Cardiac Catheterization

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Overview

Cardiac catheterization involves passing a catheter (i.e., a thin flexible tube) through an artery or a vein to the heart, and into a coronary artery. This procedure produces angiograms (i.e., x-ray images) of the coronary arteries and the left ventricle, the heart's main pumping chamber, and also can be used to measure pressures in the pulmonary artery and to monitor heart function, usually in critically ill patients (called right heart catheterization).

In most cases, cardiac catheterization is recommended when a partial or complete arterial blockage is suspected. It is used to evaluate how well the heart is functioning and to obtain information about blockages.

Cardiac catheterization is performed in a hospital. Usually, the procedure takes 2 to 3 hours to perform and patients are required to remain immobile for 4 to 6 hours following cardiac catheterization.

Indications
Indications for the procedure include the following:

• Angina that is not easily controlled with medication, that disrupts daily routine, occurs at rest, or recurs after heart attack
• Heart failure with suspected coronary artery disease
• Heart valve disease with symptoms (e.g., shortness of breath)
• Markedly abnormal stress test results
• Recurring chest pain of unidentified cause

Not everyone with angina needs a cardiac catheterization. Patients who have very rare or easily controlled episodes of angina may desire to continue with medical therapy rather than undergo angioplasty or bypass surgery. Many patients who have suffered a heart attack can initially undergo a stress test rather than cardiac catheterization.

Cardiac catheterization usually is not performed in patients who have infrequent episodes of angina (chest pain) or angina that is easily controlled.

Risks
The risk for serious complications (e.g., stroke, heart attack) from the procedure is approximately 1 in 1000. Other complications include the following:

• Allergic reaction to iodine-based dye
• Bleeding at the insertion site
• Damage to arteries
• Infection at the insertion site
• Kidney damage and/or kidney failure

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