What Happens During Cardiac Catheterization?

What is cardiac catheterization?

Cardiac catheterization is a procedure where a catheter, a small hollow tube, is inserted through an artery in the wrist or groin and advanced into the heart, where the doctor can do a number of tests.

What procedures are performed in a cardiac catheterization lab?

We can measure different pressures in different chambers of the heart, we can inject a contrast, which is a dye that can be seen on an x-ray machine, to check the blood flow in the heart arteries, as well as check the strength of the heart muscle.

Are there symptoms a patient may have that would cause a physician to recommend a cardiac catheterization?

Most common are symptoms that we refer to as angina, which are symptoms from not enough blood flow to the heart. These include chest discomfort, pain, pressure, or squeezing that typically comes on with activity and is relieved by rest. Symptoms can also include shortness of breath, marked fatigue, exercise intolerance or symptoms of heart failure where a patient fills up with fluid, gains a lot of weight, swells in the legs or can’t lay flat in bed.

What can cardiac catheterization be used to diagnose?

It can be both diagnostic and therapeutic. Let’s say a cardiac catheterization is performed to evaluate coronary arteries; if there’s a narrowing in one of them, we can use that same catheter to insert equipment such as a wire and balloon to dilate that narrowed spot in the artery and leave a stent, restoring normal blood flow back to the area. Today, we can even replace a heart valve or place pacemakers through the same type of procedure.

What can a patient expect to experience during the cardiac catheterization?

A patient arrives in the morning, responds to a couple of questions, we get them ready, and then when it’s their turn, they’re brought to the catheterization suite where they lay down on an x-ray table and are administered sedation to help relax. They’re not completely out because we still want them to be able to talk to us, but often a patient will sleep or not remember all of the procedure. We anesthetize or numb the patient’s wrist (where we enter 90% of the time) with some lidocaine, and though it initially hurts like a bee sting when we insert the catheter, patients shouldn’t feel any pain during the procedure.

After the procedure is completed, we put a band over the wrist, remove the catheter, and the patient is taken to the recovery room. Over the next few hours, the band gets released, forming a blood clot, and the patient leaves for home with a band-aid.

What should a patient do if they think they need a cardiac catheterization?

Usually, primary care physicians can start diagnostic workup, but if somebody’s having chest discomfort that’s not going away or getting worse, they can go to the emergency room, and then we’ll get involved that way. But if you’re having symptoms where your endurance is decreasing, or you’re having chest discomfort or shortness of breath with activity, see your primary care physician right away.

For more information, call 636.928.WELL

To learn more about heart care at BJC, visit https://www.bjsph.org/Medical-Services/Heart-Care/Cardiac-Catheterization

Michael Missler, DO, is an interventional cardiologist with BJC Medical Group. He sees patients at Barnes-Jewish St. Peters Hospital and Progress West Hospital.