Who performs cardiac catheterization?

Cardiologists and interventional cardiologists often perform cardiac catheterizations. A cardiologist is a doctor who focuses on diagnosing and treating heart diseases. Many cardiologists are trained to perform nonsurgical, catheter-based procedures and specialized imaging techniques (interventional cardiology). 

Other specialists who perform cardiac catheterization include:

  • Cardiac surgeons specialize in the surgical treatment of conditions of the heart and its blood vessels. Cardiac surgeons may also be known as cardiothoracic surgeons.
  • Pediatric cardiologists are internists or pediatricians who have extra training in the medical care conditions and diseases of the heart and its blood vessels.
  • Thoracic surgeons specialize in the surgical treatment of diseases of the chest, including the blood vessels, heart, lungs and esophagus. Thoracic surgeons may also be known as cardiothoracic surgeons.

How is cardiac catheterization performed?

Your cardiac catheterization will be performed in a hospital or outpatient setting. It takes several hours and generally includes these steps:

  1. You will dress in a patient gown and lie on a procedure table.
  2. Your team will insert an IV to provide fluids, medications, or a contrast agent.
  3. Your team attaches devices to monitor your heart rate and blood pressure.
  4. Your team may give you sedative medications through the IV to help you relax.
  5. Your doctor will determine the location to insert the catheter, often in the groin. The team will shave, clean and numb the area with a local anesthetic. 
  6. Your doctor will make an incision and insert the catheter through the incision. Your doctor will guide the catheter to your heart using special real-time, moving X-rays that he or she sees on a video screen. 
  7. Your doctor will perform an angiography. This involves injection of a contrast agent (dye) through the catheter. The contrast agent improves the image quality. The team then takes X-rays as the contrast agent flows through your heart’s blood vessels. You may feel a brief sensation of warmth during the procedure.
  8. Your doctor may complete other procedures, such as opening a narrowed artery (angioplasty) and placing a stent to keep the artery open.
  9. Your doctor will remove your catheter and sew up the incision.

Will I feel pain?

Your comfort and relaxation is important to you and your care team. You may feel a pinch or pin prick pain during the IV placement and some brief stinging when the catheter site is numbed. You will have enough sedative medications to keep you comfortable. Tell your doctor or care team if you are uncomfortable.

What are the risks and potential complications of cardiac catheterization?  

Cardiac catheterization involves risks and potential complications. Complications may become serious in some cases. Complications can occur during the procedure or recovery. Complications include: 

  • Abnormal heart rhythms (cardiac arrhythmias)
  • Adverse reaction or problems related to sedation or contrast agents, such as an allergic reaction and problems with breathing
  • Bleeding
  • Blood clots that can cause a heart attack, stroke or death
  • Damage to the artery from the catheter
  • Exposure to radiation, which may be harmful in excessive doses. Your care team follows strict standards for X-ray techniques and will use the lowest amount of radiation possible to make the best images.
  • Infection
  • Kidney injury from the contrast agent, especially if you have kidney disease
  • Low blood pressure
  • Need for immediate open heart surgery

Reducing your risk of complications

You can reduce the risk of certain complications by following your treatment plan and: 

  • Following activity, dietary and lifestyle restrictions and recommendations before your procedure and during recovery
  • Informing your doctor if you have kidney disease or diabetes
  • Informing your doctor or radiologist if you are nursing or there is any possibility that you may be pregnant
  • Notifying your doctor immediately of any concerns, such as bleeding, fever, or increase in pain
  • Taking your medications exactly as directed 
  • Telling all members of your care team if you have any allergies, especially iodine or shellfish