Cardiac catheterization is a diagnostic procedure which is performed in order to detect problems with the heart and its blood supply. A long, thin tube (a catheter) is inserted into the femoral artery and vein to the heart and cardiac pressures are measured and the catheters are used to inject X-Ray dye to visualize the heart and the blood vessels. Newer catheter have allowed the use of the wrist artery for certain patients (radial artery catheterization). The catheterization procedure will provide a great deal of information about the heart including the heart pumping ability (Ejection Fraction, EF), the pressure within the various heart chambers, and detailed structural information about the heart and blood vessels, and the pattern of flow within the heart and major blood vessels.
The catheterization itself normally takes less than an hour and a simple heart catheterization is often an outpatient procedure. However, often, if a blockage is found that can be treated with balloon angioplasty, stenting, or other interventional techniques, the procedures will be performed in the same seting and the patient will stay overnight.
Cardiac catheterization takes place in a specialized
cardiac catheterization laboratory with an x-ray movie camera which takes images
of the heart from various angles. The heart and blood pressure will be monitored
throughout the procedure. The usual sites of entry are the groin area, the forearm,
of the wrist. The immediate skin area is numbed with a local anesthetic, which
is administered through a needle. This will feel like an initial pin prick as
the needle is inserted, and then a burning sensation as the anesthetic is injected.
Patient may also feel pressure when the catheter itself is inserted, and/or
exchanged with other catheters during the procedure. Once the initial needle
is inserted, a guide wire is passed through the needle and the needle itself
is removed. Next, a small plastic tube (catheter) is threaded over the wire
and guided through the vessel and into the chambers of the heart. This is done
under x-ray guidance. The catheter is connected to special equipment that records
pressures in the different heart chambers.
Patients will be awake throughout the procedure; in fact, the physicians will require patients' cooperation at various times during the testing (exhale, cough, hold your breath). Patients are usually sedated. When x-ray sensitive contrast dye is injected, via catheter, into the bloodstream, patients may feel a warm sensation and occasionally chest pain. Once the testing is complete, the catheters will be removed and pressure will be applied for approximately 15 minutes. The Cardiologist may elect to use a groin closure device if indicated (suture in artery or collagen plug in the artery)