Coronary artery disease is caused by the buildup of plaque on the inside of your coronary arteries. In most people, plaque buildup begins early in life and gradually develops over a lifetime.
Coronary artery disease typically begins when the inside walls of the coronary arteries are damaged because of another health problem, such as:
High cholesterol.
High blood pressure.
Diabetes.
Smoking.
Plaque, which is made up of excess cholesterol, calcium, and other substances in your blood, builds up on the damaged inner walls of your coronary arteries. This process usually occurs throughout the body and is called atherosclerosis, or "hardening of the arteries."
Over time, plaque buildup narrows the coronary arteries and can lead to ischemia (insufficient blood flow to the heart muscle). Ischemia (say "is-KEE-mee-uh") can weaken the heart muscle, but it usually does not cause heart muscle cells to die.
But heart muscle cells can die if blood flow is severely reduced or completely blocked for a period of time. This can happen if plaque breaks apart and makes a clot that blocks an artery. This can cause myocardial infarction, or heart attack.
Symptoms of coronary artery disease
The most common symptoms of coronary artery disease are:
Chest pain, also called angina.
Shortness of breath when exercising or during another vigorous activity.
Other symptoms include:
A fast heartbeat.
Weakness, dizziness, and feeling sick to your stomach (nausea).
Increased sweating.
Angina (chest pain)
Chest pain, also called angina, is the most common symptom of coronary artery disease. The pain may have a distinct pattern. Angina can be described as:
A feeling of pressure, heaviness, weight, tightness, squeezing, discomfort, burning, or dull aching in the chest. People often put their fist to their chest when describing the pain.
Hard to pinpoint (you can't point to the exact location of the pain). Pressing on the chest wall does not cause the pain.
The chest pain of angina usually begins at a low level, then increases over several minutes to a peak. Angina that starts with an activity usually will decrease when the activity is stopped. Chest pain that begins suddenly or lasts only a few seconds is less likely to be angina.
Angina usually begins in the chest, but it can also start in or spread to different areas of the body, such as:
Down the left arm (most common site).
To the left shoulder.
To the neck or lower jaw.
To the mid-back.
Down the right arm.
Some people may feel tingling or numbness in their arm, hand, or jaw when they have angina.
Angina is often brought on by activities that make the heart work harder, because the heart needs more oxygen than can be delivered through the narrowed arteries. Some of these activities include:
Strenuous exercise (especially if you ordinarily do not exercise).
Use of cocaine or amphetamines.
Exposure to cold temperatures.
Sudden, intense emotions such as anger or fear.
Smoking.
Eating a heavy meal.
Many people have stable angina, which is predictable. It eases after they rest and take nitroglycerin, a medicine that opens blood vessels to improve blood flow. But if there is a change in the usual pattern of your angina, you may have unstable angina. In unstable angina, chest pain occurs at rest or with less and less exertion, may be more severe and last longer, or doesn't respond to nitroglycerin. Because unstable angina can progress to a heart attack, it requires medical attention right away.
Tests to diagnose coronary artery disease
If your doctor thinks you may have heart disease, you will need some tests to make sure. Most often, the first tests include:
An electrocardiogram (EKG or ECG).
A chest X-ray.
Blood tests.
An exercise electrocardiogram. This is also called a "stress test."
Other tests may include:
Cardiac perfusion scan. This test shows if you have enough blood flow to the heart.
Echocardiogram and stress echocardiogram. This test uses ultrasound to see areas of poor blood flow in the heart. It can also check how well your heart is working after a heart attack. The test can help your doctor find out how much blood your heart is pumping during each heartbeat (ejection fraction).
Coronary angiogram. This is an X-ray test that creates pictures of the blood flow through your coronary arteries. It allows your doctor to see any blockage or narrowing of the artery. It's done using a soft, thin tube (catheter) that is put in a blood vessel in the arm or groin and gently moved into the heart. Most often, the test is only done if bypass surgery or angioplasty is an option.
