Back to Cardiac Imaging
Involves the introduction of a thin tube (catheter) inside the
heart chambers. It may carry specialized devices on it that
help it perform both diagnostic and therapeutic functions (see
- Cardiac catheters may be used for both diagnostic and
- Measurement of pressure in the heart and great vessels.
- Injection of a radioopaque contrast medium to visualize the
heart chambers and diagnosis of coronary artery disease
- Stenting and dilatation of coronary artery disease,
vulvoplasty and cardiac biopsies.
- Intracardiac ultrasonographic imaging to quantify arterial
- Intracardiac electrophysiology is a technique which can
determine types of arrhythmias and locate aberrant pathways and
ablate these pathways.
Cardiac catheterization is usually performed as day case
procedures provided that the patient can rest lying down at home for
Clinical history and examination should be performed. Full blood
counts, kidney and liver function tests as well as coagulation
profile must be performed. Chest-xray and ECG. Patient consent
should be taken. The patient should be fasting (NBM - nil by mouth)
for at least 6 hours prior to the procedure. His daily medication
should have been given to him the morning of procedure.
The catheter is usually introduced through the femoral artery or
vein. It passes all the way up to the right atrium and can be pushed
all the way through the right ventricle and into the pulmonary
artery and then to the pulmonary capillaries.
Patient should avoid dehydration to prevent renal injury by the
contrast medium. Patient should be checked for swelling of the
puncture site or bleeding. The peripheral pulses should be checked
regularly for the rare complication of arterial dissection,
thrombosis or arterial spasm.
- Renal insult due to contrast medium (enhanced by patient
dehydration). This is rare with modern contrast media.
- Contrast reaction, which is usually mild with modern agents.
- Hemorrhage from the puncture site. This may resolve by simple
pressure or may require surgery in cases of aneurysmal formation.
- Loss of peripheral pulses which is rare and due to arterial
dissection, thrombosis or arterial spasm.
- Pericardial tamponade
> 1 in 1000.