Cardiac Catheterization

(Coronary Angiography; Coronary Arteriography; Coronary Angiogram)

by Editorial Staff and Contributors

Click here to view an animated version of this procedure.

Definition    TOP

Cardiac catheterization is a test that uses a catheter and x-ray machine to check the heart and its blood supply.

Reasons for Procedure    TOP

Cardiac catheterization is used to find the cause of symptoms, such as chest pain, that could suggest heart problems.

Cardiac catheterization helps doctors:

  • Identify narrowed or clogged arteries of the heart
  • Measure blood pressure within the heart
  • Evaluate how well the heart valves and chambers are working
  • Check heart defects
  • Evaluate an enlarged heart
  • Decide on an appropriate treatment

Possible Complications    TOP

If you are planning to have cardiac catheterization, your doctor will review a list of possible complications. Complications may include:

  • Bleeding at the point of the catheter insertion
  • Damage to arteries
  • Heart attack, or abnormal heart beats known as arrhythmia
  • Allergic reaction to x-ray dye
  • Blood clot formation
  • Infection

Some factors that may increase the risk of complications include:

What to Expect    TOP

Prior to Procedure

Your doctor may order:

Talk to your doctor about your medications. You may be asked to stop taking or change the doses of some medications before the procedure, like:

  • Anti-inflammatory drugs
  • Blood thinners
  • Diabetes medication

Leading up to your procedure:

  • Arrange for a ride to and from the procedure.
  • The night before, do not eat or drink anything after midnight.

Anesthesia

Local anesthesia will be used at the insertion site. A mild sedative may be given one hour before the procedure or through an IV during the procedure. This will help you relax.

Description of the Procedure    TOP

During the procedure, you will receive IV fluids and medications. An EKG will be monitoring your heart's activity.

You will be awake but sedated so that you will be more relaxed. Your doctor will ask you to perform basic functions such as coughing, breathing out, and holding your breath. Tell your doctor if you feel any chest pain, lightheadedness, nausea, tingling, or other discomfort.

The catheter will be inserted into an artery in either the groin or arm. The insertion area will be cleaned, and numbed. A needle will be inserted into a blood vessel. A wire will be passed through the needle and into the blood vessel. The wire will then be guided through until it reaches your heart. A soft, flexible catheter tube will then be slipped over the wire and threaded up to your heart.

The doctor will be taking x-ray pictures during the procedure to know where the wire and catheter are. Dye will be injected into the arteries of the heart. This will make the arteries and heart show up on the x-ray images. You may feel warm during the dye injection.

Insertion of Catheter with Guide Wire through the Groin

Nucleus factsheet image
Copyright © Nucleus Medical Media, Inc.

Once in place, the catheter can be used to take measurements. Blood pressure can be taken within the heart's different chambers. Blood samples may also be taken. Multiple x-ray images will be taken to look for any disease in the arteries. An aortogram may also be done at this time. This step will give a clear image of the aorta. After all the tests and images are complete, the catheter will be removed.

Sometimes, the doctor will do a balloon angioplasty and stenting if there is an area in your arteries that is narrow or clogged. These procedures help to open narrowed arteries.

Finally, a bandage will be placed over the groin or arm area.

How Long Will It Take?    TOP

The procedure takes about 30-90 minutes. Preparation before the procedure and recovery after it will add several hours to the total time.

How Much Will It Hurt?    TOP

Although the procedure is generally not painful, it can cause some discomfort, including:

  • Burning sensation when the skin at the catheter insertion site is anesthetized
  • Pressure when the catheter is inserted or replaced with other catheters
  • A flushing feeling or nausea when the dye is injected
  • Headache
  • Heart palpitations

Pain medication will be given when needed.

Average Hospital Stay    TOP

0-1 days

Postoperative Care    TOP

At the Care Center
  • EKG and blood studies may be done.
  • If the catheter was inserted in the groin area, you will likely need to lie still in bed and flat on your back for a period of time. If the catheter was in your arm, you will likely be out of bed sooner.
  • A pressure dressing may be placed over the area where the catheter was inserted to help prevent bleeding. It is important to follow the nurse's instructions.
At Home

When you return home, do the following to help ensure a smooth recovery:

  • Do not drive until your doctor says it is okay.
  • Do not lift heavy objects or engage in strenuous exercise or sexual activity for at least 5-7 days.
  • Change the dressing around the incision area as instructed.
  • Your doctor will explain which medications you can take and which ones to avoid. Take medications as instructed.
  • You can make lifestyle changes to lower your risk for further complications of heart disease. These include eating a healthier diet, exercising regularly, and managing stress.
  • Ask your doctor about when it is safe to shower, bathe, or soak in water.
  • Be sure to follow your doctor’s instructions.

Call Your Doctor If Any of the Following Occurs    TOP

Monitor your recovery after you leave the hospital. Call your doctor if any of these occur:

  • Signs of infection, including fever and chills
  • Redness, swelling, increasing pain, excessive bleeding, or any discharge from the catheter insertion site

Call for Medical Help Right Away If Any of the Following Occurs    TOP

Call for medical help right away if you have symptoms including:

  • Drooping facial muscles
  • Changes in vision or speech
  • Difficulty walking or using your arms
  • Change in sensation to affected leg or arm, including numbness, feeling cold, or change in color
  • Extreme sweating, nausea or vomiting
  • Lightheadedness
  • Chest pain
  • Rapid, irregular heartbeat
  • Cough, shortness of breath, or difficulty breathing
  • Weakness or fainting

If you think you have an emergency, call for medical help right away.

RESOURCES:

American Heart Association
http://www.heart.org
National Heart, Lung, and Blood Institute
http://www.nhlbi.nih.gov

CANADIAN RESOURCES:

Canadian Cardiovascular Society
http://www.ccs.ca
Heart and Stroke Foundation
http://www.heartandstroke.ca

References:

American College of Cardiology Task Force. American College of Cardiology/Society for Cardiac Angiography and Interventions clinical expert consensus document on cardiac catheterization laboratory standards: a report of the American College of Cardiology Task Force on clinical expert consensus documents. J Am Coll Cardiol. 2001 Jun 15;37(8):2170-2214.
Cardiac catheterization. Cleveland Clinic website. Available at:
...(Click grey area to select URL)
Updated February 2011. Accessed August 7, 2013.
Explore cardiac catheterization. National Heart Lung and Blood Institute website. Available at:
...(Click grey area to select URL)
January 30, 2013. Accessed August 7, 2013.
Preparing for cardiac catheterization, angiography, and electrophysiology studies. Cedars Sinai Hospital website. Available at:
...(Click grey area to select URL)
Accessed August 7, 2013.
Last reviewed August 2013 by Michael J. Fucci, DO; Brian Randall, MD
Last Updated: 5/11/2013