Table of ContentsView AllTable of ContentsPurpose of TestRisks and ContraindicationsBefore the TestDuring the TestAfter the TestInterpreting Results
Table of ContentsView All
View All
Table of Contents
Purpose of Test
Risks and Contraindications
Before the Test
During the Test
After the Test
Interpreting Results
Cardiac catheterization(also referred to as cardiac cath or heart cath) is an invasive procedure used to evaluate and treat heart conditions. A thin, long, flexible tube is inserted, usually in the arm or groin, and is guided to the blood vessels of your heart.
Angiographyis almost always done during the procedure, which involves injecting dye into your vessels so they can be visualized with imaging, typically an X-ray or an intravascular ultrasound.
Your healthcare provider may use this to help diagnose a concern, deliver medication, or repair heart defects and disease.
Verywell / Emily Roberts
Cardiac catheterization allows your healthcare provider to access your coronary arteries for blockages and to assess heart muscle function and the structure and function of your heart valves. The catheterization procedure can also be used to deliver therapy for many cardiac conditions.
A specialized type of cardiac catheterization, theelectrophysiology study,is used to assess and treat various heart rhythm disturbances.
Diagnostic Uses
If you have signs of atherosclerosis orcoronary artery disease(blockage in your heart vessels) such as fatigue, shortness of breath, or chest pain,you may need a cardiac catheterization.
Cardiac catheterization produces images that can identify the location and severity ofblockages in the coronary arteries, show your overall heart function and the condition of individual cardiac chambers (cardiac ventriculography), and determine whether your heart valves are narrow, stiff, or leaky.
A cardiac catheterization can also be used to take a sample of tissue if you have a possibility of an infection or inflammation of the heart, to measure oxygen levels for assessment of cardiac and pulmonary disease, or to determine the pressure in various areas of the heart (right heart catheterization).
Sometimes cardiac catheterization can be used as one of the diagnostic tests for heart valve disease, congestive heart failure, cardiomyopathy, or heart failure.
Therapeutic Uses
Often, cardiac catheterization is useful in the treatment of heart problems. As with diagnostic catheterization, imaging with angiography is used, which allows your healthcare providers to see your heart as the procedure is being performed.
Therapeutic catheterizations are used to relieve blockages in the coronary arteries with angioplasty (widening the arteries), to remove obstructive material (thrombectomy), and for stent placement (a tube that remains in place to keep the artery open).
The procedure can also treat heart valve conditions such as mitral stenosis andaortic stenosis(valvuloplasty) and heart rhythm irregularities (cardiac ablation), or to repairpatent foramen ovale.
Sometimes a cardiac catheterization with anangioplastyis done urgently for the diagnosis and treatment of a heart attack to restore blood flow to a coronary artery, with the aim of preventing permanent heart damage.
Similar Tests
Depending on your condition, your healthcare provider may opt for:
Some forms of testing may be better suited to some patients than others. You and your healthcare provider can discuss which one(s) is right for you.
Limitations
Cardiac catheterization and angiography are relatively safe, but because they are invasive procedures involving the heart, several complications are possible. For this reason, a cardiac catheterization is performed only when the treatment is expected to be highly beneficial or when there is a strong likelihood that the information gained from the procedure will be of significant benefit.
Serious and less common complications include:
In addition, cardiac catheterization and angiography involve exposure to radiation. As with any medical test using radiation, these tests may produce a tiny increase in the lifetime risk of developing cancer.
Cardiac catheterization for the treatment of coronary artery disease is less invasive than open-heart surgery. But complicated heart conditions often require open-heart surgery, which can allow your healthcare providers better access to your heart for extensive repairs. Complications and emergencies that result from a diagnostic or therapeutic catheterization and angiography may require emergency open-heart surgery.
If you are going to have a cardiac catheterization, you will first need some pre-testing to make sure you can tolerate the procedure and that your healthcare providers are well-prepared for complications.
You may also be instructed to stop some of your medications, such as blood thinners and heart medications, a day or two before the test.Always alert your healthcare provider about any nonprescription medications you take as well.
Timing
If you are scheduled for a cardiac catheterization, you should be prepared to spend the rest of the day recovering after your exam is complete.
A diagnostic cardiac catheterization procedure can take between 30 minutes to over an hour, and a therapeutic catheterization can take several hours. For both, you will need to have an IV placed and you will receive an anesthetic.
You may or may not be awake during the procedure. It can take approximately an hour to fully wake up after anesthesia, even if you are not completely put to sleep, and most people feel groggy until after getting a full night’s sleep.
