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[[Cardiac catheterization]] refers to the insertion of hollow tubes (catheters) into various structures of the heart.  When catheters are inserted specifically into the [[coronary arteries]] that supply blood to the [[heart muscle]] (the [[myocardium]]), this instrumentation is called coronary catheterization.  Coronary catheterization is to be distinguished form [[left heart catheterization]] in which catheters (hollow tubes) are inserted into the blood filled chambers of the [[heart]].  
[[Cardiac catheterization]] refers to the insertion of hollow tubes (catheters) into various structures of the heart.  When catheters are inserted specifically into the [[coronary arteries]] that supply blood to the [[heart muscle]] (the [[myocardium]]), this instrumentation is called coronary catheterization.  Coronary catheterization is to be distinguished form [[left heart catheterization]] in which catheters (hollow tubes) are inserted into the blood filled chambers of the [[heart]].  


Once the catheter is inserted into the coronary artery, coronary angiography is the process of injecting iodinated contrast material (i.e. dye) into the [[coronary arteries]] to assess the [[coronary circulation]].  Coronary angiography is performed for both diagnostic and interventional (treatment) purposes.  Coronary angiography is a visually interpreted test performed to recognize occlusion, [[stenosis]], [[restenosis]], [[thrombosis]] or [[aneurysm|aneurysmal]] enlargement the [[coronary artery]] [[lumen]]s, [[heart chamber]] size, [[heart muscle]] contraction performance and some aspects of [[heart valve]] function.  The relevant problems that the test deals with most commonly occur as a result of advanced [[atherosclerosis]], [[atheroma]]activity within the wall of the coronary [[artery|arteries]]. Less frequently, other issues, [[heart valve|valvular]], [[heart muscle]] or [[arrhythmia]] issues are the primary focus of the test.<ref>Connolly JE. The development of coronary artery surgery: personal recollections. ''Tex Heart Inst J'' 2002;29:10-4. PMID 11995842.</ref> <ref>Proudfit WL, Shirey EK, Sones FM Jr. Selective cine coronary arteriography. Correlation with clinical findings in 1,000 patients. ''Circulation'' 1966;33:901-10. PMID 5942973.</ref> <ref>Sones FM, Shirey EK. Cine coronary arteriography. ''Mod Concepts Cardiovasc Dis'' 1962;31:735-8. PMID 13915182.</ref> <ref>Smith SC Jr, Feldman TE, Hirshfeld JW Jr, Jacobs AK, Kern MJ, King SB 3rd, Morrison DA, O'neill WW, Schaff HV, Whitlow PL, Williams DO, Antman EM, Smith SC Jr, Adams CD, Anderson JL, Faxon DP, Fuster V, Halperin JL, Hiratzka LF, Hunt SA, Jacobs AK, Nishimura R, Ornato JP, Page RL, Riegel B; American College of Cardiology/American Heart Association Task Force on Practice Guidelines; ACC/AHA/SCAI Writing Committee to Update the 2001 Guidelines for Percutaneous Coronary Intervention. ACC/AHA/SCAI 2005 Guideline Update for Percutaneous Coronary Intervention-Summary Article: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (ACC/AHA/SCAI Writing Committee to Update the 2001 Guidelines for Percutaneous Coronary Intervention). J Am Coll Cardiol. 2006 Jan 3;47(1):216-35. PMID 16386696</ref>
Once the catheter is inserted into the coronary artery, coronary angiography is the process of injecting iodinated contrast material (i.e. dye) into the [[coronary arteries]] to assess the [[coronary circulation]].  Coronary angiography is performed for both diagnostic and interventional (treatment) purposes.  Coronary angiography is a visually interpreted test performed to recognize occlusion, [[stenosis]], [[restenosis]], [[thrombosis]] or [[aneurysm|aneurysmal]] enlargement the [[coronary artery]] [[lumen]].  The relevant problems that the test deals with most commonly occur as a result of advanced [[atherosclerosis]], [[atheroma]]activity within the wall of the coronary [[artery|arteries]]. <ref>Connolly JE. The development of coronary artery surgery: personal recollections. ''Tex Heart Inst J'' 2002;29:10-4. PMID 11995842.</ref> <ref>Proudfit WL, Shirey EK, Sones FM Jr. Selective cine coronary arteriography. Correlation with clinical findings in 1,000 patients. ''Circulation'' 1966;33:901-10. PMID 5942973.</ref> <ref>Sones FM, Shirey EK. Cine coronary arteriography. ''Mod Concepts Cardiovasc Dis'' 1962;31:735-8. PMID 13915182.</ref> <ref>Smith SC Jr, Feldman TE, Hirshfeld JW Jr, Jacobs AK, Kern MJ, King SB 3rd, Morrison DA, O'neill WW, Schaff HV, Whitlow PL, Williams DO, Antman EM, Smith SC Jr, Adams CD, Anderson JL, Faxon DP, Fuster V, Halperin JL, Hiratzka LF, Hunt SA, Jacobs AK, Nishimura R, Ornato JP, Page RL, Riegel B; American College of Cardiology/American Heart Association Task Force on Practice Guidelines; ACC/AHA/SCAI Writing Committee to Update the 2001 Guidelines for Percutaneous Coronary Intervention. ACC/AHA/SCAI 2005 Guideline Update for Percutaneous Coronary Intervention-Summary Article: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (ACC/AHA/SCAI Writing Committee to Update the 2001 Guidelines for Percutaneous Coronary Intervention). J Am Coll Cardiol. 2006 Jan 3;47(1):216-35. PMID 16386696</ref>


