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Cardiac catheterization is a cardiological examination aimed at assessing the condition of the heart. It allows, among others for the direct measurement of pressure in the heart cavities and in the large blood vessels leaving it. It is necessary, for example, before complicated cardiac surgery procedures. What is cardiac catheterization? How does the patient's preparation for the examination look like? What are the complications after cardiac catheterization?

Cardiac catheterizationiscardiological examination , which is performed using a vascular (venous or arterial) catheter. This diagnostic method allows you to directly measure the pressure in the various chambers of the heart and the large vessels coming out of it, as well as to determine the degree of oxygen saturation in the blood.

Cardiac catheterization - indications

Cardiac catheterization is performed to evaluate the ejection fraction, i.e. the volume of blood that has been ejected into the aorta during systole, and the systolic and diastolic volumes of the heart, i.e .:

  • end-diastolic volume - that is, the volume of blood that remains in the ventricle just before contraction
  • end systolic - i.e. the volume of blood that remains in the ventricle after systole

This type of information is essential when there are diagnostic concerns about certain congenital heart defects or when the severity of a heart defect needs to be determined (e.g. mitral and aortic valve disease). Cardiac surgery or cardiac surgery also requires prior cardiac catheterization, as the test provides information about possible heart disorders, cardiac structural abnormalities, as well as aneurysms and thrombi. Cardiac catheterization is also performed in the case of pulmonary arterial hypertension.

Cardiac catheterization - how does patient preparation look like?

Before cardiac catheterization, some basic tests should be performed: ECG, heart and chest X-ray, and echocardiography. A follow-up visit to the dentist is also recommended. It is also advisable to shave the groin.

Immediately before the examination, local anesthesia and a sedative are administered. When the patient is a child, general anesthesia is performed. Before the examination, you should undress.Then the patient is placed on a special table and covered with a surgical sheet.

Cardiac catheterization - course

During the examination, which lasts several dozen minutes, the patient is lying on his back. In the case of catheterization of the "left heart" cavities, the test consists of a percutaneous puncture of the femoral artery (hence the need for depilation of the groin) and the introduction of the so-called an arterial catheter into the aorta, which is then advanced through the lumen of the vessel through the aortic valve into the left ventricle and large vessels. In order to get to the right ventricle, the vein is punctured and the so-called venous catheter through the venous vessels towards the right atrium, heart and pulmonary artery.

The movements of the catheter in the vessels and cavities of the heart are visible on the monitor screen. To assess whether the catheter is in the right place, a contrast is administered and then a beam of x-rays is passed through the patient's body. Typically, at the end of the test, contrast (contrast agent) is administered to the heart cavities to give a feeling of warmth spreading throughout the body.

Important

Any sudden symptoms, even the slightest, should be reported during the examination (e.g. chest pain, shortness of breath, warmth).

After the examination, the vascular sheath is removed, and a tourniquet is put on the injection site, which can be removed after a few, preferably several hours.

After the end of the examination, the patient must lie still for several hours, therefore he is taken to the hospital ward. It is not recommended to eat during this time.

The test result is provided in the form of a description, sometimes with x-ray plates or video tapes attached to it.

Important

What should I inform my doctor about before catheterization of the heart?

Before cardiac catheterization, inform the examiner about

  • bleeding tendency (e.g. bleeding disorder)
  • allergic to contrast agents
  • pregnancy
  • medications (especially those that can reduce blood clotting)

Cardiac catheterization - complications after the procedure

The most common complication after cardiac catheterization is a hematoma at the site of catheter insertion.

An allergic reaction to the contrast agent in the form of skin lesions that passes quickly is also possible. You may experience vomiting, nausea and headaches that pass quickly.

The list of very rare complications includes: puncture of the heart muscle by a catheter, sudden closure of the vessel, myocardial infarction, damage to the vessel wall, infection, arrhythmias andconduction.

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