Your healthcare provider may talk to you about the preliminary results after you recover from anesthesia, or you may need to come back at another time to discuss the results. If there is something concerning noted during a diagnostic test, you may need to have another test or a procedure, so ask your healthcare provider if you should be prepared to spend the whole day or even to stay overnight.
After a therapeutic procedure, you may need to spend a few hours in recovery, or even spend the night in the hospital.
Location
A cardiac catheterization with an angiogram is performed in a special cardiac procedure suite. Sometimes, if there is a concern that the procedure may be complicated, it is performed in an operating room in case open heart surgery is needed.
With all catheterization procedures, there is a backup plan for a surgical emergency, in which case you would need to move from the cardiac procedure suite to the operating room. Some hospitals do not perform cardiac surgery. In this case, if emergency surgery is required, you will be transferred to another hospital.
What to Wear
You will need to wear a gown for the procedure, so you can wear whatever is comfortable to the test.
Food and Drink
You will need to abstain from food and drink after midnight before your test or for six to eight hours if your test is scheduled for late in the day.
Cost and Health Insurance
You may need health insurance preauthorization before your test, and the facility where it is being done will most likely take care of obtaining the approval. You may also need to pay a copay, and you can ask your health insurance provider or the facility about your fee responsibility in advance.
If you are paying for the procedure yourself, the cost can run in the high thousands for a diagnostic procedure and in the tens of thousands for a therapeutic procedure.
There is a huge range in cost, depending on the facility, the region of the country, and your specific diagnosis, so it is best to get an estimate in writing ahead of time instead of making any assumptions. In fact, for a nonemergency cardiac catheterization, it is not unusual to “shop around” if you are paying for it yourself.
What to Bring
You should bring your test order form (if you have one), your insurance card, a form of identification, and a method of payment. Because you will not be able to drive yourself home after the test, you should make sure you have someone to drive you home.
Pre-Test
After you fill out the sign-in forms, you will meet with a nurse or a technician, who will confirm that you have not eaten after midnight and may ask you whether you have any symptoms of chest pain, shortness of breath, dizziness, or vision changes.
You will be asked to change into a gown, and you will have an IV placed in your hand. You will meet with the healthcare provider who is going to perform the procedure, the rest of the team, and the healthcare provider, nurse, or other practitioners who will give you the anesthetic.
Throughout the Test
Afterlocal anesthesiais given, a catheter is inserted in one of the blood vessels in your groin, arm, wrist, or neck. The catheter is inserted either through a small incision or with a needle-stick. Once in the artery, the catheter is advanced to the heart using X-ray guidance.
During the procedure, catheters are typically maneuvered to various locations within the heart, and the pressures within the chambers of the heart are measured. Measuring these intracardiac pressures can be helpful in diagnosing certain kinds of heart disease.
Blood samples can be taken through the catheter from different locations in the heart to measure the amount of oxygen in the blood. You may be asked to hold your breath for a few seconds, as this can change oxygen concentration and help your healthcare providers visualize your heart from different angles.
Dye is injected through the catheter while a series of rapid X-ray images are recorded, which produce videos of theblood flowingthrough the cardiac chambers orcoronary arteries.
Post-Test
At this point, you will probably move to a post-surgical recovery suite. As the anesthetic wears off, your nurse will check your blood pressure, pulse, oxygen level, and possibly perform an ECG.
Your medical team will want to make sure you urinate at least once after the procedure because you have been abstaining from food and drink, which can make you dehydrated. If you need more fluid, your team will likely provide you with liquids to drink and/or IV fluid and wait for you to urinate before allowing you to leave.
Once you are fully alert and can walk without assistance, and it is confirmed that someone will drive you home, you will be discharged. You will be given instructions to check on your catheter puncture site and extra bandages in case they need to be replaced.
At home, you should take it easy, try to get some rest, and eat something light. By the morning, you should feel fully recovered and can resume your normal activities.
Managing Side Effects
If you remain a bit tired on the day of the procedure, you should take a nap or relax. If there is minor bleeding that soaks one or two bandages on the day of the test without overflowing, then it is fine to change the bandages.
But if you experience continuous bleeding, swelling, or oozing from the puncture site, call your healthcare provider. If you have chest pain, shortness of breath, lightheadedness, or syncope (loss of consciousness), you should seek emergency help right away.
The test results are generally descriptive and detailed. The report will note how well each of the coronary arteries was visualized and provide a characterization of their shape, whether there is calcification or narrowing, and the exact extent and location of narrowing.
Often, a description of the heart chambers and valves, anatomical defects, or aspects of heart function may be included in the report as well.
