Cardiac Catheterization (Heart Cath)

Introduction

Cardiac catheterization, often called "heart cath," is a minimally invasive procedure used to diagnose and sometimes treat heart conditions. It involves inserting a thin, flexible tube (catheter) into a blood vessel in the arm, groin, or neck and guiding it to the heart. This procedure helps doctors assess heart function, detect blockages in the coronary arteries, measure pressure inside the heart, and even perform interventions such as stent placement.

Why Is It Done?

Cardiac catheterization is used for: - Diagnosing Coronary Artery Disease (CAD): Identifying blockages in the coronary arteries. - Evaluating Heart Valve Issues: Assessing how well the heart valves function. - Measuring Heart Pressures: Checking pressures inside the heart chambers. - Assessing Heart Function: Determining how well the heart is pumping blood. - Performing Interventions: Balloon angioplasty and stent placement may be done during the procedure.

How Is It Performed?

1. Preparation: The patient receives local anesthesia and sometimes mild sedation.
2. Catheter Insertion: A catheter is inserted into a large blood vessel (usually in the groin, wrist, or arm) and guided toward the heart using X-ray imaging.
3. Contrast Dye Injection: A dye is injected to make blood flow visible in imaging studies.
4. Diagnosis and Treatment: The doctor evaluates blockages or valve function and, if necessary, may open arteries using a balloon or stent.
5. Recovery: Patients are monitored for a few hours after the procedure and may need to limit activities for a day or two.

Risks and Complications

While generally safe, cardiac catheterization carries some risks, including: - Bleeding or infection at the catheter insertion site. - Blood vessel damage or arrhythmias. - Allergic reactions to contrast dye. - Heart attack or stroke (though rare).

Conclusion

Cardiac catheterization is a crucial procedure for diagnosing and treating heart disease. With modern techniques and skilled specialists, it is a safe and effective way to manage heart health.

Relevant Guidelines

• 2021 ACC/AHA/SCAI Guideline for Coronary Artery Revascularization
• 2018 ESC/EACTS Guidelines on Myocardial Revascularization

Source recommendations

1. 2021 ACC/AHA/SCAI Guideline for Coronary Artery Revascularization

1. https://www.ahajournals.org/doi/10.1161/CIR.0000000000001038
2. https://pubmed.ncbi.nlm.nih.gov/34882436/
3. https://www.jacc.org/guidelines/revascularization
4. https://pubmed.ncbi.nlm.nih.gov/34895950/
5. https://www.acc.org/Latest-in-Cardiology/ten-points-to-remember/2021/12/08/21/19/2021-Guideline-for-Revascularization-gl-revasc

2. 2018 ESC/EACTS Guidelines on Myocardial Revascularization

1. https://academic.oup.com/eurheartj/article/40/2/87/5079120
2. https://pubmed.ncbi.nlm.nih.gov/30165437/
3. https://www.escardio.org/Guidelines/Clinical-Practice-Guidelines/ESC-EACTS-Guidelines-in-Myocardial-Revascularisation-Guidelines-for
4. https://www.eacts.org/clinical-practice-guideline/2022-joint-esc-eacts-review-of-the-2018-guideline-recommendations-on-the-revascularization-of-left-main-coronary-artery-disease-in-patients-at-low-surgical-risk-and-anatomy-suitable-for-pci-or-cabg/
5. https://www.heartuniversity.org/guidelines/esc-eacts-guidelines-on-myocardial-revascularization-2018-the-task-force-on-myocardial-revascularization-of-the-european-society-of-cardiology-esc-and-european-association-for-cardio-thoracic-surge/