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Cardiac Catheterization (Heart Cath, Cardiac Cath, Cardiac Angiography)
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Description | Treatment Options | John Muir Health Capabilities
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Definition
Cardiac Catheterization (Heart Cath) is a test using computerized x-ray and moving pictures to highlight the heart arteries and evaluate how well the heart is pumping. Narrowed or blocked arteries can be seen. If a problem is identified, the doctor can decide the best treatment for the condition.
Description
What is a heart cath?
The heart cath procedure is performed in a special room called the "cardiac cath lab". A great deal of equipment is necessary to gather and review the information obtained during the heart cath. A light sedation is used to create a "sleepy" state. During a heart cath, one may be asked to cough or to take a deep breath. To begin the test, a small flexible tube, called a catheter, is inserted into a vein or artery. The large blood vessels (femoral vessels) found at the top of the leg in the groin use for most procedures. Occasionally, blood vessels in the arm near the elbow (brachial vessels) are used. Once the catheter is in the blood vessel, the doctor uses x-rays and moving pictures to carefully guide the catheter to the heart. Small amounts of a special dye, called contrast, are used to outline the heart arteries and heart chambers. The heart has 3 main coronary arteries: the left coronary artery, the right coronary artery, and the circumflex artery. Each of these has branches. The doctor reviews the x-ray pictures on a television-like screen while the test is in progress. If narrowing of an artery is identified, the doctor may choose to open the artery during the heart cath. The doctor also evaluates the pressures within the heart and checks the heart valves. In a normal heart, the valves open and close tightly as the heart pumps. The valves keep the blood flowing forward as the heart pumps. Valves that do not close completely or are stiff are identified during a heart cath procedure.
The heart cath is used as both an evaluation procedure and a treatment procedure. A heart cath is often performed as an emergency treatment for a heart attack or as a planned procedure to evaluate a heart related complaint. As the evaluation or diagnostic examination proceeds, problem areas may be seen. The doctor may choose to repair, or treat, the artery narrowing at that time. The doctor may use a special balloon to open the blocked artery (angioplasty) and/or a metal spring-like device (stent) to support the artery wall.
Treatment Options
What can be done during the heart cath to fix the artery?
The heart cath procedure offers the doctor a great deal of information. The arteries are inspected for narrowing and/or blockages. Depending upon location of the blocked or narrowed artery and the amount of narrowing, the doctor may choose to use a special balloon to increase the opening immediately. Occasionally, the doctor may decide to treat the damaged artery later. Plaque, fatty deposits found on artery walls, is the most common cause of arterial narrowing.
The procedure used to dilate (widen) narrowed arteries is called Angioplasty. The doctor inserts and advances a catheter with a deflated balloon at its tip into the narrowed part of an artery. Then the balloon is inflated, compressing the plaque and enlarging the inner diameter of the blood vessel so blood can flow more easily. Then the balloon is deflated and the catheter removed. An additional treatment may be indicated to keep the newly opened artery from collapsing. A metal spring-like device (Stent) is frequently used to keep the walls of the artery from collapsing. Angioplasty and stents are the two most common treatment procedures that a doctor uses during a heart cath.
After reviewing the x-ray pictures, the doctor may decide that cardiac surgery is indicated to repair or reestablish heart circulation or to fix the valves. If the heart muscle is not squeezing well, the doctor may decide to use additional support with medication or devices.
John Muir Health Capabilities
John Muir Health offers a wide variety of cardiac diagnostic and treatment procedures. John Muir Health has been identified as one of the most comprehensive centers for cardiac care. State-of-the-art, computerized Cardiac catheterization laboratories are available at both John Muir Medical Center, Walnut Creek Campus and John Muir Medical Center, Concord Campus. These laboratories are available 24 hours a day, 7 days a week.
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