When the procedure is done for therapeutic reasons, you can expect the report to specify the findings, as well as to describe how the procedure was done, and to report on any complications, unexpected challenges, and whether the procedure achieved what it was meant to achieve.
After a cardiac catheterization, you may need some follow-up tests after a few days or weeks, including ECG to check your heart function after the procedure, or cardiac echo, depending on whether there are still concerns that were not answered based on the catheterization. You may also need to have some medication adjustments after the procedure.
In general, a cardiac catheterization would not be routinely repeated, and you will need to have another one only if your healthcare provider thinks you have had a significant change in the blood vessels of your heart that requires intervention.
A Word From Verywell
The medical treatments available for heart disease are generally very successful and safe. If you need to have a cardiac catheterization with angioplasty or if you need to have heart surgery, you should know that most people recover quite well.
If you need a cardiac catheterization, this is generally the most invasive portion of an extensive cardiac evaluation that includes ECG, blood tests, X-rays, and possibly echocardiogram or pulmonary function tests.
Sometimes the workup can take time, and you may not get a diagnosis right away. While it can be frustrating to have to wait to know what is affecting you, try to take comfort in knowing that this test puts you one step closer to an answer.
14 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Cleveland Clinic.Cardiac catheterization.The American Heart Association.Cardiac catheterizations for heart defects.The American Heart Association.Electrophysiology studies (EPS).The American Heart Association.Coronary artery disease - Coronary heart disease.The American Heart Association.Cardiac catheterization.Ceders-Sinai.Heart tests and studies - Cardiac catheterization.Johns Hopkins Medicine.Cardiac catheterization.The University of Tennessee Medical Center.Cardiac catheterization lab.National Heart, Lung and Blood Institute.Arrhythmia.Gupta PN, Salam basheer A, Sukumaran GG, et al.Femoral artery pseudoaneurysm as a complication of angioplasty. How can it be prevented?.Heart Asia. 2013;5(1):144-7. doi:10.1136/heartasia-2013-010297Kobayashi T, Hirshfeld JW.Radiation exposure in cardiac catheterization: Operator behavior matters.Circ Cardiovasc Interv. 2017;10(8). doi:10.1161/CIRCINTERVENTIONS.117.005689Al-hijji MA, Lennon RJ, Gulati R, et al.Safety and risk of major complications with diagnostic cardiac catheterization.Circ Cardiovasc Interv. 2019;12(7):e007791. doi:10.1161/CIRCINTERVENTIONS.119.007791Cleveland Clinic.Cardiac Catheterization: Test Details.Shah SN, Sharma S.Mitral Stenosis. In: StatPearls [Internet].Additional ReadingJone PN, Zablah JE, Burkett DA et al.Three-Dimensional Echocardiographic Guidance of Right Heart Catheterization Decreases Radiation Exposure in Atrial Septal Defect Closures.J Am Soc Echocardiogr. 2018 Jun 26. pii: S0894-7317(18)30210-4. doi: 10.1016/j.echo.2018.04.016.Kedev S, Vasilev I.Assessment of coronary microcirculation during cardiac catheterization. Curr Pharm Des. 2018 Jul 1. doi: 10.2174/1381612824666180702112018.
14 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Cleveland Clinic.Cardiac catheterization.The American Heart Association.Cardiac catheterizations for heart defects.The American Heart Association.Electrophysiology studies (EPS).The American Heart Association.Coronary artery disease - Coronary heart disease.The American Heart Association.Cardiac catheterization.Ceders-Sinai.Heart tests and studies - Cardiac catheterization.Johns Hopkins Medicine.Cardiac catheterization.The University of Tennessee Medical Center.Cardiac catheterization lab.National Heart, Lung and Blood Institute.Arrhythmia.Gupta PN, Salam basheer A, Sukumaran GG, et al.Femoral artery pseudoaneurysm as a complication of angioplasty. How can it be prevented?.Heart Asia. 2013;5(1):144-7. doi:10.1136/heartasia-2013-010297Kobayashi T, Hirshfeld JW.Radiation exposure in cardiac catheterization: Operator behavior matters.Circ Cardiovasc Interv. 