- Related Resources - Heart Disease and Cardiac Catheterization
- A Visual Guide to Heart Disease
- Medical Illustrations of the Heart Image Collection
- Take the Heart Disease Quiz!
- Patient Comments: Cardiac Catheterization - Cause
- Patient Comments: Cardiac Catheterization - Risks
- Patient Comments: Cardiac Catheterization - Recovery
- Find a local Cardiologist in your town
Cardiac catheterization (also called cardiac cath or coronary angiogram) is an invasive imaging procedure that tests for heart disease by allowing your doctor to see how well your heart is functioning. During the test, a long, narrow tube, called a catheter, is inserted into a blood vessel in your arm or leg and guided to your heart with the aid of a special X-ray machine. Contrast dye is injected through the catheter so that X-ray movies of your valves, coronary arteries, and heart chambers can be created.
Why Do I Need a Cardiac Catheterization?
Your doctor uses cardiac cath to:
- Evaluate or confirm the presence of heart disease (such as coronary artery disease, heart valve disease, or disease of the aorta).
- Evaluate heart muscle function.
- Determine the need for further treatment (such as an interventional procedure or bypass surgery).
- At many hospitals, several interventional, or therapeutic, procedures to open blocked arteries are performed after the diagnostic part of the cardiac catheterization is complete. Interventional procedures include balloon angioplasty and stent placements.
What Are the Risks Associated With Cardiac Catheterization?
Cardiac catheterization is generally safe. However, as with any invasive procedure, there are risks. Special precautions are taken to decrease these risks. Your doctor will discuss the risks of the procedure with you.
Risks are rare but can include:
- Bleeding around the point of puncture
- Abnormal heart rhythms
- Blood clots
- Allergic reaction to the dye
- Heart attack
- Perforation of a blood vessel
- Air embolism (introduction of air into a blood vessel, which can be life-threatening)
Be sure to ask your doctor any questions you may have before undergoing cardiac catheterization or other tests for heart disease.
How Should I Prepare for Cardiac Catheterization?
You can wear whatever you like to the hospital. You will wear a hospital gown during the procedure.
Your doctor or nurse will give you specific instructions about what you can and cannot eat or drink before the procedure.
Tell your doctor all of the medications you are currently taking, including herbal preparations and dietary supplements.
Ask your doctor what medications should be taken on the day of your test. You may be told to stop taking certain medications, such as Coumadin (a blood thinner), for a few days before the procedure.
You may or may not return home the day of your procedure. Bring items with you (such as a robe, slippers, and toothbrush) to make your stay more comfortable. When you are able to return home, arrange for someone to bring you home.
How Long Does Cardiac Catheterization Last?
Cardiac catheterization usually takes about 30 minutes, but the preparation and recovery time add several hours. You should plan on being at the hospital all day for the procedure.
What Happens During Cardiac Catheterization?
You will be given a hospital gown to wear during your cardiac catheterization. A nurse will start an intravenous (IV) line in your arm so that medications and fluids can be administered through your vein during the procedure.
The cardiac catheterization room is cool and dimly lit. You will lie on a special table. If you look above, you will see a large camera and several TV monitors. You can watch the pictures of your cardiac cath on the monitors.
The nurse will clean your skin (and possibly shave) the site where the catheter will be inserted (arm or groin). Sterile drapes are used to cover the site and help prevent infection. It is important that you keep your arms and hands down at your sides and not disturb the drapes.
Electrodes (small, flat, sticky patches) will be placed on your chest. The electrodes are attached to an electrocardiogram (ECG) machine that charts your heart's electrical activity.
A urinary catheter may be necessary for the procedure.
You will be given a mild sedative to help you relax, but you will be awake and conscious during the entire procedure. The doctor will use a local anesthetic to numb the catheter insertion site.
If the catheter is to be inserted into your arm (at the bend of the elbow, called the "brachial," or in the wrist, called the "radial" approach), a local anesthetic will be injected into a vein in your arm to numb the area. A needle will be placed inside the artery and then a wire advanced to the aorta. The catheter will then be advanced over the wire. Although you may feel pressure as the sheath and catheter are inserted, you should not feel pain. Tell your health care providers if you do feel pain.
If the catheter is to be inserted at the groin (called the "femoral" approach), a local anesthetic will be injected to numb the area. A small incision will be made over the blood vessel through which the catheter and introducer sheath will be inserted. The catheter will be inserted through the sheath and threaded to the arteries of your heart. Again, if you feel pain, tell your health care providers.
