Right heart catheterization is a medical procedure performed to evaluate how well the right side of the heart is functioning. During this invasive procedure, a thin, flexible tube called a catheter is inserted into a blood vessel in the neck, groin, or arm. The catheter is then threaded through the right side of the heart and into the pulmonary artery to measure blood pressure and oxygen levels in both the heart and lungs. Here's what you need to know
Purpose of Right Heart Catheterization
Right heart catheterization serves several diagnostic and therapeutic purposes, including
- Assessing Heart Function
- Diagnosing and Monitoring Pulmonary Hypertension
- Diagnosing and Managing Congenital Heart Disease
- Measuring and Assessing Oxygen Levels
The procedure is usually performed in a hospital setting, and you may be given a sedative to help you relax. Local anesthesia will be applied to the insertion site, and you will typically remain awake during the procedure. You may feel some pressure as the catheter is inserted, but pain should be minimal.
Preparation
An intravenous (IV) line will be started in your hand or arm for medication and fluids. You'll lie on your back on the procedure table. Electrocardiogram (ECG) electrodes will be placed on your chest to monitor your heart's electrical activity, while healthcare physicians track vital signs like heart rate, blood pressure, breathing rate, and oxygen level. While you may receive a mild sedative to help you relax, you'll remain awake throughout the procedure.
Catheter Insertion
An intravenous (IV) line will be started in your hand or arm for medication and fluids. You'll lie on your back on the procedure table. Electrocardiogram (ECG) electrodes will be placed on your chest to monitor your heart's electrical activity, while healthcare physicians track vital signs like heart rate, blood pressure, breathing rate, and oxygen level. While you may receive a mild sedative to help you relax, you'll remain awake throughout the procedure.
- Sterile towels will be used to cover the area over your neck or groin, depending on the access site chosen.
- Your skin will be cleaned and numbed using a local anesthetic.
- A thin tube called a catheter will be inserted into your vein. You might feel some burning or stinging during the numbing process and slight pressure as the needle enters your vein.
- An introducer sheath (a slightly larger, hollow tube) will be placed into your vein first, followed by the pulmonary artery (PA) catheter.
- Measurements of your heart chamber pressures will be taken.
- Intravenous heart medicine may be administered to assess your heart's response, with about 30 minutes of monitoring.
Procedure Details
- The right heart catheterization procedure typically lasts about an hour, including various stages such as catheter insertion, measurements, and medication administration.
- You'll be awake and alert during the entire process.
- Your healthcare physician will clean and prepare the catheter entry site (groin, arm, or neck), administer local anesthesia to numb the area, and use a specialized needle or cutting tool to access the blood vessel.
- The catheter will be inserted and slowly advanced to different positions within your heart and blood vessels.
- Measurements or tissue samples may be collected as necessary.
- You might be asked to stay still, change positions, or breathe in specific ways.
- Intravenous medications may be given to assess your heart's reaction.
- At the conclusion of the procedure, the catheter is removed, and the incision site is closed.
After right heart catheterization, you will be monitored for a few hours to ensure there is no bleeding or other complications. Most patients can go home after this period, although someone else may need to drive you. You'll receive specific post-procedure instructions, which may include avoiding strenuous activities and keeping the insertion site clean to promote a smooth recovery. It's essential to report any unusual symptoms or discomfort to your healthcare physician.