What is cardiac catheterisation?
Cardiac catheterisation is a common diagnostic procedure used when the cardiologist believes that blood is not flowing normally. This procedure lets cardiologists examine or treat the heart and arteries. It is also called ‘cardiac cath’ or ‘heart cath’.
When does the patient need cardiac catheterisation?
Cardiac catheterisation is often performed to help get a more accurate diagnosis when other tests, such as an electrocardiogram (ECG) or x-ray, can’t give enough information. Cardiac catheterisation also helps define the most effective treatment or medication.
Cardiac catheterisation involves inserting a catheter (a thin, hollow tube) in the groin, arm or neck, through a blood vessel, then into the heart. The procedure lets the cardiologist examine the heart muscles and valves, and also the blood vessels leading to and from the heart. The cardiologist will look for any narrowing or blockage.
After the insertion of the catheter, a special dye is injected in the arteries to prepare the patient for an angiography (an x-ray or radiography of blood vessels). This medical imaging technique can show whether the patient suffers from any narrowed arteries.
Cardiac catheterisation is also done in specific medical procedures, such as instilling a stent into an artery to keep it open.
Preparation for cardiac catheterisation
To prepare for cardiac catheterisation, the patient should follow correctly the guidelines given by the cardiologist and the hospital clinic.
A couple of days before the procedure, the patient should tell the cardiologist in case he/she takes any blood-thinning medication, as it has some risky consequences and most probably the cardiologist will ask the patient to stop taking the medicine.
The patient will be asked to fast for some hours before admission to the clinic.
During cardiac catheterisation
Cardiac catheterisation is a relatively short procedure; often takes from 30 to 60 minutes. It is commonly performed in a special catheterisation room or cath lab, in the hospital. Adults mostly have a local anaesthetic plus a sedative to help them relax. However, children are usually given a general anaesthetic.
The cardiologist will make a small incision, usually in the groin or arm, less commonly in the neck, to get to a large blood vessel. Then a small tube, known as a sheath, is inserted. After that, the catheter is threaded through the sheath and guided to the heart. The cardiologist often injects some dye containing a tiny amount of radioactive material and monitor where it goes. The whole process is followed on a screen.
The patient could be asked to hold your breath at certain times during the procedure. Apart from some pressure and heat, the procedure is painless.
After cardiac catheterisation
The place where the patient has the catheter inserted doesn’t usually need stitches, but it might be bruised and feels sore for a few days.
If the entry is through the groin, the patient will need to lie down for the first few hours to avoid any possible bleeding.
The guidelines provided by the clinic or the cardiologist must be followed correctly. It is very important to know how to rest and when to resume regular physical activities.
Any abnormal symptoms should be shared with the doctor.
What might go wrong?
Cardiac catheterisation is a simple and normally a very safe operation. Unusual complications involve bleeding and bruising at the incision place, a blood clot or an abnormal heartbeat. Should any of the above-mentioned complications happen, the patient must call the doctor immediately.
HeartCentre at the Alfred (Coronary angiogram / coronary angioplasty and stenting), Royal Children’s Hospital (What is meant by cardiac catheterisation and interventional procedures?), Heart, Lung and Circulation (Cardiac catheterisation laboratory complications in an Australian tertiary hospital), Heart (Complications of cardiac catheterisation in children), Mayo Clinic (Cardiac catheterization), Heart Foundation (Coronary angioplasty), HealthTimes (Caring for patients post cardiac catheterisation), American Heart Association (Cardiac catheterization), Merck Manuals (Cardiac catheterization and coronary angiography)