Heart catheterization involves threading a thin tube called a catheter through a vein to your child's heart. The doctor can then inject contrast fluid to learn about the structure of the heart, perform a special test called an electrophysiology study, or perform certain treatments.
Heart catheterization test
What is a heart catheterization test?
This test is also called a cardiac catheterization test. This is one of the tests that gives your child’s cardiologist information about how your child’s heart is working. It tells the doctor about:
- the structure of your child’s heart and its valves
- the pressure in the chambers of the heart and its blood vessels
- the amount of oxygen in the chambers of the heart and its blood vessels
- the amount of blood your child’s heart pumps to the body
- the rhythm of the heart
How is the heart catheterization test done?
The cardiologist makes a small cut in an artery or vein, usually in the groin at the top of the leg. Then the cardiologist carefully threads a long, thin tube called a catheter through the artery or vein and into your child’s heart. The cardiologist uses X-rays on a TV screen to watch the catheter as it enters the heart. Your child’s heart will keep working normally during this test.
To learn about the structure of your child’s heart, the doctor will inject a dye that shows up on X-rays (contrast fluid) into the chambers of the heart through the catheter. They then take X-ray pictures of the flow of the dye through your child’s heart. Your child will get rid of this dye in their urine, a few hours after the test.
After the test is finished, the cardiologist takes the catheter out. They cover the small wound in your child’s groin with a heavy bandage. Your child will not need stitches.
Sometimes heart catheterization can also be used to treat heart problems. Heart catheterization can be used to close a hole in the heart or blood vessel, or to stretch a valve or a blood vessel. This treatment is called interventional catheterization. Each type of catheterization is different, and your child’s doctor will explain this treatment if your child needs it.
For more information, please see "Heart Catheterization" in the Treatment section of this site.What should you tell your child about the test?
What, when, and how you tell your child about the heart catheterization test will depend on how old your child is. Talk to your child in a way that they can understand. It is important to be honest. Your child will feel less anxious or scared when they know what to expect.
A few days before the test, tell your child that they will be going to the hospital for a special test. Try to say this in a way that will not make your child afraid of the test. Do not tell your child that there will be no pain or needles. Comfort your child. Tell them that you will be with them as much as you can. Tell your child that they need the test and that the doctors and nurses are there to help.
How should you prepare your child for the test?
Your child will need to have some other tests done a few days before the heart catheterization test. These may include:
- an electrocardiogram
- blood tests
- a chest X-ray
- an echocardiogram
What your child will be able to eat and drink before the catheterization test will be discussed at your pre-catheterization visit. The nurse, child life specialist, and doctor will explain to you and your child what will happen during the catheterization.
Your child will need an intravenous line (IV). An IV is a small tube put in a vein of an arm or leg to give your child liquids and medicines. It may be started in the hospital before the test.
Where is the heart catheterization test done?
Your child will be taken to a special treatment room called a catheterization laboratory for the heart catheterization test. This room looks like a small operating room.
Who will be part of your child’s heart catheterization team?
Doctors, nurses, and an anaesthesiologist will be part of the heart catheterization team. The heart catheterization team will watch your child closely during the heart catheterization test.
Will your child be awake for the heart catheterization test?
Most children need a general anaesthetic for the heart catheterization test, although some older children and teens may prefer to have local anaesthetic and a mild sedative.
How long does the heart catheterization test take?
Your cardiologist will tell you how long they think your child’s heart catheterization test will take. The amount of time needed for this test depends on how much information is needed and what needs to be done.
What happens after your child’s heart catheterization test?
If your child has a general anaesthetic, they will wake up in the post-anaesthetic care unit, or wake-up room. Your child will stay there until they are ready to come back to their own room in the in-patient unit. After you talk to the cardiologist about your child’s test, you may be with your child, if you wish.
The nurse will check your child’s heart rate, blood pressure, and breathing for the next 4 hours. They will also check the bandage over the area where the catheter was put in. Your child will be quite sleepy and may have to stay in bed for a while after the heart catheterization test. When your child is awake, they will be able to drink liquids and then slowly begin to eat normally again.
When will your child be able to go home?
When your child goes home will depend on how well they are feeling after the heart catheterization test. And it will depend on what other tests your child had during the heart catheterization test. Your child may be able to go home on the evening of the heart catheterization test. Or they may have to stay in the hospital overnight and go home the next day.
What side effects might there be?
Your child may have some bruising in the area around the groin. It may be sore for a day or two. Sometimes, if an artery is used, the pulse can be weakened in the leg. This will require special treatment that the doctor will explain. Normally your child should be able to go back to their normal activities after the first day. Your child may have an upset stomach for the first day, or 24 hours, after the heart catheterization test, particularly if they had a general anaesthetic. Your child may have a fever or a temperature under 38°Celsius for the first 24 hours due to the dye. This is normal.
When will you get the results of your child’s heart catheterization test?
The doctor will talk to you about some of the results of your child’s heart catheterization test before your child goes home from the hospital. You will get the final results of the test and the plans for your child’s treatment later, after the doctors have looked at all the information from the test. This may take some time. Your child’s cardiologist will call you with these results.
Electrophysiology study (EPS)
What is an electrophysiology study (EPS)?
This is a special form of heart catheterization test. It helps the doctor evaluate the electrical functioning of the heart. It’s usually done if the doctor suspects a heart rhythm abnormality (arrhythmia).
How does your child prepare for the test?
Feeding will be discussed when your test is booked. Your child may also need a number of tests prior to the EPS, like a chest X-ray, ECG, and an echocardiogram. Children are usually anaesthetized for this procedure.
How is an electrophysiology study done?
The doctor puts catheters (thin tubes) into the veins and passes them through to the heart. That way the cardiologist can see and record the electrical activity in the heart. Oxygen and blood pressure are continuously monitored.
The doctor may stimulate the heart with artificial electrical signals to see how it responds, and may see how an antiarrhythmic drug can help correct the abnormality. Sometimes corrections to an arrhythmia can be made during the EPS, using a technique called ablation.
What are the risks?
The risk of any complication from this procedure is extremely low, but it can include bleeding, blood clots, tearing of the heart muscle or a blood vessel, stroke, and cardiac arrest.
How long does it take to do the test?
The test usually takes several hours.
What will recovery involve?
Your child will need some rest to recover from the anaesthesia and to make sure the incision where the catheter was inserted will not bleed. This means taking it easy, no intense exercise, and no baths or swimming for a few days until the area has healed. Your child will also be encouraged to drink lots of fluids to flush the dye out of his system. Your child will be able to go home the same day of the procedure or the next day.