Treatment Overview
Treatment for coronary artery disease focuses on taking steps to manage symptoms and reduce the risk of heart attack and stroke. For example:
If your doctor agrees, take a low-dose aspirin each day to reduce your risk of heart attack.
If you can't control your high blood pressure and high cholesterol with healthier habits, you may need to take medicines. They can help you manage these health problems and lower your risk.
Your doctor may also suggest medicines if you often have chest pain that makes it hard to do everyday activities.
If medicines don't help your chest pain, your doctor may suggest procedures to improve blood flow to the heart. Angioplasty with or without stent placement is one way to open clogged coronary arteries. Or sometimes coronary artery bypass graft surgery may be needed.
No matter what kind of treatment you get, healthy habits such as quitting smoking, eating a heart-healthy diet, and getting regular exercise are important. You can start today:
Initial treatment
Lifestyle changes are the first step for anyone with coronary artery disease. But sometimes lifestyle changes are not enough. You may also need medicines.
Lifestyle changes
When you're first diagnosed with heart disease, your doctor will strongly advise you to make lifestyle changes. These include quitting smoking, eating a heart-healthy diet, and getting regular exercise. These healthy habits can slow or even stop the disease and improve the quality and length of your life.
Quit smoking. It's the best thing you can do to reduce your risk of future problems. And avoid secondhand smoke. People with heart disease who keep smoking have a 43% greater chance of dying from a heart attack than those who quit.
Your doctor may prescribe medicine and counseling to help you quit. Nicotine replacement therapy, the medicines bupropion (Zyban or Wellbutrin) and varenicline (Chantix), and counseling can help you quit for good.
Eat a heart-healthy diet. This can help you keep your disease from getting worse. It means:
Eat more fruits, vegetables, whole grains, and other high-fiber foods.
Choose foods that are low in saturated fat, trans fat, and cholesterol.
Limit salt.
Stay at a healthy weight by balancing the calories you eat with how much physical activity you get.
Eat more foods that are high in omega-3 fatty acids, such as fish.
Start an exercise program (if your doctor says it's safe). Try walking, swimming, biking, or jogging for at least 30 minutes on most, if not all, days of the week. You may need to start slow and build up to this amount. Any activity you enjoy will work, as long as it gets your heart rate up. In people with heart disease, exercise reduces the chances of having a fatal heart attack.
Medicines
Aspirin - Your doctor will probably recommend that you take an aspirin every day. Aspirin can reduce the risk of having a heart attack in people with heart disease. Lower doses seem to work as well as higher doses to prevent heart attacks, and they have fewer side effects. Talk with your doctor before you start taking aspirin.
Cholesterol - If you have average to high cholesterol, your doctor may prescribe a medicine to lower your cholesterol, such as a statin.
Chest pain
If you have chest pain (angina), your doctor may prescribe medicines such as:
Nitroglycerin and other nitrates, which relax arteries and increase blood flow.
Beta-blockers, which decrease the heart's workload.
Calcium channel blockers, which may be used to treat angina if you can't take beta-blockers.
Ranolazine, if nitroglycerin, beta-blockers, and calcium channel blockers don't help your chest pain. Unlike other medicines used to treat angina, ranolazine doesn't affect heart rate or blood pressure. Most of the time, it is taken with nitrates or beta-blockers.
An ACE inhibitor. ACE inhibitors save lives and reduce the risk of heart attack in people with heart disease.
Ongoing treatment
After you start treatment for coronary artery disease, your doctor will want to keep track of how you are doing. He or she will want to know if you've made lifestyle changes and if they have helped. For example, your blood pressure, cholesterol, and weight will be checked. These measures will help your doctor find out if lifestyle changes are working.
If you take medicines, your doctor will want to know if you feel any side effects. If you take medicine for chest pain (angina), your doctor will want to know how well it works. Does the medicine ease your pain quickly? Do you get chest pain less often?
