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Cardiac (Heart) Catheterization

Cardiac (heart) catheterization is a minimally invasive, outpatient procedure that allows your doctor to effectively diagnose – and often treat – your heart problem.

At UPMC, you will receive your cardiac catheterization care from some of the region's most experienced cardiologists who perform hundreds of cardiac catheterizations each year.



What Is Cardiac Catheterization?

Cardiac catheterization, also known as coronary angiogram, is a diagnostic procedure that allows your cardiologist to see blockages, blood flow, and other problems within the arteries leading to your heart.

Catheterization procedures involve threading a long tube (catheter) into the arteries to bring miniature cameras and instruments to a diseased site in the heart or blood vessels.

Types of cardiac catheterization

Our surgeons perform the following cardiac catheterization procedures:

Angioplasty and stenting

If your doctor finds a blockage during your cardiac catheterization, he or she will perform an angioplasty to remove the blockage. Your doctor will insert a soft wire carrying a balloon and a stent into the catheter and pass them to the site of the blockage. Some stents may be coated with medication that reduces the chance that your coronary artery will become blocked again.

After the balloon has reached the narrowed section of your coronary artery, your cardiologist will inflate the balloon at high pressure. This pressure will crush the blockage against the walls of your artery. After the narrowed area is pushed open, your doctor will place a stent within the newly cleared area. The stent is expanded tightly against your artery wall to hold your artery open.

Is cardiac catheterization the same as a stent?

Cardiac catheterization is the procedure your doctors use to diagnose and treat problems with the blood vessels leading to your heart. During a cardiac catheterization procedure, your doctor may alleviate blockages in your blood vessels and insert a stent to hold the blood vessel open.

Intravascular ultrasound

Intravascular ultrasound uses catheter-based technology to help your doctor see your blood vessels from the inside.

Distal embolic protection

Distal embolic protection devices block blood clots and plaque from traveling through your blood vessels to your brain. These devices are used during catheterization procedures to enhance safety and reduce your risk of stroke.

Rotational atherectomy

During a rotational atherectomy, your doctor uses a rotating instrument on the end of a special catheter to break up tough plaque blockages in your coronary arteries. Rotational atherectomy is often used on blockages that can’t be removed with balloon angioplasty.

Optical coherence tomography (OCT)

OCT uses light to create detailed images of the inside of your blood vessels, allowing your doctor to see blood flow, blockages, and more.

Percutaneous transluminal septal myocardial ablation (PTSMA)

Used to treat cardiomyopathy, PTSMA uses a catheter to inject alcohol into the thickened area of the heart, thinning the tissue to allow blood to move through the heart more freely.

Transradial cardiac catheterization

In a traditional cardiac catheterization, a cardiologist inserts a small, thin tube (a catheter) into the femoral artery near the groin and advances it into the aorta to assess cardiac function and the coronary arteries.

Transradial cardiac catheterization is the same procedure, except the doctor accesses your radial arteryby inserting the catheter through yourwrist. Benefits of transradial cardiac catheterization include:

  • Faster recovery.
  • Less bleeding.
  • Lower risk of nerve damage.

Conditions we treat with cardiac catheterization

UPMC cardiologists use cardiac catheterization to evaluate and treat:

UPMC experts also use catheterization to treat peripheral artery disease, including:

Why Would I Need Cardiac Catheterization?

If you have been diagnosed with a cardiac condition or if you are having a cardiac emergency, such as a heart attack, your doctor may perform a cardiac catheterization to learn more about or treat your condition.

Who is a candidate for cardiac catheterization?

Your doctor may recommend cardiac catheterization to:

  • Evaluate chest pain.
  • Identify narrowed or blocked arteries.
  • Restore blood flow to threatened heart tissues.

What Are the Risks and Complications of cardiac catheterization?

Cardiac catheterization is a safe procedure. However, like all medical procedures, cardiac catheterization comes with some risks, such as:

  • Abnormal heartbeats.
  • Allergic reactions.
  • Bleeding and bruising.
  • Blood clots and stroke.
  • Damage to the artery where the catheter is inserted.
  • Damage to the kidneys.
  • Heart attack.
  • Infection at the insertion site.

What Should I Expect from Cardiac Catheterization?

Before: How to prepare for cardiac catheterization

Your doctor will explain the cardiac catheterization procedure to you and give you a chance to ask questions. To prepare for cardiac catheterization, you should:
  • Tell your doctor if you are sensitive or allergic to any medications, iodine, latex, tape, or anesthetic agents (local and general).
  • Tell your doctor about all medications (prescription and over-the-counter) and herbal or other supplements you are taking.
  • Tell your doctor if you have heart valve disease, as you may need to receive an antibiotic before the procedure. 
  • Tell your doctor if you have a history of bleeding disorders or if you are taking any blood-thinning medications, aspirin, or other medications that affect blood clotting. It may be necessary to stop some of the medications prior to the procedure.
  • Fast for a certain time before the procedure. Your doctor will tell you how long to fast (usually overnight).
  • Have any tests that your doctor recommends. For example, your doctor may request a blood test prior to the procedure to determine how long it takes your blood to clot.

