply to you.

When should I call the doctor?

Call the doctor immediately if your groin keeps swelling where the catheter went in.

Call the doctor during office hours if:

• You have questions about the procedure or its result.

• You want to make another appointment.