You will likely need to keep taking medicines that lower your cholesterol and blood pressure and that reduce your risk of having a heart attack. Your doctor will also want to check how well these medicines work for you. If they're not working, he or she may want you to try a different dose or take a different kind of medicine.
It can be hard to make lifestyle changes on your own. If you need help, talk to your doctor about cardiac rehabilitation. In cardiac rehab, a team of health professionals provides education and support to help you make new, healthy habits.
Treatment if the disease gets worse
Sometimes coronary artery disease gets worse even with treatment. If you start to have abnormal heart rhythms (arrhythmias), your doctor might suggest a pacemaker or medicines to control your heart rate.
If your chest pain keeps getting worse even though you are taking medicines, you may need procedures to improve blood flow to your heart. They are also done when the coronary arteries are severely blocked. These procedures include angioplasty with or without stenting and coronary artery bypass graft (CABG) surgery.
When deciding between bypass surgery and angioplasty, your doctor will think about several things, such as how many arteries are blocked and whether you have diabetes.
Coronary artery disease can lead to heart failure and the need for other medicines. These medicines can help you feel better and prevent your heart failure from getting worse.
Palliative care
If your coronary artery disease gets worse, you may want to think about palliative care. Palliative care is a kind of care for people who have diseases that do not go away and often get worse over time. It is different from care to cure your illness, which is called curative treatment.
Palliative care focuses on improving your quality of life-not just in your body, but also in your mind and spirit. Some people combine palliative care with curative care.
Palliative care may help you manage symptoms or side effects from treatment. It can also help you and your family to:
Cope with your feelings about living with a long-term disease.
Make future plans around your medical care.
Understand your disease and how to support you.
Prevention
You can slow or even prevent coronary artery disease by taking steps toward a healthier lifestyle. Many people already have. More people are adopting healthy habits such as eating right, exercising more, and not smoking. Doing these things can also help reduce risk factors such as high cholesterol and high blood pressure. In one study by the American Heart Association, the number of deaths from heart disease dropped because so many people made these kinds of changes.
Lifestyle changes
Quit smoking. It may be the best thing you can do to prevent heart disease. Smokers who quit cut their risk of heart disease by half after 1 year. You can cut your risk even more by staying away from cigarettes for good. After 15 years of not smoking, your risk of death from heart disease is the same as if you had never smoked at all. And avoid secondhand smoke.
Exercise. There are lots of ways that exercise boosts your health. It can lower cholesterol and blood pressure. It can also help you reach a healthy weight. Try to exercise for at least 30 minutes on most, if not all, days of the week. Talk to your doctor before starting an exercise program.
Eat a heart-healthy diet. The way you eat can help you control your cholesterol and blood pressure. It can be hard to know what's best to eat for a healthy heart. See these guidelines for heart-healthy eating for general tips and special diets to help lower cholesterol and blood pressure. Remember that some foods you may hear about are just fads that don't prevent heart disease at all.
These three big changes-quitting smoking, getting exercise, and eating right-will give you the best chance at preventing heart disease. But there are a few other things you can do to keep yourself healthy.
Relax, and reduce stress. Stress can hurt your heart. Keep stress low by talking about your problems and feelings, rather than keeping your feelings hidden. Try exercise, deep breathing, meditation, or yoga.
Manage depression and anger. Getting treatment for depression and learning how to manage anger can help you stay healthy.
Control your cholesterol and blood pressure
To reduce your risk of heart disease, it's important to control your cholesterol and manage your blood pressure. Quitting smoking, changing the way you eat, and getting more exercise can help. But if these things don't work, you may need to take medicines as well.
Aspirin to prevent heart attack and stroke
If you're already at risk for heart disease, taking daily aspirin may reduce your chances of having a stroke or a heart attack. That's because a daily aspirin lowers your risk of getting blood clots. Blood clots can lead to a heart attack in people with heart disease. Clots can also cause heart attacks in people who have other problems that can lead to heart disease, such as diabetes, high blood pressure, and high cholesterol.