On the day of your cardiac catheterization procedure, be sure to bring your photo ID and health insurance card(s). Leave valuables such as cash and jewelry at home.

After your cardiac catheterization, you may need to stay in the hospital or be discharged the same day. Your doctor will tell you if you need to stay overnight for the type of procedure.

If you will be staying overnight, you should bring toiletries, a robe, slippers, a cell phone and charger, medications, and a change of clothes. You should also arrange for someone to drive you home from the hospital after you are discharged.

How long does cardiac catheterization take?

Cardiac catheterization takes 45 minutes to an hour.

During your cardiac catheterization

Before your cardiac catheterization, several monitoring patches will be placed on your chest, and you will receive an IV to deliver medication and fluids during the procedure.

A small catheter will then be inserted into an artery or vein through your groin or wrist and guided through your aorta into your heart. After the catheter is in place, an opaque, iodine-based fluid will be injected into your coronary blood vessels. This special fluid will show up on an x-ray, which will enable your doctor to see, locate, and measure blockages and other problems in your arteries. Additional tests may be done to evaluate the pressure in your heart chambers and valves.

Are you awake during heart catheterization?

Most patients will receive a mild sedative prior to the procedure and numbing medication at the catheter insertion site. General anesthesia is usually not required.

Recovery after cardiac catheterization

After the catheters are removed, your medical team will apply pressure to the insertion site for several minutes to help stop the bleeding. If your catheter was inserted through your groin, you must remain lying down for 4-6 hours and refrain from moving the limb where the catheter was inserted. If your catheter was inserted through your wrist, you may be able to move around sooner.

How long do you stay in the hospital for a heart catheterization?

Your medical team will need to monitor your blood pressure and check the insertion site frequently, so you will need to remain in the hospital for several hours, or possibly overnight. It is very important that you follow your discharge instructions and take good care of your insertion site to prevent complications.

How long does it take to recover after cardiac catheterization?

Talk to your doctor about when you can resume normal activities or return to work. You may be instructed not to drive for a certain amount of time after the procedure. It also is very important that you see your doctor for follow-up visits as recommended. 

When to call your doctor about cardiac catheterization complications

You should call your doctor if you are experiencing any unusual symptoms, including:

  • A fever of more than 100.0°F.
  • Difficulty breathing.
  • Difficulty swallowing, throat pain, or bloody cough.
  • New or increasing shortness of breath.
  • Pain, redness, bleeding, drainage, or increased swelling at the insertion site.
  • Pain or burning in your chest.
  • Rapid or pounding heartbeat.
  • Redness or rash on your chest or back.
  • Severe pain, coldness, numbness, or discoloration in the limb where the catheter was inserted.

If any of these symptoms are severe, you should dial 911 immediately.

What’s the prognosis after cardiac catheterization?

Depending on your condition, your doctor may be able to provide effective treatment during your cardiac catheterization. Most patients experience few complications after cardiac catheterization.

What is the survival rate of cardiac catheterization?

Nearly all patients survive non-emergency cardiac catheterizations. Emergency cardiac catheterizations due to heart attack and other life-threatening cardiac emergencies have a lower survival rate than non-emergency procedures.

What’s the success rate of cardiac catheterization?

The success rate of cardiac catheterization depends on your condition, overall health, and other factors. Your doctor will discuss the goals and expected success rate of your procedure.

Why Choose UPMC for Cardiac Catheterization?

UPMC has one of the largest and most experienced diagnostic and interventional cardiac catheterization programs in the United States. Our cardiac catheterization laboratories are staffed around the clock with specialists in emergency catheterization who treat acutely ill patients — including many who arrive by helicopter from regional community hospitals.

Other benefits of choosing UPMC for cardiac catheterization include:

  • UPMC was one of the first hospitals in the country to use drug-coated stents, which release a drug into the blood-vessel wall that significantly decreases the likelihood of re-narrowing.
  • UPMC cardiologists have developed a method to support heart function in critically ill patients without surgery.
  • UPMC has a dedicated transradial cardiac catheterization program. In select patients, this approach allows for diagnostic and therapeutic cardiac catheterization via the radial artery in the wrist, instead of the traditional leg approach.

Medically reviewed by Kathryn Elizabeth Fatigante, PA-C on 2024-10-01.