When the catheter is in place, the lights will be dimmed and a small amount of dye (or "contrast material") will be injected through the catheters into your arteries and heart chambers. The contrast material outlines the vessels, valves, and chambers.
When the contrast material is injected into your heart, you may feel hot or flushed for several seconds. This is normal and will go away in a few seconds. Please tell the doctor or nurses if you feel itching or tightness in the throat, nausea, chest discomfort, or any other symptoms.
The X-ray camera will be used to take photographs of the arteries and heart chambers. Your doctor may ask you to take a deep breath, hold your breath, or to cough during the procedure. You will be asked to hold your breath while the X-rays are taken. When all the photos have been taken, the catheter will be removed and the lights will be turned on.
Latest Health News
- Healthy Living Boosts Life Span, Even for Former Smokers
- AHA News: For This Race Car Driver, Curing a Racing Heart Was Key to Crossing the Finish Line
- Money, Good Info Can't Undo Resistance to COVID Vaccine: Study
- U.S. Suicide Rates Rose in 2021, Reversing 2 Years of Decline
- After Ian's Destruction: How to Safely Enter, Clean Flood-Damaged Homes
- More Health News »
What Happens After a Cardiac Catheterization?
If the catheter was inserted in your arm for your cardiac catheterization, the catheter and sheath are removed. A special band will b placed on your wrist to keep the artery from bleeding. You will be able to walk around. You will be observed for a few hours to make sure you are feeling well after the procedure. You may receive medication to relieve discomfort in your arm after the anesthetic wears off. You will be given instructions regarding how to care for your arm when you return home. Tell your nurse if you think you are bleeding or feel any numbness or tingling in your fingers.
If the catheter was inserted in your groin, the introducer sheath will be removed and the incision will be closed with stitches, a collagen seal, or applied pressure. In some situations, the introducer sheath may be sutured into place and removed after the bleeding stops. A collagen seal is a protein material that works with your body's natural healing processes to form a clot in the artery.
A sterile dressing will be placed on the groin area to prevent infection. You will need to lay flat and keep the leg straight for two to six hours to prevent bleeding. Your head can not be raised more than two pillows high (about 30 degrees). Do not raise your head off the pillows, as this can cause strain in your abdomen and groin. Do not try to sit or stand. The nurse will check your bandage regularly, but tell your nurse if you think you are bleeding (have a wet, warm sensation) or if your toes begin to tingle or feel numb. You may receive medication to relieve discomfort in the groin area after the anesthetic wears off. Your nurse will help you out of bed when you are allowed to get up.
Your doctor's orders will determine when you will be allowed out of bed to go to the bathroom after your cardiac catheterization. You will need assistance getting out of bed, so ask for help. The nurse will help you sit up and dangle your legs on the side of the bed.
You will need to drink plenty of liquids to clear the contrast material from your body.
You may feel the need to urinate more frequently. This is normal. If a urinary catheter was not placed during the procedure, you will need to use a bedpan or urinal until you are able to get out of bed.
Your doctor will tell you if you are able to return home or will need to stay overnight. In either case, you will be monitored for several hours after the procedure.
Treatment, including medications, dietary changes, and future procedures will be discussed with you prior to going home. Care of the wound site, activity, and follow-up care will also be discussed.
Please ask your doctor if you have any questions about cardiac catheterization.
Health Solutions From Our Sponsors
Top Cardiac Catheterization Related Articles
Blood Clots (in the Leg)Blood clots can occur in the venous and arterial vascular system. Blood clots can form in the heart, legs, arteries, veins, bladder, urinary tract and uterus. Risk factors for causes of blood clots include high blood pressure and cholesterol, diabetes, smoking, and family history. Symptoms of a blood clot depend on the location of the clot. Some blood clots are a medical emergency. Blood clots are treated depending upon the cause of the clot. Blood clots can be prevented by lowering the risk factors for developing blood clots.
Congestive Heart Failure (CHF)Congestive heart failure (CHF) refers to a condition in which the heart loses the ability to function properly. Heart disease, high blood pressure, diabetes, myocarditis, and cardiomyopathies are just a few potential causes of congestive heart failure. Signs and symptoms of congestive heart failure may include fatigue, breathlessness, palpitations, angina, and edema. Physical examination, patient history, blood tests, and imaging tests are used to diagnose congestive heart failure. Treatment of heart failure consists of lifestyle modification and taking medications to decrease fluid in the body and ease the strain on the heart. The prognosis of a patient with congestive heart failure depends on the stage of the heart failure and the overall condition of the individual.
