Your doctor may do a right-heart catheterization (cath) to see how well or poorly your heart is pumping, and to measure the pressures in your heart and lungs. This test is also known as pulmonary artery catheterization.
In a right-heart cath, your doctor guides a special catheter (a small, hollow tube) called a pulmonary artery (PA) catheter to the right side of your heart. He or she then passes the tube into your pulmonary artery. This is the main artery that carries blood to your lungs. Your doctor observes blood flow through your heart and measures the pressures inside your heart and lungs.
As the catheter advances toward your pulmonary artery, your doctor measures pressures along the way, inside the chambers on the right side of your heart. This includes the right atrium and right ventricle. Your doctor can also take indirect measurements of pressures on the left side of your heart. Your cardiac output—the amount of blood your heart pumps per minute—is also determined during a right-heart cath. All of these measurements are used to diagnose heart conditions and to determine what treatment might be right for you.
In some cases, you get intravenous (IV) heart medicine during right-heart cath to see how your heart responds. For example, if the pressure in your pulmonary artery is high, your doctor will give you medicine to dilate, or relax, the blood vessels in your lungs and lower the pressures. A healthcare provider will take several pressure measurements during the procedure to assess your body's response to the medicines.
If output from your heart is low or the pressures in your heart and lungs are too high, your doctor will leave the PA catheter in place to monitor the effects of different IV medicines. You will most likely be monitored in the intensive care unit (ICU) in this case. This lets your healthcare providers determine the best treatment to improve your heart's function.
You might need a right-heart cath to diagnose or manage the following conditions:
A right-heart cath with biopsy may be done as part of your evaluation before and after a heart transplant. Pressures in your pulmonary (lung) circulation need to be as low as possible for a donor heart to work as well as possible. Excessive pressures will make it hard for the new (donor) heart to pump effectively. A right-heart cath will help to determine if pulmonary pressures can be decreased with medicines (vasodilators) to help ensure a successful transplant. After a heart transplant, the right heart cath with a biopsy measures how well the transplanted heart is working and detects signs of rejection of the transplanted organ.
Your healthcare provider may have other reasons to recommend a right-heart cath with biopsy.
Possible risks of right-heart cath include:
Other, rare complications may include:
For some people, having to lie still on the cardiac cath table for the length of the procedure may cause some discomfort or back pain.
There may be other risks, depending on your specific condition. Be sure to discuss any concerns with your healthcare provider before the procedure.
Your healthcare provider will explain the procedure and you can ask questions.
Based on your condition, your healthcare provider may request other specific preparation.
Your doctor will do your right-heart cath in the cardiac cath lab. If you are critically ill, your doctor may do the procedure in the ICU. The procedure may be done on an outpatient basis, or as part of your hospital stay. The procedure may vary, depending on your condition and your doctor's practices.
A member of the medical staff will put pressure over your insertion site for a minute or two, to make sure you are not bleeding. If the catheter was placed in your groin vein, pressure will be placed over the insertion site for a few minutes longer.
If your neck vein was used (most common), you can sit up comfortably. If a groin vein was used for the procedure, you will have to lie flat in bed for a few hours so the puncture site can heal properly.
You can eat and drink normally after the procedure. The nurse will watch the insertion site for bleeding and check your blood pressure, heart rate, and breathing while you recover. Let the nurse know if you have any chest pain or trouble breathing.
Your healthcare provider will discuss the findings of the right-heart cath and plans for treatment, if needed. Most of the time, you will be able to go home a few hours after the procedure.
Once at home, watch the insertion site for bleeding, unusual pain, swelling, and abnormal discoloration or temperature change at or near the insertion site. A small bruise is normal. If you notice a constant or large amount of blood at the site that cannot be contained with a small bandage, or dressing, call your healthcare provider.
It will be important to keep the insertion site clean and dry. Your healthcare provider will give you specific bathing instructions.
Your doctor may advise you not to do any strenuous activities. He or she will tell you when you can return to work and resume normal activities.
Call your healthcare provider to report any of the following:
Your healthcare provider may give you other instructions after the procedure, depending on your situation.
Before you agree to the test or the procedure make sure you know:
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