Taking aspirin has some risks. Talk with your doctor before starting aspirin treatment.
What is angina pectoris?
Angina pectoris, often called simply "angina", can be the earliest symptom of coronary artery disease. It is usually experienced as a pain in the chest. A person might feel a sense of heaviness, tightness, pain, burning, pressure, or a squeezing sensation, usually behind the breastbone but sometimes also in the arms, neck, or jaws. Other possible symptoms include feeling short of breath, experiencing an irregular heartbeat, or a loss of stamina when trying to exercise. A person may notice it during exertion (such as in climbing stairs). It is often relieved within a few minutes by resting or by taking prescribed angina medicine. People who have been diagnosed with angina have a greater risk of a heart attack than do other people. However, an episode of angina is NOT a heart attack, although it may be difficult to tell the difference between angina symptoms and heart attack symptoms.
What are the risk factors for CAD?
Risk factors are conditions that increase your risk of developing heart disease. Risk factors that we have no control over include gender, family history and age.
Risk factors that can be changed, or controlled, are referred to as "Controllable Risk Factors." These factors include high blood pressure, high cholesterol, smoking, obesity, physical inactivity, and diabetes.
Stress is sometimes listed as a possible risk factor for coronary artery disease, but in reality, we still don't know exactly how stress might be involved in heart disease.
Although each of these factors increases the risk of coronary artery disease, they do not describe all of the causes. In other words, even if a person had none of these risk factors, they might still develop coronary artery disease.
What is an echocardiogram?
Using sound waves that bounce off of the heart's walls and valves, an echocardiogram provides a "picture" of the shape, texture and movement of the heart. An echocardiogram gives the provider a sense of how well the chambers of the heart are working. This test is particularly useful when evaluating abnormal valves or wall motion defects. There are several types of echocardiograms, including stress echocardiograms, and transesophageal echocardiograms, or TEE's.
What is coronary angiography?
Coronary angiography is used to explore the coronary arteries. A thin tube called a catheter is put into an artery of an arm or leg and guided to the heart with the aid of a special X-ray machine. Contrast dye is injected through the catheter so that the heart and blood vessels can be filmed while the heart pumps. The picture that is seen, called an angiogram or arteriogram, will show problems such as a blockage caused by atherosclerosis.
What is electrophysiology (EP) testing?
The electrophysiology study, also called an EP study, is a test that records the electrical activity and measures the electrical pathways of your heart. During EP testing, electrode catheters (flexible, insulated wires with metal electrode tips) are inserted into the heart in order to study the cardiac electrical system. This test is used to determine the cause of heart rhythm disturbance, and to help the provider develop a treatment plan for that arrhythmia.
What is ablation therapy?
Ablation therapy uses energy sources, such as radio frequency, or microwave energy to correct an irregular heartbeat. Various types of ablation are used depending on the type of arrhythmia experienced by the patient.
During ablation, a catheter is inserted into the patient's heart and then a device is used to direct energy to the heart muscle. This technique can either "disconnect" or "isolate" the pathway of the abnormal rhythm. The energy may also be used to disconnect the electrical pathway between the atria, or upper chambers, and the ventricles, or lower chambers of the heart.
What is a Holter Monitor?
A Holter monitor is a test that allows your provider to determine if there are changes in the heart's rhythm or electrical appearance over a longer period of time than can be easily observed during one doctor's appointment. It is most often done to evaluate symptoms that come and go and that might be related to heart-rhythm changes. Usually the Holter monitor is used over a 24-hour period, in the comfort of your own home
What is a pacemaker, and how does it work?
A pacemaker is a small device that sends electrical impulses to the heart muscle to maintain a healthy heart rate and rhythm. This device sets the pace for the heart, and helps to regulate arrhythmia, which is the term used to describe an irregular heartbeat. Arrhythmia sometimes results from heart disease, although there are other causes as well.
A pacemaker is used when the heart's natural pacemaker is not working properly or the heart's own electrical pathway is blocked. During a simple operation, this electrical device is placed under the skin. A lead extends from the device to the right side of the heart, where it is permanently anchored.
