Cardiac Catheterization

Cardiac catheterization is one of the most extensively performed cardiac procedures. If you have chest pain or irregular heartbeat, your doctor may recommend cardiac catheterization.

Cardiac catheterization is a minimally invasive procedure used to detect and treat cardiovascular diseases. This procedure involves the insertion of a catheter (a thin hollow tube) into the large arteries or veins present in the neck, arm or groin, which is then guided to the heart using a special X-ray. Once the catheter reaches the location, diagnostic tests or treatment procedures are carried out.

Why perform Cardiac Catheterization?

Cardiac catheterization is done to find the cause of the signs and symptoms of a heart problem or to treat or repair the heart damage.

This procedure is performed to:

• Determine the pressure levels in the chambers of the heart.
• Determine the heart function after a cardiac intervention.
• Detect blockages in the coronary arteries (coronary angiography) or valve dysfunction.
• Perform procedures such as angioplasty, ablation therapy or valve repair.
• Obtain a small piece of heart tissue to examine under a microscope for detecting conditions affecting the heart muscle (cardiac biopsy).

What is the difference between Cardiac Catheterization and Coronary Angiography?

Catheterization is a procedure used to diagnose and treat various conditions. It involves the insertion of a catheter into the arteries and veins to reach the heart and to measure how much blood the heart pumps out, the pressure in each heart chamber, and to detect any defects in the heart. Also, various small instruments can be inserted into the catheter to view the interior of the blood vessels, to remove a tissue sample from the heart for further examination, etc.

Coronary angiography is a type of catheterization procedure, which involves analysing the arteries that supply the heart with oxygen-rich blood. This procedure involves the insertion of a catheter in the arm or the groin, which is threaded to reach the coronary arteries. During insertion, fluoroscopy (a continuous x-ray procedure) is used to guide the catheter to reach the precise position. After the catheter tip is at the right location, a contrast dye is injected into the coronary arteries. This dye can be seen on x-rays, and the outline of the arteries is viewed on a video screen.

How do I prepare for the procedure?

Inform your doctor about:

• The medications that you are taking, especially blood-thinners or anti-inflammatory medications
• Any medical conditions that you have
• Allergies to any dyes or specific medications

Before the procedure:

• Fast for at least 6 hours, as food and liquid increase the possibility of complications with general anaesthesia.
• Empty your bladder before heading to the procedure.
• Remove dentures and jewellery, as they may interfere with the imaging procedures.
• Your general health status and vital signs will be monitored.

What happens during the procedure?

During cardiac catheterization, an IV cannula is inserted in your arm to administer medications. You will be given a mild sedative to help you relax during the procedure.

The general procedure of cardiac catheterization is given below:

• The site of catheter insertion (usually the groin) is cleaned and shaved.
• Usually, local anaesthesia is administered. General anaesthesia may be given before surgical procedures such as valve repair or ablation.
• When the site of catheter insertion becomes numb, an incision is made, and the catheter is inserted using a catheter sheath.
• Once the catheter reaches the heart, a dye is administered which outlines the vessels, valves and chambers of the heart.
• The diagnostic tests or surgical procedures will then be performed for treating the condition.

Vital signs and electrocardiogram will be continuously monitored during the procedure.

Cardiac catheterization usually lasts for about 30 minutes. It may be longer if you are undergoing any other test or intervention using this procedure.

After the procedure is done, the catheter will be removed, and the incision will be closed by stitches. A sterile dressing will be used to prevent infection in the incision site.

What happens after the procedure?

Once the procedure is done, you will be asked to lie flat on the bed for 2-6 hours after the procedure. Your heart rate and blood pressure will be continuously monitored.

Once the anaesthesia wears off, you will be given pain medications. You will be asked to drink plenty of water to eliminate the dye that was administered. Usually, you will be asked to stay in the hospital for a few hours or a day.

After leaving the hospital, follow all the post-procedural instructions given by your doctor. You may resume your normal activities in a day’s time. Some soreness at the incision site is normal; it may reduce within a week.

What are the risks of Cardiac Catheterization?

Cardiac catheterization is a relatively safe procedure. However, like any other invasive procedure, some uncommon risks of this procedure are:

• Infection
• Blood clotting
• Bruising at the incision site
• Allergic reaction to dye
• Arrhythmia
• Air embolism
• Stroke

Call your doctor if you experience:

• Severe pain at the incision site
• Signs of infection: redness, warmth, pus oozing or excessive swelling around the incision site
• Numbness or tingling sensation in your limbs