One of the most accurate tests in the diagnosis of coronary artery disease, cardiac catheterization, is performed more than a million times each year. Doctors use this minimally invasive procedure to diagnose and/or treat cardiac problems including the heart arteries, valvular heart disease, and to assess pressure within the heart.
The method involves threading a long, thin tube (called a catheter) through an artery or vein in the groin, or within the heart, through the aorta or arm, and into the heart. Depending on the type of information your doctor needs, different things may happen during cardiac catheterization. For example, a dye may be injected through the catheter to see the heart and its arteries (a test called coronary angiography or coronary arteriography). Pressures may be measured through the catheters as well. Often, doctors use the terms cardiac catheterization, angiography, and arteriography to mean the same thing.
You will most likely have blood tests and an electrocardiogram before the procedure. Once you are in the catheterization laboratory (also called cath lab), you will see television monitors, heart monitors, and blood pressure machines. You will lie on an examination table, which is usually near an x-ray camera. Staff will place small metal disks called electrodes on your chest. These electrodes have wires called leads, which hook-up to an electrocardiogram machine. This machine will monitor your heart rhythm during the test.
To prevent infection, you will be shaved and cleansed around the area of your legs and arms catheters may be inserted. A needle with a tube connected to it will be put in your arm. This is called an intravenous line or IV. A mild sedative will be injected through the IV to relax you throughout the test. You will be given an anesthetic medicine with a needle to numb the area around where the catheter will be inserted. You may feel mild discomfort.
Then, a small incision will be made in the skin. Once doctors feel the artery into which the catheter will go, a special needle is used to access it. Doctors then put the catheter into the artery. You should not feel pain during this part of the test. The catheter is gently threaded through the artery and into your heart. After doctors have the information they need, the catheter and IV will be removed. Firm pressure will be applied to the site where the catheter was inserted to stop any bleeding and you will have a bandage put on.
After the procedure, staff will move you to another room where you will need to rest for a few hours. You may feel a little sleepy until the sedative has worn off. You should try to lie still and not bend your knee too much. Nurses will watch you to see that your heart rate and blood pressure are stable. After this time of rest, you will be able to go home.