Cardiac catheterisation

Cardiac catheterisation is a common procedure used to diagnose and treat various heart conditions. A cardiologist inserts a thin and hollow tube, known as a catheter, through a blood vessel in your groin or wrist and guides it up into your heart.

Cardiac catheterisation is usually done under local anaesthetic, except in children, where it is usually done under general anaesthetic.

Cardiac catheterisation is a procedure that can diagnose and treat heart conditions such as:

• narrowing of your coronary arteries
• problems with your heart valves and heart muscle
• assessing heart failure and congenital heart disease

Cardiac catheterisation can help your doctor plan the best treatment for your heart condition.

Your cardiac catheterisation procedure is performed by a specialist doctor and generally involves the following process:

1. You will be taken to the operating theatre or x-ray room, helped onto an operating table and connected to a monitor that tracks your vital signs (measurements of your body's basic function).
2. You will usually be given a local anaesthetic and stay awake during the procedure. If your child is having this procedure, they will usually be given a general anaesthetic
3. Sterile sheets will be draped over you.
4. Your doctor will insert a narrow tube (sheath) into a blood vessel in your wrist or groin. A long, thin tube (catheter) will be threaded through the sheath to your heart.
5. Depending on the purpose of the procedure and what your cardiologist sees, they may perform additional steps, such as coronary angioplasty or coronary angiogram.
6. At the end of the procedure, your doctor will remove the catheter. The sheath will remain in place for a few hours. If the catheter was inserted into a blood vessel in your groin, your doctor may put a special device to seal the artery and prevent bleeding.

Coronary angiogram (also called coronary angiography)

If your doctor suspects narrowing or blockages of your coronary arteries, they can inject a dye through the catheter that shows up on x-ray. You will then have x-rays of your coronary arteries to see where they are narrowed or blocked.

Coronary angioplasty

After a coronary angiogram, your doctor can repair a narrowing of your arteries by stretching your artery wall with a small balloon. They may also insert a small metal coil called a stent to keep your artery open.

It is important you let your doctor know if you feel any discomfort in your chest during your procedure.

Your doctor will give you specific instructions about how to prepare for your procedure.

You may need to have tests to assess your general health, including:

• blood tests to check your kidney function and iron levels
• an ECG (electrocardiogram)
• a chest x-ray

If you take blood thinning medicines, you may need to stop them a few days before the procedure or take an alternative medicine. Your doctor will give you specific advice based on your situation.

It's a good idea to ask your doctor any questions you may have about your upcoming procedure to help you make an informed decision.

Recovery after cardiac catheterisation depends on your medical history and any interventions you have. You will need to lie flat for 4 hours to reduce the chance of bleeding from the puncture site.

Straight after your procedure

• You will be taken to a special ward where your heart rate and blood pressure will be monitored.
• A nurse will check for bleeding from the catheter site in your wrist or groin.
• You will be asked to rest for a while.
• You can eat or drink when you feel ready.
• If dye was used, your urine may be monitored to make sure your kidneys are not having a reaction to the dye.

If your doctor performed any interventions during your procedure, such as inserting a stent, you may be moved to a different ward for overnight observation.

Your health team will advise you when to start taking your medicines again. They may also prescribe new heart medicines. It is very important you take your medicines as prescribed.

Make sure you ask your doctor about follow up or further treatment.

Minor complications after cardiac catheterisation are rare, but can include:

• discomfort and bruising where the catheter entered your body
• vessel wall injury
• allergic reaction to local anaesthetic or contrast agents (dye) used

Major complications are very rare but can include:

• infection
• heart attack
• stroke
• severe bleeding
• fainting caused by an irregular heart rhythm (arrhythmia)

Remember that complications are rare. Cardiac catheterisation is a common procedure and considered generally very safe.

Depending on your situation and condition your doctor may discuss other types of imaging to assess your heart, such as ultrasound (echocardiogram) or CT.

If you choose not to have cardiac catheterisation, your doctor may not be able to diagnose and treat any heart conditions accurately. This may affect your health. You should discuss your options with your doctor.

If your procedure is delayed for any reason, contact your healthcare provider to:

• manage any changes to your medicines made in the lead up to your procedure
• reschedule your procedure

• Visit the Heart Foundation website to learn about other heart procedures.
• Book a Heart Health Check to learn your risk of heart attack or stroke.
• Learn more about healthy eating to protect your heart.
• You can also call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available 24 hours a day, 7 days a week.

Do you prefer to read in languages other than English?

Watch a video in your preferred language to learn more about heart failure.

Looking for information for Aboriginal and/or Torres Strait Islander people?

Visit Australian Indigenous HealthInfoNet to learn more about cardiovascular health.