What is angioplasty?
Angioplasty is a cardiology procedure that can be used to open blocked coronary arteries. In this procedure, a fine tube, or catheter, is threaded through an artery into the narrowed heart vessel. The catheter has a tiny balloon at its tip. The balloon is repeatedly inflated and deflated to open and stretch the artery, improving the flow of blood. The balloon is then deflated, and the tube is removed.
During the angioplasty, providers sometimes insert a wire mesh tube, called a stent, into the narrowed artery. The stent keeps the artery open, hopefully on a permanent basis.
What is a coronary bypass surgery?
When a patient's coronary arteries are blocked, the provider may treat the problem by giving the blood a new pathway to the heart (also known as a "graft"). This procedure is called coronary artery bypass surgery. During this procedure, a blood vessel is removed from one area of the body and placed around the area of narrowing to "bypass" it and restore blood flow to the heart muscle.
What are the warning-signs for heart attack?
CHEST DISCOMFORT - Most heart attacks involve discomfort in the center of the chest that can last for more than a few minutes, or come and go, intermittently. The discomfort can feel like unpleasant pressure, squeezing, fullness, or pain.
UPPER BODY DISCOMFORT - Discomfort in other areas of the upper body can also signal a heart attack. This can include pain or discomfort in one or both arms, the back, neck, jaw, or stomach.
SHORTNESS OF BREATH - A third common warning sign for heart attack is shortness of breath. This is often experienced in combination with chest discomfort, although it can also occur before chest discomfort.
COLD SWEAT, NAUSEA AND LIGHT-HEADEDNESS - Other heart attack warning signs may include breaking out in a cold sweat, experiencing nausea, or light-headedness.
If you experience any of these symptoms, be sure to call an ambulance or immediately rush to nearby hospital, preferably to a heart hospital with the help of one else not by self driving. Heart attacks often start out slowly with only mild pain or discomfort. Even if you're not sure it's a heart attack, you should still have it checked out. In fact, there are some heart attack treatments that are substantially more effective if started within one hour after the symptoms begin. For that reason, it's crucial that you act quickly if you have any reason to suspect that you're having a heart attack.
What Is Cardiac Catheterization?
Cardiac catheterization (KATH-e-ter-i-ZA-shun) is a medical procedure used to diagnose and treat certain heart conditions.
A long, thin, flexible tube called a catheter is put into a blood vessel in your arm, groin (upper thigh), or neck and threaded to your heart. Through the catheter, doctors can do diagnostic tests and treatments on your heart.
For example, your doctor may put a special dye in the catheter. This dye will flow through your bloodstream to your heart. Once the dye reaches your heart, it will make the inside of your coronary (heart) arteries show up on an x ray. This test is called coronary angiography (an-jee-OG-ra-fee).
The dye can show whether a substance called plaque (plak) has narrowed or blocked any of your coronary arteries. Plaque is made up of fat, cholesterol, calcium, and other substances found in your blood.
Plaque narrows the inside of the arteries and, in time, may restrict blood flow to your heart. When plaque builds up in the coronary arteries, the condition is called coronary heart disease (CHD) or coronary artery disease.
Blockages in the coronary arteries also can be seen using ultrasound during cardiac catheterization. Ultrasound uses sound waves to create detailed pictures of the heart's blood vessels.
Doctors may take samples of blood and heart muscle during cardiac catheterization and do minor heart surgery.
Cardiologists (heart specialists) usually do cardiac catheterization in a hospital. You're awake during the procedure, and it causes little to no pain. However, you may feel some soreness in the blood vessel where the catheter was inserted. Cardiac catheterization rarely causes serious complications.
Who Needs Cardiac Catheterization?
Cardiac catheterization is used to diagnose and/or treat many heart conditions. Doctors may recommend this procedure for various reasons. The most common reason is to evaluate chest pain.
