Left Heart Catheterization (LHC)

Introduction

Left heart catheterization (LHC) is a minimally invasive procedure used to diagnose and sometimes treat conditions affecting the left side of the heart. It allows doctors to evaluate blood flow, measure pressures, and assess coronary artery blockages.

Indications for LHC

LHC is performed for various reasons, including: - Coronary Artery Disease (CAD): To check for blockages in the coronary arteries. - Valvular Heart Disease: To assess the function of the heart valves. - Heart Failure: To evaluate heart function and pressures. - Congenital Heart Defects: To assess abnormalities present at birth. - Pre-Surgical Evaluation: Before major cardiac surgery.

Procedure Overview

1. Preparation: The patient is given local anesthesia, and mild sedation may be administered.
2. Catheter Insertion: A thin catheter is inserted into an artery, usually in the wrist (radial artery) or groin (femoral artery).
3. Guidance to the Heart: The catheter is advanced to the left side of the heart using imaging techniques.
4. Measurements and Imaging: Contrast dye is injected to visualize the coronary arteries (coronary angiography) and measure pressures inside the heart.
5. Completion: Once necessary data is collected, the catheter is removed, and pressure is applied to prevent bleeding.

Risks and Complications

LHC is generally safe, but potential risks include: - Bleeding or hematoma at the catheter insertion site. - Arrhythmias (irregular heart rhythms). - Infection (though rare). - Allergic reaction to contrast dye. - Stroke or myocardial infarction (very rare but possible).

Recovery and Aftercare

• Patients are monitored for a few hours.
• Avoid heavy lifting for 24–48 hours.
• Follow up with a cardiologist for results and next steps.

Conclusion

LHC is a valuable diagnostic tool for detecting and evaluating heart diseases. It is a relatively safe procedure that provides crucial information for managing cardiac conditions.

Source recommendations

1. American College of Cardiology/American Heart Association Guidelines for Cardiac Catheterization

1. https://www.acc.org/Guidelines
2. https://www.ahajournals.org/doi/10.1161/CIR.0000000000001038
3. https://www.heart.org/en/health-topics/heart-attack/diagnosing-a-heart-attack/cardiac-catheterization
4. https://www.ahajournals.org/doi/10.1161/01.CIR.84.5.2213
5. https://pubmed.ncbi.nlm.nih.gov/20048207/

2. European Society of Cardiology Guidelines on Percutaneous Coronary Interventions

1. https://pubmed.ncbi.nlm.nih.gov/15769784/
2. https://www.escardio.org/Guidelines/Clinical-Practice-Guidelines/Acute-Coronary-Syndromes-ACS-Guidelines
3. https://academic.oup.com/eurheartj/article/26/8/804/2888081
4. https://www.escardio.org/Guidelines/Clinical-Practice-Guidelines/ESC-EACTS-Guidelines-in-Myocardial-Revascularisation-Guidelines-for
5. https://academic.oup.com/eurheartj/article/40/2/87/5079120