What is a right heart catheterization?
A right heart catheterization is a test used to see how well your heart is pumping (how much it pumps per minute) and to measure the blood pressure in your heart and the main blood vessels in your lungs. The test is also called pulmonary artery catheterization. A right heart catheterization is different than a left heart catheterization (coronary angiography), which is used to check for blockages in your arteries.
Why do I need a right heart catheterization?
Your doctor may want you to have a right heart catheterization to find out if you have high blood pressure in your lungs (pulmonary hypertension). The test can help find the cause of pulmonary hypertension and show how bad it is.
You may also need a right heart catheterization if you are being evaluated for a heart, lung or other organ transplant.
How is a right heart catheterization done?
A right heart catheterization is done by a cardiologist or pulmonologist in a special procedure room designed for that purpose. Please let us know if you are uncomfortable lying on the table used for the procedure.
- You will be awake during the procedure, but we will numb the area of your body where the procedure will be done. The neck area (jugular vein) is usually used, but the doctor may use a vein in your arm (radial) or groin (femoral).
- Your doctor will make a small incision to insert a long, thin tube called a catheter. The catheter is guided to your heart and pulmonary arteries. The pressure in these areas is checked throughout the procedure.
- Your doctor will ask you to hold your breath, bear down, cough and do other activities during the test. Please tell your procedure team if you have any pain or discomfort at any time during the test.
- You may get nitric oxide to help the blood vessels in your lungs relax. Your doctor will see if the medication affects the blood pressure in the vessels.
- You may get saline solution through an IV to see if fluid affects your blood pressure.
- If you are having this procedure because you have had a heart transplant, your doctor will take a small tissue sample (biopsy) to check for signs of organ rejection and see how your new heart is working.
How long does the procedure last?
The right heart catheterization itself takes about an hour. Additional time is needed for other tests that may be done, and for you to get ready and recover from the procedure.
What happens after the procedure?
- Most patients can go home after the procedure.
- You will be able to drive after the procedure, but you may feel more comfortable if you have someone drive you home.
- Do not bend down or lift, push or pull for 2 to 4 hours after the procedure.
- You may need to go to an intensive care unit (ICU) for more tests or treatment if the pressure in your heart or lungs is very high or if your heart isn’t pumping enough blood.
Is a right heart catheterization safe?
Your doctor will talk to you about the risks and benefits of having a right heart catheterization. You will be asked to sign a consent form before you have the procedure. Please talk to your doctor about any questions or concerns you have about the procedure.
Complications are rare, but can include:
Bleeding at the catheter insertion site
- Abnormal heart rhythm
- Mild skin reactions (like a sunburn) from X-ray exposure
- Heart attack, blood clots, stroke
- Lung collapse
- Cardiac tamponade- A build-up of fluid around your heart
- Pulmonary artery rupture (extremely rare) - Damage to your pulmonary artery that could cause death. Emergency surgery is needed to fix the artery.
- Please tell your doctor if you are:
- Allergic to latex, tape, local or general anesthesia (numbing medicines or medicines used to make you sleepy).
- Pregnant or think you may be pregnant. You may need a pregnancy test before the procedure for your safety.
- Taking any medication to thin your blood. Examples are Coumadin (warfarin), Eliquis (apixaban), Pradaxa (dabigatran), Xarelto (rivaroxaban).
Ask your doctor if you need to make any changes to the way you take your medications before the procedure.
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