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JAMA Patient Page
June 13, 2017

Cardiac Catheterization

JAMA. 2017;317(22):2344. doi:10.1001/jama.2017.0708

Cardiac catheterization is a procedure performed by doctors to help diagnose and treat heart problems.

This test can measure the pressure and oxygen levels in the different chambers of the heart, determine the amount of blood pumped by the heart, find heart defects that have been present since birth, and help diagnose heart valve problems.

Coronary angiography is often performed as part of cardiac catheterization to help find blockages in the arteries that supply blood to the heart muscle. If a significant blockage is found, a doctor may be able to treat it by inflating a tiny balloon in the artery and then placing a small metallic tube called a stent to keep the vessel propped open.

How Is Cardiac Catheterization Performed?

Cardiac catheterization is performed in an operating or procedure room that has specialized x-ray equipment. The patient may receive sedating medication but will usually be awake during the procedure. The doctor administers local anesthetic to numb the site over the blood vessel (this is typically in the groin, wrist, or neck). Once the site is numb, the doctor uses a needle to help place a plastic tube called a sheath into the blood vessel. He or she then inserts a long, thin tube (catheter) and advances the catheter toward the heart using x-ray imaging for guidance. The catheter can be used to measure pressure, take blood samples, or perform a coronary angiogram by injecting dye to allow the doctor to examine the arteries of the heart. After the procedure is completed, the catheters and sheaths are removed. Pressure is held at the site of the puncture to prevent bleeding, or a specialized device is used to close the hole in the artery area and to aid in healing.

Who Should Have Cardiac Catheterization?

Cardiac catheterization can help a doctor diagnose and manage heart valve problems, congestive heart failure, or pulmonary hypertension (high blood pressure in the lungs). Cardiac catheterization with coronary angiography is commonly performed in patients who are having a heart attack or experiencing chest pain that is not relieved with medications or who have an abnormal stress test result.

Risks of Cardiac Catheterization

Cardiac catheterization is a commonly performed and generally very safe procedure. The most common problems after cardiac catheterization are bruising and tenderness at the puncture site.

Rare but more serious risks due to cardiac catheterization include significant bleeding or blood vessel injury, allergic reaction, kidney injury, stroke, heart attack, or death. You should discuss these risks as well as the benefits of the procedure with your doctor prior to the test.

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Article Information

Conflict of Interest Disclosures: The authors have completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest and none were reported.

Sources: Polanczyk CA, Rohde LE, Goldman L, et al. Right heart catheterization and cardiac complications in patients undergoing noncardiac surgery: an observational study. JAMA. 2001;286(3):309-314.

Mehta SR, Cannon CP, Fox KA, et al. Routine vs selective invasive strategies in patients with acute coronary syndromes: a collaborative meta-analysis of randomized trials. JAMA. 2005;293(23):2908-2917.

Topic: Cardiovascular Disease