2017;10(8). doi:10.1161/CIRCINTERVENTIONS.117.005689Al-hijji MA, Lennon RJ, Gulati R, et al.Safety and risk of major complications with diagnostic cardiac catheterization.Circ Cardiovasc Interv. 2019;12(7):e007791. doi:10.1161/CIRCINTERVENTIONS.119.007791Cleveland Clinic.Cardiac Catheterization: Test Details.Shah SN, Sharma S.Mitral Stenosis. In: StatPearls [Internet].Additional ReadingJone PN, Zablah JE, Burkett DA et al.Three-Dimensional Echocardiographic Guidance of Right Heart Catheterization Decreases Radiation Exposure in Atrial Septal Defect Closures.J Am Soc Echocardiogr. 2018 Jun 26. pii: S0894-7317(18)30210-4. doi: 10.1016/j.echo.2018.04.016.Kedev S, Vasilev I.Assessment of coronary microcirculation during cardiac catheterization. Curr Pharm Des. 2018 Jul 1. doi: 10.2174/1381612824666180702112018.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Cleveland Clinic.Cardiac catheterization.The American Heart Association.Cardiac catheterizations for heart defects.The American Heart Association.Electrophysiology studies (EPS).The American Heart Association.Coronary artery disease - Coronary heart disease.The American Heart Association.Cardiac catheterization.Ceders-Sinai.Heart tests and studies - Cardiac catheterization.Johns Hopkins Medicine.Cardiac catheterization.The University of Tennessee Medical Center.Cardiac catheterization lab.National Heart, Lung and Blood Institute.Arrhythmia.Gupta PN, Salam basheer A, Sukumaran GG, et al.Femoral artery pseudoaneurysm as a complication of angioplasty. How can it be prevented?.Heart Asia. 2013;5(1):144-7. doi:10.1136/heartasia-2013-010297Kobayashi T, Hirshfeld JW.Radiation exposure in cardiac catheterization: Operator behavior matters.Circ Cardiovasc Interv. 2017;10(8). doi:10.1161/CIRCINTERVENTIONS.117.005689Al-hijji MA, Lennon RJ, Gulati R, et al.Safety and risk of major complications with diagnostic cardiac catheterization.Circ Cardiovasc Interv. 2019;12(7):e007791. doi:10.1161/CIRCINTERVENTIONS.119.007791Cleveland Clinic.Cardiac Catheterization: Test Details.Shah SN, Sharma S.Mitral Stenosis. In: StatPearls [Internet].
Cleveland Clinic.Cardiac catheterization.
The American Heart Association.Cardiac catheterizations for heart defects.
The American Heart Association.Electrophysiology studies (EPS).
The American Heart Association.Coronary artery disease - Coronary heart disease.
The American Heart Association.Cardiac catheterization.
Ceders-Sinai.Heart tests and studies - Cardiac catheterization.
Johns Hopkins Medicine.Cardiac catheterization.
The University of Tennessee Medical Center.Cardiac catheterization lab.
National Heart, Lung and Blood Institute.Arrhythmia.
Gupta PN, Salam basheer A, Sukumaran GG, et al.Femoral artery pseudoaneurysm as a complication of angioplasty. How can it be prevented?.Heart Asia. 2013;5(1):144-7. doi:10.1136/heartasia-2013-010297
Kobayashi T, Hirshfeld JW.Radiation exposure in cardiac catheterization: Operator behavior matters.Circ Cardiovasc Interv. 2017;10(8). doi:10.1161/CIRCINTERVENTIONS.117.005689
Al-hijji MA, Lennon RJ, Gulati R, et al.Safety and risk of major complications with diagnostic cardiac catheterization.Circ Cardiovasc Interv. 2019;12(7):e007791. doi:10.1161/CIRCINTERVENTIONS.119.007791
Cleveland Clinic.Cardiac Catheterization: Test Details.
Shah SN, Sharma S.Mitral Stenosis. In: StatPearls [Internet].
Jone PN, Zablah JE, Burkett DA et al.Three-Dimensional Echocardiographic Guidance of Right Heart Catheterization Decreases Radiation Exposure in Atrial Septal Defect Closures.J Am Soc Echocardiogr. 2018 Jun 26. pii: S0894-7317(18)30210-4. doi: 10.1016/j.echo.2018.04.016.Kedev S, Vasilev I.Assessment of coronary microcirculation during cardiac catheterization. Curr Pharm Des. 2018 Jul 1. doi: 10.2174/1381612824666180702112018.
Jone PN, Zablah JE, Burkett DA et al.Three-Dimensional Echocardiographic Guidance of Right Heart Catheterization Decreases Radiation Exposure in Atrial Septal Defect Closures.J Am Soc Echocardiogr. 2018 Jun 26. pii: S0894-7317(18)30210-4. doi: 10.1016/j.echo.2018.04.016.
Kedev S, Vasilev I.Assessment of coronary microcirculation during cardiac catheterization. Curr Pharm Des. 2018 Jul 1. doi: 10.2174/1381612824666180702112018.
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