Chest pain may be a symptom of coronary heart disease (CHD). Cardiac catheterization can show whether plaque is narrowing or blocking your heart's arteries.
Doctors can treat CHD during cardiac catheterization with a procedure called angioplasty (AN-jee-oh-plas-tee). During angioplasty, a tiny balloon is put through the catheter and into the blocked artery. When the balloon is inflated, it pushes the plaque against the artery wall. This creates a wider pathway for blood to flow to the heart.
Sometimes a stent is placed in the artery during angioplasty. A stent is a small mesh tube that's used to treat narrowed or weakened arteries in the body.
Most people who have heart attacks have partly or completely blocked coronary arteries. Thus, cardiac catheterization may be done on an emergency basis while you're having a heart attack. When used with angioplasty, the procedure allows your doctor to open up blocked arteries and prevent more damage to your heart.
Cardiac catheterization also can help your doctor figure out the best treatment for your CHD if you:
Recently recovered from a heart attack, but are having chest pain
Had a heart attack that caused major damage to your heart
Had an EKG (electrocardiogram), stress test, or other test with results that suggested heart disease
You also may need cardiac catheterization if your doctor suspects you have a heart defect or if you're about to have heart surgery. The procedure shows the overall shape of your heart and the four large spaces (heart chambers) inside it. This inside view of the heart will show certain heart defects and help your doctor plan your heart surgery.
Sometimes doctors do cardiac catheterization to see how well the valves at the openings and exits of the heart chambers are working. Valves control the flow of blood in the heart.
To check your valves, your doctor will measure blood flow and oxygen levels in different parts of your heart. Cardiac catheterization also can check how well a man-made heart valve is working and how well your heart is pumping blood.
If your doctor thinks you have a heart infection or tumor, he or she may take samples of your heart muscle through the catheter. With the help of cardiac catheterization, doctors can even do minor heart surgery, such as repair certain heart defects.
What To Expect Before Cardiac Catheterization
Before having cardiac catheterization, discuss with your doctor:
How to prepare for the procedure
Any medicines you're taking, and whether you should stop taking them before the procedure
Whether you have diabetes, kidney disease, or other conditions that may require taking extra steps during or after the procedure to avoid complications
It may not be safe to drive after having cardiac catheterization, so you must arrange arrange for a ride home.
What To Expect During Cardiac Catheterization
Cardiac catheterization is done in a hospital. During the procedure, you'll be kept on your back and awake. This allows you to follow your doctor's instructions during the procedure. You'll be given medicine to help you relax, which may make you sleepy.
Your doctor will numb the area on the arm, groin (upper thigh), or neck where the catheter will enter your blood vessel. A needle is used to make a small hole in the blood vessel. Through this hole your doctor will put a tapered tube called a sheath.
Next, your doctor will put a thin, flexible wire through the sheath and into your blood vessel. This guide wire is then threaded through your blood vessel to your heart. The wire helps your doctor position the catheter correctly. Your doctor then puts a catheter through the sheath and slides it over the guide wire and into the coronary arteries.
Special x-ray movies are taken of the guide wire and the catheter as they're moved into the heart. The movies help your doctor see where to position the tip of the catheter.
When the catheter reaches the right spot, your doctor will use it to do tests or treatments on your heart. For example, your doctor may do angioplasty and stenting.
The animation below shows the process of cardiac catheterization. Click the "start" button to play the animation. Written and spoken explanations are provided with each frame. Use the buttons in the lower right corner to pause, restart, or replay the animation, or use the scroll bar below the buttons to move through the frames.
During the procedure, your doctor may put a special dye in the catheter. This dye will flow through your bloodstream to your heart. Once the dye reaches your heart, it will make the inside of your heart's arteries show up on an x ray called an angiogram. This test is called coronary angiography.
Coronary angiography can show how well blood is being pumped out of the heart's main pumping chambers, which are called ventricles (VEN-trih-kuls). When the catheter is inside your heart, your doctor may use it to take blood samples from different parts of the heart or to do minor heart surgery.
