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Cardiac catheterisation is an invasive diagnostic procedure that provides important information about the structure and function of the heart.
It usually involves taking X-rays of the heart's arteries (coronary arteries) using a technique called coronary angiography or arteriography.
The resulting images are known as coronary angiograms or arteriograms.
Coronary angiography can be used to help diagnose heart conditions, help plan future treatments and carry out certain procedures. For example, it may be used:
Coronary angiography is also considered to be the best method of diagnosing coronary heart disease (where a build-up of fatty substances in the coronary arteries affects the heart's blood supply).
Read more about why coronary angiography is used.
During the procedure, a long, thin and flexible tube called a catheter is inserted into a blood vessel in your groin or arm. Using X-ray images as a guide, the tip of the catheter is passed up to the heart and coronary arteries.
A special type of dye called contrast medium is injected into the catheter and X-ray images (angiograms) are taken.
The contrast medium is visible on the angiograms, showing the blood vessels that the fluid travels through. This clearly highlights any blood vessels that are narrowed or blocked.
The procedure is usually carried out under local anaesthetic, so you'll be awake while the procedure is carried out, but the area where the catheter is inserted will be numbed.
Read more about how coronary angiography is performed.
You'll usually be able to leave hospital on the same day you have a coronary angiography, after a period of rest and observation.
Most people feel fine a day or so after having the procedure, although you may feel a bit tired afterwards and the wound site is likely to be tender for up to a week. Any bruising may last for several weeks.
You'll usually be advised to avoid certain activities – such as bathing, driving and lifting heavy objects – for a day or two after the procedure.
While you're recovering, it's important to look out for signs of any problems. You should seek immediate medical attention if swelling at the site of your wound gets worse, or if you experience excessive bleeding or circulation problems in your limbs.
Read more about recovering from coronary angiography.
Cardiac catheterisation and coronary angiography are usually very safe. However, as with all procedures, there are some risks, including:
Read more about the risks of coronary angiography.
Cardiac catheterisation and coronary angiography can provide important information about the heart and the surrounding blood vessels supplying it.
This can help to diagnose heart conditions, plan future treatments and carry out certain procedures.
The heart has four chambers: the two small chambers at the top are called atria and the two larger chambers at the bottom are called ventricles. Each ventricle has two valves to control the flow of blood in and out of the ventricle.
Using cardiac catheterisation, your cardiologist (heart specialist) can tell how well your heart valves and chambers are working. The procedure can also provide important information about the blood pressure inside your heart.
Coronary angiography also gives video images (angiograms) that can show whether the blood vessels surrounding your heart are narrowed or blocked. You may need treatment if there are any narrow areas or blockages.
Cardiac catheterisation and coronary angiography can be used to help diagnose a number of heart conditions, including:
Coronary angiography is also used before or during certain treatments. For example, it may be used if you need to have:
Cardiac catheterisation and coronary angiography is carried out at a hospital or specialist heart centre.
The team responsible for your care may include:
The procedure is usually carried out in an X-ray room or a catheterisation laboratory.
Before the procedure is carried out, you should tell your cardiologist if:
You'll be told whether to continue taking your medication or if you need to stop. You shouldn't stop taking prescribed medication unless you're advised to do so.
You may also be asked not to eat or drink anything for a few hours before the procedure.
The procedure is usually carried out under local anaesthetic, so you'll be awake while the procedure is carried out, but the area where the catheter is inserted (either the groin or arm) will be numbed.
You may also be given the option of having a sedative. This makes you feel sleepy and relaxed while remaining awake and being aware enough to respond to instructions, such as being asked to take a deep breath and hold it at certain points during the procedure.
General anaesthetic is sometimes used when young children need to have the procedure, because they may find it too difficult to stay still while it's being carried out.
You'll be attached to an electrocardiogram (ECG) machine throughout the procedure. An ECG records your heart's rhythms and electrical activity.
A number of electrodes (small metallic discs) are placed on your arms, legs and chest. The electrodes are connected to a machine that records the electrical signals of each heartbeat.
If you don't need any further procedures, such as balloon angioplasty, cardiac catheterisation and coronary angiography should take about half an hour.
Below is a step-by-step guide to what you can expect during the procedure. The healthcare professionals who are with you will explain what is happening.
Read more about recovering from cardiac catheterisation and coronary angiography.
After having cardiac catheterisation and coronary angiography, your pulse and blood pressure will be checked and recorded.
If the catheter was inserted into your groin, a nurse may apply pressure for up to 10 minutes to stop the bleeding after the catheter and sheath have been removed.
Sometimes the doctor carrying out the procedure inserts a small surgical plug, a special stitch or another closure device to seal the wound. In these cases, it isn't necessary to apply pressure to the wound.
If the catheter was inserted into your arm, a small pressurised cuff may be placed around your arm. The pressure is gradually decreased over the course of several hours. A nurse will check whether there's any bleeding at the point where the catheter was inserted.
You should be able to sit up straight away and you may be able to walk around soon afterwards if the catheter was inserted into your arm.
However, if the catheter was inserted into your groin, you'll be asked to lie flat after any bleeding has stopped. If all is well, you'll be asked to sit up after a few hours and you should be able to get up and walk around shortly after.
You should tell the healthcare professionals treating you if you feel unwell at any time after the procedure.
Most people are able to go home on the same day the procedure is carried out, although you'll need to arrange a lift home from a family member or friend.
You should also make sure that someone stays with you overnight in case you experience any problems.
Most people feel fine a day or so after having the procedure. You may feel a bit tired and the wound site is likely to be tender for up to a week. Any bruising may last for up to two weeks.
You'll be advised about things to do or avoid during your recovery before leaving hospital. Examples of advice you may be given include:
Call your GP or NHS 111 if you have concerns about your wound or your recovery in general.
Contact your GP if you experience:
If you experience any bleeding from your wound, apply pressure to the area. If the bleeding from your wound doesn't stop or restarts after applying pressure for 10 minutes, dial 999 and ask for an ambulance.
Cardiac catheterisation and coronary angiography are generally considered to be safe procedures. However, as with all medical procedures, there are some associated risks.
The main risks of coronary angiography include:
In very rare cases, more serious complications of coronary angiography can occur. These include:
The risk of a serious complication occurring is estimated to be less than 1 in 1,000. People with serious underlying heart problems are most at risk.
Your cardiologist should discuss the risks with you before the procedure.