December 2, 2022

What is a right heart catheterization?

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This procedure helps identify what may be causing problems with your heart.

A right heart catheterization, or “right heart cath,” is a procedure that helps your provider understand more about the function of your heart.  

In a right heart cath, the provider guides a small, thin tube (catheter) into the vein that leads to the right side of your heart. The catheter continues to be guided into your pulmonary artery, which is the main artery that carries blood to your lungs. As the catheter moves through different heart chambers, the provider measures pressures in these chambers. This helps the doctor learn whether you might be retaining extra fluid. It also provides information about whether your heart is pumping enough blood to your body.

What does a right heart cath measure?

In some cases, your health-care provider gives you IV (intravenous) heart medicines during the right heart cath to see how your heart responds. For example, if the pressure is high in your pulmonary artery, you may be given medicines to dilate, or relax, the blood vessels in your lungs to help lower the pressure. The medical team will check the pressure in this artery several times during the procedure to measure your body’s response to the medicines.

Sometimes, the doctor will do a heart biopsy along with a right heart cath. A special catheter is inserted into the vein leading to your heart. It is used to obtain several very tiny pieces of heart tissue, which go to the lab for an exam under a microscope. Doctors in the lab, called pathologists, examine your tissue under a microscope for signs of infection, inflammation or abnormal cells. The examination will indicate if your heart tissue is normal and if not, what might be causing your heart disease.  

Why someone might need a right heart catheterization or heart tissue biopsy

A right heart catheterization is usually done to:

  • Help determine a patient’s fluid status — that is, whether the patient is retaining extra fluid
  • Help determine whether and why lung pressures are elevated
  • Help determine whether the heart is pumping enough blood to the body

A heart biopsy may be performed to: 

  • Learn the cause of heart failure or heart disease. These conditions can be caused by infection or other problems affecting the heart. Knowing the cause of heart failure can help the doctor decide what treatment will be best for you.
  • Evaluate heart tissue after a heart transplant to make sure the body is not rejecting the transplanted (donor) heart.

Your health-care provider may have other reasons to recommend a right heart cath, with or without heart biopsy. You and your provider should also discuss the risks of a right heart catheterization with a heart tissue biopsy.

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Vanderbilt University Medical Center has one of the top heart failure programs in the nation with the expertise to care for all stages and causes of heart failure, from the most basic to the most complex. Vanderbilt’s innovative treatments offer hope when it’s needed most.

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