Cost of left heart catheterization by state

What is a left heart catheterization?

A left heart catheterization is an invasive procedure in which the heart arteries are able to be visualized on a screen to assess for heart blockages, or plaque, that might require a stent or bypass surgery.  This is a very commonly performed procedure that your doctor may order if you have had an abnormal stress test or symptoms that are concerning for heart disease, such as chest pain or shortness of breath.

Are you awake during a heart catheterization?

Typically, you are awake or given a light sedative that allows you to sleep through the procedure and not remember most of it. You are not put under general anesthesia. You will be given local anesthesia into your skin at the site of the catheter insertion.

The doctor will insert a small tube called a catheter either through the big artery at the top of the leg, or in your arm, and direct the catheter into the heart arteries. The arteries are injected with iodine, which allow them to be visualized on a screen above your body. The heart arteries can be visualized in multiple views to assess how much, if any, plaque is present. If severe blockage is present, you may need either a stent or bypass surgery to help restore adequate blood flow to the heart. 

Additional information can be obtained during the procedure about the size of the various blood vessels, strength of your heart, and valve functioning.

What is the difference between a right heart cath and a left heart cath?

A right heart cath is an invasive procedure. Your doctor may recommend a right heart cath if you are having breathing problems, are being assessed for a heart or lung transplant, or have a heart valve condition. Patients are either not sedated but given light local anesthesia, or given a light oral or IV sedative. In contrast to the left heart cath, the catheter is inserted into a big vein in the neck, arm, or the top of your leg.  Information that can be obtained from a right heart cath include oxygen levels at various levels of the heart, pressure levels in the heart and lungs, and data on how well the heart is pumping. 

A right and left heart cath can be performed during the same procedure.

Is a heart cath the same as a stent?

A heart cath is not the same as a stent.  A left heart cath is the procedure in which the heart blood vessels are assessed for blockage. At the same time, if there is a heart artery that has a major blockage, a stent can be placed. This involves ballooning open the area of blockage, then feeding a small spring- like device (stent) through a catheter and placing it in the affected area to help prop open the artery. The stent stays in your artery and becomes part of your body.

What are the risks of a left heart catheterization?

There is a small amount of risk to performing this procedure, since it involves putting a catheter into the body.  These risks include bleeding and infection.

Additionally, there is a small risk of causing a heart attack or stroke during the procedure, if a piece of plaque breaks loose and lodges in the brain or heart.

The iodine that is used to visualize the heart arteries can irritate the kidneys.  If you have kidney problems or diabetes, this should be discussed with your doctor ahead of time so that the procedure can be performed as safely as possible.

Some people are allergic to iodine.  If you have a had iodine in the past and developed a rash or breathing problems, be sure to let your doctor know before the procedure is scheduled.

How long does it take to recover from a heart catheterization?

You should be awake and able to eat and drink within an hour after the test is completed.  If you did not need a stent placed, you may be able to go home within a few hours of the procedure.  You will be monitored for any sites of bleeding or bruising at the site of the catheter placement for a couple of hours.  You may be sore at the site of the catheter insertion (neck, arm, or leg) for a few days.

If you need a stent placed, it is typically performed during the same procedure, and you may stay overnight in the hospital and go home the next day.

What can you not do after a heart cath?

You may have a protective bandage at the site where the catheter was placed.  You will be given instructions on when to remove this, and when you can shower or get the site wet.  You should avoid heavy lifting or straining for about one week after the procedure, if the catheter was placed in your leg.  If the catheter was placed in your wrist, you should avoid heavy lifting or excessive bending of your wrist for one week.  You will be instructed to monitor the catheter site for redness, bleeding, bruising, or swelling and should report this to the doctor if it happens.