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What is this test?
A cardiac catheterization is an invasive test in which a catheter is introduced into the heart. This test allows for precise measurement of the pressures within the heart. A special radiopaque dye is injected into the catheter, and this dye allows for the taking of detailed pictures of the blood vessels that supply the heart.
Why is this performed?
A cardiac catheterization can tell your doctor about the structure and function of the heart valves, the heart's ability to pump blood, and the pressure within the heart chambers.
What does this test involve?
A cardiac catheterization is done in a specialized laboratory in a hospital that is similar to an operating room. Before the test begins, an intravenous infusion is inserted into a vein in your arm. Electrodes are placed on the chest so that your heart rate and rhythm can be monitored with an electrocardiogram during the procedure. An electrocardiogram is a machine that measures the electrical activity of the heart. A blood pressure cuff remains in place to check your blood pressure every so often.
Although you are awake throughout the procedure, you are given medication to help you relax. Before the test begins, you are put on your back, lying flat if you are able to tolerate that position. Sterile drapes and towels are placed over your body, and you need to lie as still as possible during the procedure.
The catheter (a tube) used for this test is usually inserted into an artery in the groin area but may also be placed in a forearm artery. A local anesthetic (a painkiller) is given before the catheter is inserted, and you may feel a little burning as this medication is injected. Once the catheter is in place, a guide wire is passed through the needle and the needle itself is removed. Next, a small plastic tube is threaded over the wire and guided through veins and into a chamber on the right side of the heart. At this point, special equipment is connected to the catheter that records pressure readings inside the heart's chambers.
A special type of radiopaque dye may be injected through the catheter and into a heart artery. As the dye is injected, you will probably feel a warm sensation throughout your body. Shortly after the dye is injected, pictures of the heart will be obtained. You may be asked to breathe deeply or cough while certain pictures are being taken. The entire test takes several hours.
Once the test is done, the catheter is removed and direct pressure is applied to the groin or forearm for about 15 minutes. This is necessary to reduce the risk of bleeding at the site of the catheter. After the test, you are returned to your hospital room or special monitoring area.
If the catheter was inserted into your groin, you will be required to lie flat in bed for anywhere from two to six hours. You will not be able to bend the affected limb. During this period, a nurse will check on you often to check your blood pressure and pulse and check the site where the catheter was inserted. Pain medication may be used, if you have discomfort at the site of the injection. Immediately following the test, you will be given only fluids to drink. Your diet will be increased during the next several hours.
In many instances, you spend the night at the hospital and are discharged the next morning. At times, patients undergoing cardiac catheterization are discharged the same day, after several hours of observation once the test is completed.
To prepare, you will be told not to eat or drink for about eight hours before the test. Certain medications, especially anticoagulants (medication that helps prevent clotting) will be withheld prior to the test. Your doctor may order blood work, a chest X-ray and an electrocardiogram to be done before this test.
What are the risks and precautions for this test?
A cardiac catheterization is an invasive test. Before this procedure, your doctor will explain the test and tell you about the risks. You will have to sign a written consent form before this exam.
Because iodine-based dye is injected into your bloodstream during this procedure, tell your doctor if you have an allergy to iodine, shellfish or other X-ray dye.
During the procedure, tell your doctor immediately if you have chest pain, shortness of breath or dizziness. To reduce the risk of blood loss after this test, it is very important to keep the part of the body where the catheter was inserted completely still for several hours. If you have any numbness, bleeding or weakness in that area of your body, tell the nurse immediately.
What do the results mean?
Cardiac catheterization can evaluate whether or not muscle function or the pumping action of the heart is impaired. A cardiac catheterization can evaluate the extent of valvular heart disease as well as congenital heart defects (defects that you may be born with).
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External Source
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American Heart Association
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This article was reviewed and updated
June 2007.
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