Cardiology

Cardiac Catheterisation (Right and Left Heart Study)

Thin tubes measure pressure and oxygen inside your heart and lung arteries directly, when scans can't settle a question about your valves or the pressure in your lungs.

Cardiac Catheterisation (Right and Left Heart Study) at Prakash Hospital, Cardiology
Test duration
45 to 90 minutes
Anaesthesia
Local, with mild sedation
Hospital stay
Same day or one night
Results
Usually explained the same day

Overview

Sometimes the tests don't agree. The echo calls your valve narrowing moderate, yet you're breathless walking to the gate. Or a scan suggests high pressure in your lungs, and before you start lifelong medicines your doctors need to know exactly how high it is, and why.

Cardiac catheterisation measures from inside the heart. A cardiologist passes a thin tube (catheter) through a vein or artery into the heart chambers and the lung artery, records the pressure in each, takes small blood samples for oxygen and calculates how much blood the heart pumps each minute. A right heart study goes in through a vein and covers the right side of the heart and the lungs. A left heart study goes through an artery to the main pumping chamber and the aortic valve.

It's related to coronary angiography but asks a different question. An angiogram takes X-ray pictures of the heart's own arteries to find blockages, while catheterisation measures how the heart and lungs are working. The two are often combined, for example before valve surgery.

Cardiac catheterisation is one of the diagnostic tests offered by our cardiology department, alongside ECG, 2D echo with Doppler, TMT and Holter monitoring.

Why the test is done

Catheterisation usually follows an echo or other scans, when the answer affects a major decision such as surgery, a valve procedure or long-term medicines.

  • Suspected pulmonary hypertension (high pressure in the lung arteries), to confirm it and find the type
  • Valve disease where the echo and your symptoms don't match, or before valve surgery
  • Heart failure with an unclear cause, or an assessment for advanced treatment such as a transplant
  • A hole in the heart or another defect present from birth, to measure how much blood flows the wrong way
  • Telling constrictive pericarditis (a stiff sac around the heart) apart from a stiff heart muscle
  • Taking a tiny sample of heart muscle (biopsy) when myocarditis or amyloid disease is suspected

Types of test

Right heart catheterisation

A balloon-tipped catheter enters a vein in the neck, arm or groin and floats through the right side of the heart into the lung artery. It records pressure at each point, including a "wedge" pressure that reflects the left side of the heart, and measures cardiac output, usually without any dye.

Left heart catheterisation

A catheter passes from the wrist or groin artery across the aortic valve into the left ventricle, measuring the pressure there and the pressure drop across the valve. A coronary angiogram is usually done at the same time.

Extra tests during the study

In pulmonary hypertension, a medicine may be given to see whether the lung arteries relax, which helps choose treatment. Oxygen samples from several chambers can find and size a hole in the heart.

Preparing for the test

  • Blood tests including kidney function, blood count and clotting, plus an ECG. Bring your latest echo report
  • Don't eat for about 4 to 6 hours beforehand. We'll tell you which morning tablets to take, including water tablets
  • Tell us about blood thinners. They may need pausing, only on your cardiologist's advice
  • If you take metformin and dye will be used, you may be asked to pause it for 48 hours
  • Mention any past reaction to X-ray dye, and any kidney disease
  • Tell us if you might be pregnant, so X-ray exposure can be kept as low as possible or the test planned differently
  • Arrange for someone to take you home. Don't drive for at least 24 hours

What happens during the test

  1. 01

    Getting ready

    You lie in the cath lab with ECG stickers and a drip, awake but often mildly sedated. The skin over the vein, and the artery if a left heart study is planned, is numbed, and a short sheath goes into each vessel.

  2. 02

    The right side

    The catheter floats through the right side of the heart into the lung artery. Pressures are recorded and blood samples taken for oxygen along the way, and you may feel a few skipped beats as it passes.

  3. 03

    The left side

    If needed, a second catheter goes from the artery into the left ventricle. Any dye injection causes a warm flush for a few seconds.

  4. 04

    Finishing

    The catheters and sheaths come out. A vein needs a few minutes of pressure. A wrist artery gets a tight band, and a groin artery firm pressure or a closure device.

Understanding your results

Many of the numbers are ready before you leave the table, and the cardiologist usually explains them the same day. The report lists the pressures in each chamber and the lung artery, oxygen levels, cardiac output (litres of blood pumped per minute) and calculated values such as pulmonary vascular resistance.

