Cardiac catheterization

Cardiac catheterization is a common medical procedure in which a specially trained cardiologist inserts a thin, flexible tube — called a catheter — into a blood vessel that leads to the heart.

Once the catheter has reached the heart, a physician can perform diagnostic procedures to determine whether the arteries around the heart are blocked, inspect damage to heart valves and evaluate heart muscle function. If heart disease is present, the physician also can provide interventional treatments that re-open blocked arteries — nonsurgical procedures such as balloon angioplasty and stent placement.

Cardiac catheterization may be recommended if you have:

  • Chest pain (stable angina pectoris) or pain that radiates to the jaw, neck or shoulders.
  • New or increasing chest pain (unstable angina pectoris).
  • Heart failure.
  • Blood vessel damage.
  • Heart valve disease.

Cardiac catheterization is an important part of providing the community with a high level of emergency cardiac care. When you're rushed to HonorHealth hospitals by ambulance, emergency room doctors receive your EKG results while you're in transit. If heart attack is apparent, the cath lab treatment team is mobilized immediately, ready to perform emergency catheterization, cutting valuable minutes from treatment time.

How it's performed

During cardiac catheterization, a short, hollow tube called a plastic introducer sheath is inserted into an artery in the leg (the femoral artery) or the arm (the radial artery). The catheter is inserted into the sheath and, with the aid of X-ray imaging, guided through the blood vessel to the coronary arteries.

To assess the health of the heart, the cardiologist will perform an imaging procedure called a coronary angiogram. A dye (contrast material) is injected through the catheter. As the dye moves through the heart's arteries, valves and chambers, an X-ray machine captures a series of images.

For patients who have symptoms of heart disease, the dye can determine whether plaque — a waxy substance made up of fats, cholesterol, calcium and fibrin, a blood-clotting protein — is lining the walls of an artery and restricting blood flow to the heart.

Blockages in the coronary arteries also can be seen with ultrasound, an imaging technology that uses sound waves to produce detailed pictures of the heart's blood vessels.

If necessary, a cardiologist will perform an interventional procedure — such as coronary angioplasty coupled with stent placement — to open a narrowed coronary artery and increase blood flow to the heart. This is often performed immediately following a diagnostic cardiac catheterization. The specific type of interventional procedure depends upon the severity, location and degree of blockage.

Potential risks

Cardiac catheterization rarely results in serious complications. However, some of the potential risks of cardiac cath are:

  • Bleeding, infection and pain at the catheter insertion site.
  • Damage to blood vessels — in some rare situations, the catheter can poke or scrape a blood vessel as it's guided to the heart.
  • Allergic reaction to the medication or contrast material.

The risk of complications with cardiac catheterization is higher for patients with diabetes or kidney disease, or age 75 or older. Complication risk is higher for women and those who undergo emergency cardiac catheterization.

Recovery

The recovery period for cardiac catheterization typically spans several hours. After the plastic sheath is removed, pressure is applied to the insertion site, and you'll lie flat for four to six hours to prevent bleeding and enable the insertion site to heal.

How long you'll stay in the hospital depends on your condition and whether an interventional procedure is performed after the catheterization.