Many people with chest pain will find themselves referred to a cardiologist for a test to find heart blockages. McLeod Cardiologist Fred Krainin, MD, describes the role and process of the cardiac catheterization:
Here are highlights from Dr. Krainin’s comments:
A cardiac catheterization is a test that is designed to determine if a patient has any blockages in their coronary arteries. Coronary arteries are the blood vessels that supply blood to the heart. It’s a procedure that we do either as an inpatient or outpatient. It generally takes about 15 minutes or so. We use dye and contrast to outline the coronary arteries. It’s the definitive way to rule out blockages.
Before the procedure, there are some preliminary tests that are done to make sure that the kidney function is OK and that everything else is in order.
The procedure itself generally involves some sedation. So, the patient receives what we call conscious sedation, which means that they’re awake, but they’re relaxed. We don’t put folks to sleep for this procedure.
The procedure can be done one of two ways. The traditional way that it’s been done in this country is to use the artery in the leg, called the femoral artery. We achieve access to that artery through the groin. Now, more procedures are being done through the arm or the wrist using the radial artery, which is a small artery in the wrist, to access the heart.
Dye is contrast that we use to outline the coronary arteries. It’s injected directly into the coronary arteries through the use of a small tube called the “catheter.” That dye outlines the inside wall of the artery, which is basically a tube. If there are blockages, they will be indicated by injecting the dye into the artery. It will show up as an obstruction to the flow. The dye won’t flow normally.
In a normal coronary artery, you’ll see a nice smooth flow all the way down. Of there’s a blockage, there’ll be an obvious obstruction in the middle of that tube.
If someone were having symptoms, suggestive of heart problems – chest pain or shortness of breath, — the first thing they should do is discuss it with their primary care physician. Preliminary testing, such as stress testing, can be done. If necessary, they can be referred to a cardiologist for cardiac catheterization.
Let’s say a person is having chest pain. Generally, the first test that would be done would be a stress test. If the stress test shows some abnormalities that suggest the presence of some blockages in the coronary arteries, the gold standard would be a cardiac catheterization.
Obviously, if someone is having chest pain and it’s not going away, they should immediately dial 911, call an ambulance and be brought directly to the emergency room. They might be having a heart attack. That’s not something you want to wait on.