The heart is a complex plumbing system made up of valves, pumps, and pipe-like vessels that control blood flow throughout the body, and doctors who specialize in its function, diagnosis, and treatment often rely on a special tool called a cardiac catheterization to find potential obstructions. and life-threatening disease – in this system.
Evolved and perfected over many decades, performed more than a million times a year in the United States alone, cardiac catheterization is a procedure in which a thin, flexible tube or catheter is guided through a blood vessel to to the heart to diagnose or treat certain heart problems. conditions, such as blocked arteries or irregular heartbeats. It is a major method for detecting and managing coronary heart disease, congenital heart disease, heart failure, heart valve disease and other cardiovascular conditions. It provides doctors with vital information about heart muscle, valves and vessels.
Although it is the most commonly performed cardiac procedure, cardiac catheterization is rarely the first thing to do when a cardiologist assesses symptoms a patient may be experiencing. A patient may report chest discomfort, feeling irregular heartbeat, dizziness or fainting, and other signs that something is wrong.
Before recommending catheterization, the doctor will carefully observe and examine the patient, taking into account their age and outward symptoms. Some basic stress tests can be ordered.
One may be an exercise test that asks the patient to walk on a treadmill or ride a stationary bicycle while monitoring their heart rate, blood pressure, and breathing. Another may be a nuclear stress test, in which a small amount of radioactive tracer material is injected into the patient and then an imaging machine tracks blood flow to the heart.
If such tests indicate a higher possibility of coronary heart disease or other problems, that’s when the doctor may recommend cardiac catheterization – to literally get a much more definitive picture of what’s going on with the patient’s cardio system. .
Diagnostic cardiac catheterization is usually an outpatient procedure, performed in what most hospitals call their “catheterization lab,” a room with special x-ray and imaging machines. The patient lies on a special table. In most cases, they are given a mild sedative to relax, but they are usually awake and able to converse with the doctor throughout the procedure.
A local anesthetic is used to numb the catheter insertion site. One or more catheters are passed through a blood vessel, most often in the forearm or wrist, and guided to the heart. Contrast material is injected through the catheter and X-ray videos are created as the material travels through the heart chambers, valves, and major vessels. The patient can view live images on overhead monitors.
During a diagnostic heart catheterization, a doctor can locate narrowing or blockages in blood vessels that could be causing chest discomfort, measure pressure and oxygen levels in different parts of the heart, see how far the heart pumps blood, diagnose heart valve disease and problems present from birth, and examine blood vessels for blood clots.
The diagnostic procedure itself usually takes about 30 minutes, but preparation and recovery times add several hours. Patients should expect to spend most of the day in a hospital.
If your doctor finds any blockages or other concerning issues during a diagnostic heart catheterization, they will likely recommend follow-up interventional heart catheterization or other heart procedures to actually treat those conditions.
These additional treatment procedures may include placement of a stent to widen a narrowed artery, ablation to correct irregular heart rhythms, repair or replacement, or repair of congenital heart valves.
Andrew Potash, MD, is a cardiologist specializing in diagnostic cardiac catheterization and other procedures at Berkshire Medical Center.