Cardiac catheterization is a test to check your heart and coronary arteries. It is used to check blood flow in the coronary arteries, blood flow and blood pressure in the chambers of the heart, find out how well the heart valves work, and check for defects in the way the wall of the heart moves. In children, this test is used to check for heart problems that have been present since birth (congenital heart defect).

The purpose of cardiac catheterization is to find out if you have disease in your coronary arteries (atherosclerosis). If you have atherosclerosis, this test can pinpoint the size and location of fat and calcium deposits (plaque) that are narrowing your coronary arteries. Results from cardiac catheterization help determine whether treatment with bypass surgery or percutaneous coronary intervention (PCI), such as angioplasty, may be effective.

Percutaneous coronary intervention (PCI) is similar to cardiac catheterization but it is used to open up a narrowed coronary artery. With PCI, your doctor guides a thin flexible tube (catheter) into the narrowed coronary arteries to open them using special tools and to improve blood flow to your heart. The two common types of PCI are:

• Angioplasty with stenting. The angioplasty is done by attaching a small balloon to the catheter. Once the catheter has been guided to the proper location in a coronary artery, the balloon is inflated. The pressure from the inflated balloon presses the plaque against the wall of the artery to improve blood flow. Once the plaque is compressed using angioplasty, a small expandable wire tube called a stent is inserted into the artery to hold it open. Reclosure of the artery is less likely to occur after angioplasty followed by stenting than after angioplasty alone. This is the most common procedure performed. See a picture of angioplasty.
• Atherectomy. This may be done during cardiac catheterization to open a partially blocked coronary artery. Once the catheter reaches the narrowed portion of the artery, a cutting device, a whirling blade (such as a rotoblade), or a laser beam is used to remove the plaque. This procedure is done in combination with balloon angioplasty or stenting.

Other tests can be done during cardiac catheterization to find heart problems. An X-ray test called a ventriculogram measures how well blood flows through the left side of your heart. The test looks at the movements of the wall of the left ventricle and the heart valves.

Why It Is Done

Cardiac catheterization and coronary artery disease

Cardiac catheterization is done to:

• Check blood flow and blood pressure in the chambers of the heart.
• Check blood flow in the coronary arteries and, if you have coronary artery disease (CAD), determine whether surgery or another type of procedure, such as angioplasty with stenting, is needed to open the blocked blood vessels.

Other reasons for having a cardiac catheterization

Cardiac catheterization is also done to:

• Check the pumping action of the heart.
• Find out if a congenital heart defect is present and how severe it is. Cardiac catheterization sometimes can also be used to help correct the defect.
• Check blood flow through the heart after surgery.
• Find out how well the heart valves work.