To get a more detailed view of a blocked coronary artery, your doctor may do intracoronary ultrasound. For this test, your doctor will thread a tiny ultrasound device through the catheter and into the artery. This device gives off sound waves that bounce off the artery wall (and its blockage) to make an image of the inside of the artery.
If the angiogram or intracoronary ultrasound shows blockages or other possible problems in the heart's arteries, your doctor may use angioplasty to open the blocked arteries.
After your doctor does all of the needed tests or treatments, he or she will pull back the catheter and take it out along with the sheath. The opening left in the blood vessel will then be closed up and bandaged. A small weight may be put on top of the bandage for a few hours to apply more pressure. This will help prevent major bleeding from the site.
What To Expect After Cardiac Catheterization
After cardiac catheterization, you will be moved to a special care area. You will rest there for several hours or overnight. During that time, your movement will be limited to avoid bleeding from the site where the catheter was inserted.
While you recover in this area, nurses will check your heart rate and blood pressure regularly. They also will check for bleeding from the catheter insertion site.
A small bruise may develop on your arm, groin (upper thigh), or neck at the site where the catheter was inserted. That area may feel sore or tender for about a week. Let your doctor know if you develop problems such as:
A constant or large amount of bleeding at the insertion site that can't be stopped with a small bandage
Unusual pain, swelling, redness, or other signs of infection at or near the insertion site
Talk to your doctor about whether you should avoid certain activities, such as heavy lifting, for a short time after the procedure.
What Are the Risks of Cardiac Catheterization?
Cardiac catheterization is a common medical procedure that rarely causes serious problems. However, complications can include:
Bleeding, infection, and pain where the catheter was inserted.
Damage to blood vessels. Rarely, the catheter may scrape or poke a hole in a blood vessel as it's threaded to the heart.
An allergic reaction to the dye used.
Other, less common complications of the procedure include:
Arrhythmias (irregular heartbeats). These often go away on their own, but may need treatment if they persist.
Damage to the kidneys caused by the dye used.
Blood clots that can trigger stroke, heart attack, or other serious problems.
Low blood pressure.
A buildup of blood or fluid in the sac that surrounds the heart. This fluid can prevent the heart from beating properly.
As with any procedure involving the heart, complications can sometimes be fatal. However, this is rare with cardiac catheterization.
The risk of complications with cardiac catheterization is higher if you have diabetes or kidney disease, or if you're aged 75 or older. The risk of complications also is greater in women and in people having cardiac catheterization on an emergency basis.
Key Issues
Cardiac catheterization is a medical procedure used to diagnose and treat certain heart conditions. A long, thin, flexible tube called a catheter is put into a blood vessel in your arm, groin (upper thigh), or neck and threaded to your heart. Through the catheter, doctors can do diagnostic tests and treatments.
Cardiac catheterization most often is used to evaluate chest pain. It also may be done during a heart attack to identify narrowed or blocked coronary arteries. You also may need this procedure if other tests suggest you have coronary heart disease (also called coronary artery disease).
Before having cardiac catheterization, discuss with your doctor how to prepare for the test and any special steps you need to follow. It may not be safe to drive after the procedure, so you must arrange for a ride home.
Cardiac catheterization is done in a hospital. During the procedure, you'll be kept on your back and awake. This allows you to follow your doctor's instructions during the procedure. You'll be given medicine to help you relax.
After the procedure, you'll be moved to a special care area. You will rest there for several hours or overnight. During this time, your movement will be limited to avoid bleeding from the site where the catheter was inserted.
A small bruise may develop at the site where the catheter was inserted. That area may feel sore or tender for about a week. You need to let your doctor know if you have a lot of bleeding from that area or signs of infection. You may have to avoid doing certain activities, such as heavy lifting, for a short time after the procedure.
Cardiac catheterization is a common medical procedure that rarely causes serious complications. The risk of complications is higher in people who have diabetes and kidney disease, and in older people and women.
