Cardiac Catheterisation

Useful Information

Cardiac catheterisation investigates whether or not there is any narrowing of the coronary arteries, how well the heart is pumping and how effectively the heart valves are working. 

There are three main arteries which supply blood and oxygen to the heart. These arteries are on the surface of the heart and are typically three to four millimetres wide. If these arteries are narrowed, you may experience symptoms such as angina, chest discomfort or shortness of breath. If your arteries become suddenly blocked, it may lead to a heart attack.  

This procedure takes approximately 20 minutes to perform and you will be awake throughout. 

Accessing the artery 

You will receive some sedation through a drip in your arm to help you relax. The doctor will then access the artery starting in either the groin or wrist. The area is numbed using a local anaesthetic and an incision is made through which a needle is inserted into the blood vessel. A catheter (a plastic coated wire) is passed over this needle and gently pushed up to the area of the blocked or narrowed artery. 

Examining the arteries 

Once the catheter has successfully reached the blocked or narrowed artery, a special x-ray dye is injected. An x-ray camera is used to take moving pictures of the dye flowing through the arteries. When all of the arteries have been examined, a catheter will be placed into the heart’s main pumping chamber and more dye will be injected. The dye will fill up the chamber and the x-ray camera will take moving pictures of the dye as it is pumped out of the chamber into the aorta (main blood vessel). 

Measuring blood pressure

Sometimes it is necessary to measure the blood pressure in the heart and take pictures of the heart chambers or lung circulation. This is done as part of the procedure and involves placing a tube in the right side of the heart. 

Intervention 

Occasionally during this procedure a blockage can be discovered in one of the coronary arteries. Current best practice advises that if a blockage is discovered, it should immediately be corrected using an angioplasty or stent procedure in order to avoid more serious complications such as a heart attack. If additional treatment such as an angioplasty or coronary stent is required, your consultant cardiologist will discuss this with you and inform you of the process involved. 

Following the procedure 

• Strict bed rest is required, the length of which depends on the access site used (groin or wrist). 
• If groin access is used, bed rest is required for five to six hours. You will be asked to limit your movement to reduce the risk of bleeding. 
• If radial access (wrist) is used, bed rest is required for two to four hours. 
• Frequent checks of your blood pressure, pulse and puncture site will be carried out by your nurse.