A mean lung artery pressure above 20 mmHg points to pulmonary hypertension, and the wedge pressure shows where it comes from. A high wedge suggests the left side of the heart, often valve disease or a stiff heart. A normal wedge points to the lung arteries themselves, which calls for very different treatment. For valves, the pressure drop and calculated valve area show how severe a narrowing is. For a hole in the heart, oxygen readings give the ratio of blood flow through the lungs to flow through the body, and a ratio of about 1.5 or more usually means the hole is worth closing.

These numbers guide decisions such as starting pulmonary hypertension medicines, timing valve surgery, closing a defect, or referral for advanced heart failure care.

Benefits and risks

Benefits

  • Direct measurements, where scans can only estimate
  • Settles disagreements between tests before a major decision
  • Tells apart causes of pulmonary hypertension that need different treatment
  • Can be combined with a coronary angiogram in the same sitting

Possible risks

  • Bruising or a small lump at the puncture site, which usually settles within a week or two
  • Brief extra or skipped heartbeats as the catheter passes through the heart
  • Bleeding from an artery puncture, more likely with the groin route
  • A reaction to the dye or strain on the kidneys, when dye is used
  • Serious problems such as damage to the heart or a blood vessel, a heart attack or a stroke, which are rare, well under 1 in 100. A right heart study alone carries the lowest risk

After the test

  1. 01

    First few hours

    After a vein-only study you can usually sit up within an hour or so. After a groin artery puncture you lie flat for 2 to 4 hours. If dye was used, drink plenty of water.

  2. 02

    Going home

    Most people go home the same day. An overnight stay is more likely if you're very unwell or had a biopsy.

  3. 03

    The first week

    Avoid heavy lifting and hard exercise for about 5 to 7 days. Most people are back at desk work within 2 to 3 days. Your cardiologist will go over the plan, which may be a new medicine, a referral for surgery or a repeat echocardiogram later.

When to call your doctor

  • Bleeding from any puncture site that doesn't stop after 10 minutes of firm pressure
  • A swelling at the groin, wrist or neck that keeps growing or becomes very painful
  • A cold, pale, numb or weak hand or foot on the side the catheter went in
  • Chest pain, breathlessness, fainting or a racing heartbeat
  • Fever, or redness and discharge at a puncture site

Call us on +91-8826000033 or come straight to our 24/7 emergency department.

Other tests

Echocardiography

The first test for valves, pumping and lung pressure, and often enough on its own. It estimates pressures rather than measuring them, so borderline or conflicting results may need catheterisation.

Cardiac MRI

Measures the size and pumping of each chamber very accurately and can show scarring or inflammation, but it can't measure pressure inside the heart.

Coronary angiography alone

If the only question is whether the heart's arteries are blocked, a plain angiogram is enough and pressure measurements add little. Your cardiologist will choose the simpler test when it answers the question.

Talk to our Cardiology team

Ask about your options, the cost and your insurance before you decide. See the insurance and TPA panels we work with.

This page explains Cardiac Catheterisation (Right and Left Heart Study) in general terms. Your own plan depends on your health, your test results and your doctor's advice. Please read our medical disclaimer.

Your care team

Cardiac Catheterisation (Right and Left Heart Study) is led by our Cardiology team, with other departments stepping in at each stage of your care.

Cardiology Department
Leads your treatment

Cardiology Department

At Prakash Hospital, our Cardiology Department offers expert, round-the-clock care, providing timely diagnosis and advanced treatments for heart conditions to keep your heart healthy and strong.

What the department treats

Interventional Cardiology

Echocardiography

Cardiac Rehabilitation

Pacemaker Implantation

Angioplasty and Stenting

Heart Failure Management

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Frequently Asked Questions

Answers to common questions about Cardiac Catheterisation (Right and Left Heart Study) at Prakash Hospital, Noida.

How is cardiac catheterisation different from angiography?

Angiography takes dye pictures of the heart's own arteries to look for blockages. Catheterisation measures pressure, oxygen and blood flow inside the heart chambers and lungs. They use similar equipment and are often done together, but they answer different questions.

Will I be awake? Is it painful?

You'll be awake, usually with a mild sedative. You'll feel the sting of the local anaesthetic and some pressure, but not the catheter inside the heart, though you may notice a few skipped beats.

I have pulmonary hypertension. Is the test safe for me?

It's the standard test to confirm and classify pulmonary hypertension, and the risk is low with an experienced team. People with severe disease are watched especially closely, and sedation is kept light.

Is it safe if I have kidney disease?

A right heart study usually needs no dye. If a left heart study or angiogram is added, the team uses as little dye as possible and gives fluids through a drip, and your kidney function is checked a day or two later.

Is cardiac catheterisation covered by insurance?

Most policies cover it as a day-care or inpatient procedure, subject to their terms. Get pre-authorisation for a planned test, and see our insurance and TPA panels.

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