[[Coronary artery]] [[lumen|luminal]] [[stenosis|narrowing]] reduces the flow reserve for oxygenated blood to the heart, typically producing intermittent [[Angina pectoris|angina]] if very advanced; [[lumen|luminal]] occlusion usually produces a [[myocardial infarction|heart attack]]. However, it has been increasingly recognized, since the late 1980s, that coronary catheterization does not allow the recognition of the presence or absence of coronary [[atherosclerosis]] itself, only significant [[lumen|luminal]] changes which have occurred as a result of end stage complications of the [[atherosclerosis|atherosclerotic]] process. See [[IVUS]] and [[atheroma]] for a better understanding of this issue.
[[Coronary artery]] [[lumen|luminal]] [[stenosis|narrowing]] reduces the flow reserve for oxygenated blood to the heart, typically producing intermittent [[Angina pectoris|angina]] if very advanced; [[lumen|luminal]] occlusion usually produces a [[myocardial infarction|heart attack]]. However, it has been increasingly recognized, since the late 1980s, that coronary catheterization does not allow the recognition of the presence or absence of coronary [[atherosclerosis]] itself, only significant [[lumen|luminal]] changes which have occurred as a result of end stage complications of the [[atherosclerosis|atherosclerotic]] process. See [[IVUS]] and [[atheroma]] for a better understanding of this issue.

Revision as of 03:18, 6 September 2013

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Cardiac catheterization refers to the insertion of hollow tubes (catheters) into various structures of the heart. When catheters are inserted specifically into the coronary arteries that supply blood to the heart muscle (the myocardium), this instrumentation is called coronary catheterization. Coronary catheterization is to be distinguished form left heart catheterization in which catheters (hollow tubes) are inserted into the blood filled chambers of the heart.

Once the catheter is inserted into the coronary artery, coronary angiography is the process of injecting iodinated contrast material (i.e. dye) into the coronary arteries to assess the coronary circulation. Coronary angiography is performed for both diagnostic and interventional (treatment) purposes. Coronary angiography is a visually interpreted test performed to recognize occlusion, stenosis, restenosis, thrombosis or aneurysmal enlargement the coronary artery lumen. The relevant problems that the test deals with most commonly occur as a result of advanced atherosclerosis, atheromaactivity within the wall of the coronary arteries. [1] [2] [3] [4]

Coronary artery luminal narrowing reduces the flow reserve for oxygenated blood to the heart, typically producing intermittent angina if very advanced; luminal occlusion usually produces a heart attack. However, it has been increasingly recognized, since the late 1980s, that coronary catheterization does not allow the recognition of the presence or absence of coronary atherosclerosis itself, only significant luminal changes which have occurred as a result of end stage complications of the atherosclerotic process. See IVUS and atheroma for a better understanding of this issue.

References

  1. ↑ Connolly JE. The development of coronary artery surgery: personal recollections. Tex Heart Inst J 2002;29:10-4. PMID 11995842.
  2. ↑ Proudfit WL, Shirey EK, Sones FM Jr. Selective cine coronary arteriography. Correlation with clinical findings in 1,000 patients. Circulation 1966;33:901-10. PMID 5942973.
  3. ↑ Sones FM, Shirey EK. Cine coronary arteriography. Mod Concepts Cardiovasc Dis 1962;31:735-8. PMID 13915182.
  4. ↑ Smith SC Jr, Feldman TE, Hirshfeld JW Jr, Jacobs AK, Kern MJ, King SB 3rd, Morrison DA, O'neill WW, Schaff HV, Whitlow PL, Williams DO, Antman EM, Smith SC Jr, Adams CD, Anderson JL, Faxon DP, Fuster V, Halperin JL, Hiratzka LF, Hunt SA, Jacobs AK, Nishimura R, Ornato JP, Page RL, Riegel B; American College of Cardiology/American Heart Association Task Force on Practice Guidelines; ACC/AHA/SCAI Writing Committee to Update the 2001 Guidelines for Percutaneous Coronary Intervention. ACC/AHA/SCAI 2005 Guideline Update for Percutaneous Coronary Intervention-Summary Article: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (ACC/AHA/SCAI Writing Committee to Update the 2001 Guidelines for Percutaneous Coronary Intervention). J Am Coll Cardiol. 2006 Jan 3;47(1):216-35. PMID 16386696
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