Percutaneous Coronary Intervention (PCI)Balloon angioplasty of the coronary artery and stents (percutaneous coronary intervention, PCI) is a nonsurgical procedure that relieves narrowing and obstruction of the arteries to the muscle of the heart. PCI can relieve chest pain (angina), minimize or stop a heart attack, or improve the prognosis of patients with unstable angina. The availability of stainless steel stents has expanded the spectrum of patients suitable for PCI.
Coronary Artery Bypass Graft (CABG)Coronary artery bypass graft (CABG) surgery is performed to relieve angina in individuals who have failed medical therapy and are not good candidates for angioplasty (PTCA). CABG surgery is ideal for individuals with multiple narrowings in multiple coronary artery branches. Mortality and complications increase with:
- older age,
- poor heart muscle function,
- disease obstructing the left main coronary artery,
- chronic kidney failure,
- and chronic lung disease.
How Is Coronary Heart Disease Diagosed?Coronary heart disease or coronary artery disease (CAD) screening tests can be used to potentially prevent a heart attack or cardiac event in a person without heart disease symptoms, and can assist in diagnosing heart disease in individuals with heart disease symptoms. Coronary heart disease tests can include electrocardiogram (ECC, EKG), exercise stress test, radionuclide stress test, stress echocardiography, pharmacologic stress test, CT coronary angiogram, and coronary angiogram.
Echocardiogram (Echocardiography, Diagnostic Cardiac Ultrasound)Echocardiogram is a test using ultrasound to provide pictures of the heart's valves and chambers. There are several types of echocardiograms, for example, transthoracic echocardiogram, transesophageal echocardiogram (TEE), stress echocardiogram, dobutamine or adenosine/sestamibi stress echocardiogram, and and intravascular ultrasound.
Heart Attack (Myocardial Infarction)A heart attack happens when a blood clot completely obstructs a coronary artery supplying blood to the heart muscle. A heart attack can cause chest pain, heart failure, and electrical instability of the heart.
High-Sensitivity Troponin Test
The high-sensitive troponin test can detect very low levels of troponin T in the blood. (There are three types of cardiac troponin proteins, I, T, and C.), which helps doctors diagnose a heart attack more quickly.
If troponin levels are elevated high and the ECG (EKG, electrocardiogram) indicates an acute heart attack, immediate cardiac intervention such as catheterization, stents, or a coronary artery bypass graft (CABG).
The high-sensitive troponin test can help diagnose heart conditions such as obstructive coronary disease (CAD), stable angina, congestive heart failure, cardiomyopathy, chronic heart failure, myocarditis, aortic dissection, cardiotoxic chemotherapy, blunt trauma to the chest, and strenuous exercise, for example, endurance athletes.
You can prevent elevated troponin levels in the blood with a heart-healthy lifestyle a heart-healthy diet, maintaining your weight, limit alcohol, don’t smoke, practice stress reduction through stress reduction techniques, meditation, and yoga, manage your blood pressure and diabetes, and take all of your medications as your doctor has instructed you.
Call 911 immediately if you have chest pain and have symptoms of a heart attack, which include nausea, vomiting, belching, indigestion, upper abdominal discomfort that feels like stomach pain in the middle of the upper abdomen, upper back and arm pain, feeling as though you are getting the flu, sweating, a vague feeling of illness, and sweating.
How Is A Sternotomy Done?A sternotomy is a surgical incision made through the breastbone (sternum) to access the thoracic cavity. A median sternotomy is the primary approach used for major surgeries in the thoracic region, as it offers a wide view.
Shock (Medical)Medical shock is a life-threatening medical condition. There are several types of medical shock, including:
- septic shock,
- anaphylactic shock,
- cardiogenic shock,
- hypovolemic shock, and
- neurogenic shock.
- heart attack,
- heart failure,
- heavy bleeding (internal and external),
- spinal cord injury,
- severe burns,
- chronic vomiting or
Cardiac Arrest QuizTake the Sudden Cardiac Arrest Quiz. Learning about this potentially deadly condition may save a life.