Cardiac Catheterization During Cardiac Catheterization

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Cardiac catheterization takes place in a catheterization laboratory, or cath lab, which is similar to a small operating room. The procedure is often done in a hospital, but you may be able to have the procedure in a catheterization lab located in a medical clinic, depending on the reason for the procedure.

Before cardiac catheterization, an intravenous line (IV) will be placed in a vein in your arm. Through this IV, you will get medicine to either help you relax or make you sleep during the procedure.

You will get numbing medicine at the site where the doctor will insert the catheter. This may be in the upper thigh, arm, or neck or under the collarbone. The doctor will place a needle into the blood vessel. A guidewire is inserted into the needle, and the needle is taken out. Then the doctor places a small tube called a sheath in the blood vessel around the guidewire. The guidewire is removed. The catheter is then inserted through the sheath. Your doctor watches X-ray images to see where to place the tip of the catheter.

Once the catheter is in place, your doctor may use it to perform tests or treatments on your heart. For example, your doctor may inject a dye into the catheter to look at blood flow in the heart. The dye will enter your blood vessels and make your coronary arteries visible in X-ray images.

Cardiac catheterization is a relatively safe procedure, and complications are rare. However, as with any procedure involving the heart and blood vessels, there are some risks.  

Possible risks include the following:

• Allergic reaction to the dye
• Irregular heart rhythm (arrhythmia)
• Bleeding or discomfort where the catheter was inserted
• Blood clots
• Collapsed lung, called pneumothorax
• Damage to blood vessels, heart valves, or the heart from the catheter
• Heart attack
• Hypothermia, or very low body temperature, especially for small children
• Infection
• Low blood pressure from bleeding or as a reaction to the procedure
• Need for a blood transfusion
• Need for emergency surgery to repair a tear in a blood vessel, such as the aorta or a coronary artery, and restore blood flow to the heart. This may be done using a coronary artery bypass graft (CABG).
• Side effects of the medicine to help you relax or sleep, if used. These can include nausea, vomiting, confusion, or an allergic reaction.
• Side effects of radiation. Although not an immediate risk, repeated radiation exposure from X-rays used to place the catheter may increase the risk of cancer and leukemia, skin damage, and cataracts later in life. This is especially true for children.
• Stroke

After the procedure, your doctor will remove the catheters, sheath, and guidewire. A dressing, accompanied by pressure, will be applied to the site where the catheter was inserted to stop the bleeding. The pressure may be applied by hand or with a sandbag or other device.

You will be moved to a recovery room, where you will lie in a bed. Your healthcare provider will monitor your heartbeat and blood pressure.

Depending on your health before the cardiac catheterization and any additional procedures done during the cardiac catheterization, you may have to spend the night in the hospital. Ask your healthcare provider about what medicines to take and when to resume activity as you recover from the procedure.