Cardiac catheterization is a common medical procedure in which a specially trained cardiologist will insert a thin, flexible tube — called a catheter — into a blood vessel that leads to the heart.
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Once the catheter has reached the heart, a physician can perform diagnostic procedures to determine whether the arteries around the heart are blocked, inspect damage to heart valves and evaluate heart muscle function. If heart disease is present, the physician also can provide interventional treatments that re-open blocked arteries — nonsurgical procedures such as balloon angioplasty and stent placement.
Cardiac catheterization may be recommended if the patient has:
- Chest pain (stable angina pectoris) or pain that radiates to the jaw, neck or shoulders.
- New or increasing chest pain (unstable angina pectoris).
- Heart failure.
- Blood vessel damage.
- Heart valve disease.
John C. Lincoln provides cardiac catheterization and related heart tests at both of its hospitals, which are accredited Chest Pain Centers. Each hospital operates a dedicated cardiac catheterization laboratory, which is commonly referred to as a "cath lab." In fact, Deer Valley Hospital added a second cath lab to meet the area's growing demand for services.
Cardiac catheterization is an important part of providing our community with a high level of emergency cardiac care. When patients are rushed to our hospitals by ambulance, EKG results are sent to our emergency room doctors in transit. If heart attack is apparent, the cath lab treatment team will be mobilized immediately, ready to perform emergency catheterization, cutting valuable minutes from treatment time.
How Cardiac Catheterization Is Performed
During cardiac catheterization, a short, hollow tube called a plastic introducer sheath is inserted into an artery in the leg (the femoral artery) or the arm (the radial artery). The catheter is inserted into the sheath and, with the aid of X-ray imaging, guided through the blood vessel to the coronary arteries.
To assess the health of the heart, the cardiologist will perform an imaging procedure called a coronary angiogram. A dye (contrast material) is injected through the catheter. As the dye moves through the heart's arteries, valves and chambers, an X-ray machine captures a series of images.
For patients who have symptoms of heart disease, the dye can determine whether plaque — a waxy substance made up of fats, cholesterol, calcium and fibrin, a blood-clotting protein — is lining the walls of an artery and restricting blood flow to the heart.
Blockages in the coronary arteries also can be seen with ultrasound, an imaging technology that uses sound waves to produce detailed pictures of the heart's blood vessels.
If necessary, a cardiologist will perform an interventional procedure — such as coronary angioplasty coupled with stent placement — to open a narrowed coronary artery and increase blood flow to the heart. This is often performed immediately following a diagnostic cardiac catheterization. The specific type of interventional procedure depends upon the severity, location and degree of blockage.
Potential Risks of Cardiac Catheterization
Cardiac catheterization rarely results in serious complications. However, some of the potential risks of cardiac cath are:
- Bleeding, infection and pain at the catheter insertion site.
- Damage to blood vessels; in some rare situations, the catheter can poke or scrape a blood vessel as it is guided to the heart.
- Allergic reaction to the medication or contrast material used during the procedure.
The risk of complications with cardiac catheterization is higher for patients with diabetes or kidney disease, or aged 75 or older. Complication risk is higher for women and persons who undergo emergency cardiac catheterization.
Recovery After Cardiac Catheterization
The recovery period for cardiac catheterization typically spans several hours. After the plastic sheath will be removed, pressure is applied to the insertion site and the patient will lie flat for four to six hours; this will prevent bleeding and enable the insertion site to heal.
The overall length of stay in the hospital depends upon the patient's condition and whether an interventional procedure is performed after the catheterization.