Cardiac Catheterization Health Article

Definition

Cardiac catheterization (also called heart catheterization) is a diagnostic procedure which does a comprehensive examination of how the heart and its blood vessels function. One or more catheters is inserted through a peripheral blood vessel in the arm (antecubital artery or vein) or leg (femoral artery or vein) with x-ray guidance. This procedure gathers information such as adequacy of blood supply through the coronary arteries, blood pressures, blood flow throughout chambers of the heart, collection of blood samples, and x rays of the heart's ventricles or arteries.

A test that can be performed on either side of the heart, cardiac catheterization checks for different functions in both the left and right sides. When testing the heart's right side, tricuspid and pulmonary valve function are evaluated, in addition to measuring pressures of and collecting blood samples from the right atrium, ventricle, and pulmonary artery. Left-sided heart catheterization is performed by way of a catheter through an artery which tests the blood flow of the coronary arteries, function of the mitral and aortic valves, and left ventricle.

Purpose

The primary reason for conducting a cardiac catheterization is to diagnose and manage persons known or suspected to have heart disease, a frequently fatal condition that leads to 1.5 million heart attacks annually in the United States.

Symptoms and diagnoses that may lead to performing this procedure include:

• chest pain, characterized by prolonged heavy pressure or a squeezing pain
• abnormal treadmill stress test
• myocardial infarction, also known as a heart attack
• congenital heart defects, or heart problems that originated from birth
• a diagnosis of valvular-heart disease
• a need to measure the heart muscle's ability to pump blood

Typically performed along with angiography, a technique of injecting a dye into the vascular system to outline the heart and blood vessels, a catheterization can aid in the visualization of any blockages, narrowing, or abnormalities in the coronary arteries. If these signs are visible, the cardiologist may assess the patient's need and readiness for coronary bypass surgery, or perhaps a less invasive approach, such as dilation of a narrowed blood vessel either surgically or with the use of a balloon (angioplasty).

When looking at the left side of the heart, fluoroscopic guidance also allows the following diagnoses to be assessed:

• enlargement of the left ventricle
• ventricular aneurysms (abnormal dilation of a blood vessel)
• narrowing of the aortic valve
• insufficiency of the aortic or mitral valve
• the detour of blood from one side of the heart to the other due to septal defects (also known as shunting)