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Right heart catheterization is a medical test, which can help a doctor determine the blood pressure in the right hand side of your heart, as well as your lungs. Your doctor may advise you to undergo a right heart catheterization to check if you are suffering from any heart problems.

Sometimes, this test may be a part of a procedure to treat a health condition that your doctor is already aware of. This medical test will allow your doctor to -

• Locate any blockage or narrowing in the blood vessels
• Check the levels of oxygen in your heart
• Obtain a tissue sample from your heart, for a biopsy
• Rule out the possibility of problems with the heart valves
• Diagnose congenital heart defects

Procedure

The right heart catheterization should be conducted on an empty stomach and therefore, make sure that you do not eat anything for at least 8 hours, before your scheduled time. Your doctor will perform the right heart catheterization procedure in a special operating area, called the catheterization lab. This is because special x-ray and imaging equipment is required for this procedure, which most regular operating rooms do not have. You will probably be awake during the test, but your doctor will give you a sedative that is not very strong just to calm your tense body. Soon after that-

• A small area, most probably on your groin or neck, will be cleaned and then numbed
• A small incision will be made in the vein.
• A catheter, which is a thin tube and is hollow, will be let through the incision, into the vein
• This tube will be moved to the upper chamber or the right atrium of your heart.
• Your doctor will determine where to place the catheter, with the help of x-ray images
• The catheter will be threaded through the two valves of the heart and placed in the pulmonary artery, which is an artery in the lung, where the pressure of the blood will be measured.
• A small amount of there will be some removal of blood so as to check its oxygen levels.

During the entire procedure, you will have electrodes placed on your chest, so that your doctor can monitor your heartbeat. It could take you a few hours to recover from this test.

Risks

There are a few risks that have been associated with the right heart catheterization, such as -

• Bruising after the procedure
• Bleeding at the area of incision
• Allergic reactions to the medication or dye
• Infections occurring due to improper hygiene
• Low blood pressure

Some of the risks are quite serious and could also be fatal. Severe right heart catheterization risks could include -

• Formation of blood clots
• Kidney damage
• Tearing of the tissue in the artery or the heart
• Arrhythmias or irregular heartbeat
• Pseudoaneurysm or damage to the artery
• Stroke
• Heart attack

In case you are pregnant or are planning to have a baby soon, you need to inform your doctor, before the test.

Interpretation

In case everything is normal, the reading of your right heart catheterization pressures should be -

• Pulmonary artery mean pressure - 9 mmHg to 19 mmHg
• Pulmonary artery systolic pressure - 17 mmHg to 32 mmHg
• Pulmonary capillary wedge pressure - 4 mmHg to 12 mmHg
• Pulmonary diastolic pressure - 4 mmHg to 13 mmHg
• Right atrial pressure - 0 mmHg to 7 mmHg

The normal cardiac index reading should be 2.8 to 4.2 liters per minute, per square meter. Once you have the results of the right heart catheterization, your doctor will need to study them and explain what they mean. Abnormal results could point towards -

• Heart valve diseases
• Lung diseases
• Circulatory flow problems

In case you are scheduled for a right heart catheterization in the future, it may be a good idea for you to set up an appointment with your doctor and clarify any queries that you may have.

References

• Eastwood J. Nurse's role in the cardiac catheterization laboratory. In: Moser DK, et al. Cardiac Nursing: A companion to Braunwald's heart disease. Philadelphia, Pa.: Saunders Elsevier; 2007:339.
• Faxon DP. Catheterization and angiography. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier;2007:chap 56
• http://www.nlm.nih.gov/medlineplus/ency/article/003870.htm
• http://www.georgiahealth.edu/medicine/medicine/pulmonary/pvd/hht/RightHeartCatheterization.html

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