Diagnostic Cardiac Catheterization

Diagnostic cardiac catheterization is the process of introducing hollow plastic tubes called catheters into veins and/or arteries to the heart. Once the catheters are inside the heart chambers or blood vessels, the pressure of the blood can be measured, blood samples can be taken, and dye can be injected to help visualize the structures.

Cardiac catheterization is helpful for diagnosing patients with heart conditions, such as if arteries that supply the heart muscle (coronary artery disease) are blocked.

Who is eligible for a diagnostic cardiac catheterization?

If a heart condition is suspected from a patient's history, physical examination, or an evaluation by tests like an EKG, chest x-ray, echocardiogram, and exercise stress test, diagnostic cardiac catheterization can be used to confirm a diagnosis. It can also confirm a suspected abnormality in the patient that might require a surgeon’s attention.

What conditions can be diagnosed by a diagnostic cardiac catheterization?

Conditions that a diagnostic cardiac catheterization can diagnose include:

• Heart biopsy.
• Heart valve disease.
• Decreased heart function.
• Congenital heart defects.
• Coronary artery disease (including heart attack).
• Elevated pressures in the heart chambers and/or great vessels.
• Abnormal cardiac output (volume of blood flowing through the heart).

How do I prepare for a diagnostic cardiac catheterization?

Cardiac catheterization is usually performed in the hospital. The test requires some preparations. Before your test:

• Don't eat or drink anything for at least 6 hours before your test or as directed by your doctor. Ask your doctor or nurse if you should take your medications with a small amount of water.


• If you have diabetes, ask for instructions about diabetes medications and insulin. You will usually be able to have something to eat and drink soon after your test.


• Your doctor may recommend you stop medications that may thin your blood.


• Take all your medications and supplements with you to the test. It's best if you take the original bottles so that your doctor will know the exact dose you take.

What should I expect during my diagnostic cardiac catheterization?

Cardiac catheterization is usually performed while you're awake but sedated. However, specific procedures, such as ablation, valve repair, or valve replacement, may be performed while you're asleep.

An IV line will be inserted in your hand or arm and will be used to give you any additional medications you might need during your procedure. You will also have monitors (electrodes) placed on your chest to check your heartbeat during the test.

Before the catheter is inserted into your artery, you'll be given a shot of an anesthetic to numb the area. You may feel a quick, stinging pain before the numbness sets in.

After you feel numb, the catheter will be inserted. A small cut is made to access an artery. A plastic sheath will be inserted in the cut to allow your doctor to insert the catheter.

What happens next depends on why you're having a cardiac catheterization. These are some of the common uses:

• Coronary angiogram: If you're having this test to check for blockages in the arteries leading to your heart, a dye will be injected through the catheter and X-ray images of your heart arteries are taken.


• Right heart catheterization: This procedure checks the pressure and blood flow on the right side of your heart. The catheter has special sensors in it to measure the pressure and blood flow in your heart.


• Heart biopsy: A catheter with a small, jaw-like tip is used to obtain a small sample of tissue from your heart. You may feel pressure, but you likely won't feel the actual tissue being snipped.


• Balloon angioplasty: A balloon catheter will be inflated at the narrowed area of a vessel to open it. In many cases, your doctor will also place a mesh coil called a stent at the narrowed portion to help keep the artery open.


• Repair of heart defects: Your doctor may need to close a hole in your heart, such as an atrial septal defect or patent foramen ovale. A device is then inserted through the catheter to close the hole. In heart valve leak repair cases, a clip or plug may be used to stop the leak.


• Balloon valvuloplasty: This procedure opens up narrowed heart valves. A catheter is threaded across the valve. A balloon is then blown up to make the valve open more easily.


• Valve replacement: This procedure is similar to balloon valvuloplasty, except that an artificial valve will be implanted in your heart to replace a narrowed heart valve.


• Heart ablation: In this procedure, you'll usually have multiple catheters placed in the arteries and veins of your groin or neck so that radiofrequency energy can be directed to the part of your heart, causing abnormal heartbeats.

If you're awake during the procedure, you may be asked to take deep breaths, hold your breath, cough or place your arms in various positions throughout the procedure. Your table may be tilted at times, but you'll have a safety strap on to keep you on the table.

Threading the catheter shouldn't be painful, and you won't feel it moving through your body. Tell your health care team if you have any discomfort.

Why choose Presbyterian for a diagnostic cardiac catheterization?

Presbyterian’s Heart and Vascular team has many different options to help you manage your heart condition. The team performs various diagnostic tests and procedures to help form an accurate diagnosis and create individualized treatment plans for your heart health needs. Depending on the type of heart condition you have and its underlying cause, the team can recommend a wide variety of treatment options; these may include lifestyle modifications, medications and procedures. Our cardiologists and cardiovascular surgeons work closely together for cases in which surgery is the best treatment option. We also offer a customized cardiac rehabilitation program at our Healthplex, where clinically appropriate, which can improve your endurance and exercise tolerance, as well as improve heart-related symptoms. Your cardiologist will work with the rehabilitation team to create a plan that will be tailored to your individual health needs.