More than a million people a year have a heart attack in the United States, according to the Centers for Disease Control and Prevention. Coronary artery disease, characterized by the accumulation of plaque in the vessels supplying the heart, is the cause of heart attacks. Cardiac catheterization is a diagnostic procedure in which physicians position small tubes through arteries in a patient's arm or leg and inject X-ray dye into the coronary arteries and pumping chamber of the heart. According to the National Heart Lung and Blood Institute, the risk of complications is increased in patients older than 75, female patients, patients with a history of diabetes or kidney disease, and those who receive the procedure on an emergency basis.
Vascular Complications
To perform a cardiac catheterization, physicians must access veins by making a small hole in an artery in a patient's leg or arm. Arora and colleagues reported in an April 2007 article in the "American Heart Journal" that vascular complications occur in 1 to 10 percent of cases and include bleeding, vessel laceration, infection and blood clots. Blood clots are of particular concern because they can cause a heart attack or stroke. Doctors usually give patients the medication heparin during the procedure to help prevent clot formation. Vascular complications have decreased since physicians began using small devices that close the access holes in the artery at the end of the procedure.
Heart Rhythm Disturbances
Sometimes dangerous rhythm disturbances called ventricular arrhythmias occur when physicians are placing tubes into a coronary artery or after injecting dye, according to the National Heart Lung and Blood Institute. The abnormal rhythm is usually temporary and the heart returns to normal rhythm once the physician removes the tube. Occasionally medications or electroshock therapy are required to restore proper heart rhythm.
Dye Reactions
The dye used in a cardiac catheterization is a special substance that can be seen with X-rays. Occasionally, patients have an allergic reaction with shortness of breath and hives with injection of the dye. Such reactions usually respond to medications such as antihistamines and epinephrine.
The National Heart Lung and Blood Institute reports that kidney damage is another possible complication after receiving X-ray dye, particularly in those with diabetes or underlying kidney failure. Kidney damage is usually temporary and responds to fluid administration.
Death
Death from cardiac catheterization is rare. The April 2007 issue of the "Journal of the American Medical Association" reported that death occurred in less than 1 percent of cases. Death occurs more frequently in women and in the presence of chronic illnesses such as diabetes, hypertension, congestive heart failure, kidney failure and cancer.
References
- Centers for Disease Control and Prevention: Heart Disease Facts
- American Heart Association: Cardiac Catheterization
- National Heart Lung and Blood Institute: Diseases and Conditions Index
- "American Heart Journal": A Propensity Analysis of the Risk of Vascular Complications after Cardiac Catheterization Procedures with the Use of Vascular Closure Devices; N. Aurora, et. al.; April 2007
- "Journal of the American Medical Association": Sex Differences in Outcomes After Cardiac Catheterization; K. King, et. al.; April 2007
