Cardiac catheterization or cardiac “cath” as it is sometimes called is a test that allows your doctor to directly see on an x-ray the main blood vessels (arteries) that supply blood to your heart. The test is completed using a special dye injected through a long, very thin, hollow tube or “catheter.” This study is known as coronary angiography.
On an x-ray, the dye is able to show your physician places in your blood vessels which may be blocked or narrowed. Blockages and constrictions in the arteries which supply blood to your heart can cause chest pain or heart attacks.
If your doctor finds a blockage during a cardiac catheterization, a balloon or stent may be used to restore good blood flow. This procedure is called angioplasty or percutaneous coronary intervention.
In addition to assessing for blockage, the cardiac catheter can also be used to take pictures of the left side of your heart. This will help your doctor evaluate how well your heart is pumping and also see if the cardiac valves are functioning correctly.
If your physician or cardiologist needs to get an even more precise measurement of the pressures within the heart and evaluate the heart valves more closely, he may order a right heart catheterization. This procedure can be helpful in assessing patients who have unexplained trouble breathing, severe swelling in their legs or heart valve disease.
Why did my doctor order it?
Cardiac catheterizations are often advised to evaluate patients who have symptoms of blockage in the arteries of their heart. Signs of blockage often include chest pain (angina), easy fatigue, and shortness of breath. Physicians also may order a cardiac cath for patients if other diagnostic tests such as a stress test or CT scan show signs of limited blood flow to the heart, or to look for the cause of other symptoms like shortness of breath and fluid retention.
If an artery suddenly closes, a heart attack will occur. Emergency cardiac catheterizations and angioplasties can save lives by restoring blood flow to the heart.
If any suitable narrowing is found in the coronary arteries, your cardiologist may then proceed to treat the lesion with a stent via percutaneous coronary intervention (PCI), also called coronary angioplasty.
What to Expect
- You will lie on your back and will be awake for the procedure, but you will be given medicine to make sure you are comfortable. You will be able to talk and follow the doctor’s instructions.
- It can take from 30 minutes to a few hours for the procedure to be completed. If a blockage is opened by angioplasty or stent placement, you will stay in the hospital overnight. If no blockage is found, you may be able to leave the hospital several hours following the cardiac cath.
- During the procedure you will receive x-ray dye or contrast. Be sure to let your doctor know if you are allergic to x-ray contrast or iodine-based dye.
- If you are diabetic and take Metformin or Glucophage, stop taking this medication the day prior to your procedure, and do not take it again for at least 48 hours after the procedure.
- For at least 4-5 days following the procedure avoid lifting anything over 20 pounds. The puncture site needs time to heal.
- For at least 4-5 days after the procedure do not take a tub bath, soak in a hot tub or go swimming. You may shower the day after the procedure.
Possible side effects and complications
Cardiac catheterizations are very safe procedures but there is a small risk of complications. Be sure to notify your doctor of any allergies. In addition to an allergic reaction, the contrast dye may also impair kidney function. Notify your physician if you have kidney disease and also if you are diabetic.
The procedure may also cause an irregular heartbeat, bleeding and infection. The risk of serious complication from cardiac catheterization is very low but heart attack, stroke and death may occur. These risks are increased in the elderly, in diabetics and in patients who have the procedure performed in an emergency situation.