During a cardiac catheterization, an interventional cardiologist inserts a small, flexible tube called a catheter into a blood vessel (usually in your groin or wrist) and guides it toward your heart. Using small tools that can be passed through the catheter, your doctor may be able to diagnose and/or treat your condition. Some catheterization procedures use dye injected into your coronary arteries to create images. Heart catheterizations are performed in a sterile procedure room, similar to an operating room, called a cardiac catheterization lab. While more complicated procedures may require general anesthesia, many others do not.
Cardiac Catheterization
Cardiac catheterization is a minimally invasive procedure that helps your doctors diagnose, evaluate, and treat heart conditions like coronary artery disease, valve disease, vascular disease, heart failure, arrhythmias, and congenital heart defects, among others. This approach can help manage your heart disease, inform next steps, and improve your quality of life.
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About Cardiac Catheterization
Our Cardiac Cath Labs
Duke has cardiac catheterization labs in all four of our hospitals. The cardiac cath labs at Duke University Hospital and Duke Regional Hospital operate 24/7 for emergencies such as heart attacks.
Treatments
Angioplasty with Stenting
Angioplasty with stenting, also called percutaneous coronary intervention (PCI), is a common and highly effective treatment for coronary artery disease. During this procedure, an interventional cardiologist can find blockages in the coronary arteries and treat them by inflating a small balloon at the tip of the catheter to open the narrowed artery. A small, cylindrical, mesh tube called a stent is placed in the artery to keep it open. Some stents are coated with a medication that is released slowly to prevent future narrowing of the artery.
Carotid Stenting
Similar to angioplasty, carotid stenting uses balloons and stents to repair or open blocked carotid arteries that lead to the brain. This lowers stroke risk.
Complex Coronary Intervention
In people who cannot undergo traditional coronary artery bypass grafting (also known as heart bypass surgery) or who prefer a less invasive approach, a catheterization procedure can restore blood flow to one or more clogged coronary arteries. Interventional cardiologists use specialized tools, including atherectomy devices and mechanical circulatory support devices, to treat blockages.
Chronic Total Occlusion Procedures
Chronic total occlusions are 100% blockages of one or more coronary arteries. Using small catheters, an interventional cardiologist uses specialized tools to open these otherwise impenetrable blockages.
New Appointments Within 48 Hours
Get care quickly with new heart appointments available within 48 hours. Duke Health is ready when you are.
Diagnostic Procedures
Angiogram
After a catheter is inserted, contrast dye is injected to create images of the blood vessels that supply the heart, brain, abdomen, kidneys, or extremities. An angiogram may be performed to diagnose congenital heart defects.
Heart Tissue Biopsy
A tiny sample of heart tissue is removed and analyzed in a lab for signs of diseases that can cause heart failure, including cardiomyopathy (thickening of the heart muscle) and myocarditis (inflammation of the heart). A biopsy may also help identify early signs of rejection in a transplanted heart.
Right Heart Catheterization
In addition to standard right heart catheterization to measure pressure in the heart and lungs as well as cardiac output, we also use right heart catheterization techniques to see how the heart, lungs, and blood vessels respond under stress, like during exercise. This can help identify the cause of symptoms that may not be apparent at rest and can help guide more personalized treatment decisions.
Other Catheter-Based Testing
We offer advanced cardiac catheterization testing to better understand complex symptoms such as:
- Unexplained shortness of breath
- Heart failure
- Pulmonary hypertension
Best Heart Hospital in North Carolina
When it comes to your heart care, you want the very best. Duke University Hospital is proud of our team and the exceptional care they provide. They are why our cardiology and heart surgery program is nationally ranked and the highest-ranked program in North Carolina, according to U.S. News & World Report for 2025–2026.
Cardiac Catheterization: What to Expect
From your arrival to recovery, our cath lab experts are dedicated to giving you the very best care.
Procedure Steps
Before your heart catheterization, a nurse will record your vitals to ensure you are well enough to proceed and place an IV so your care team can easily administer medications and sedatives to keep you comfortable.
Once inside the cath lab, you'll lie flat on a bed under a large X-ray tube used for imaging. A team of providers, including your interventional cardiologist, anesthesiologist, technologists, and nurses, will administer either local or general anesthesia, make a small incision to access your artery, and thread a catheter to your heart to perform the specific diagnostic and/or treatment procedure(s) you need. You shouldn't feel any pain during the procedure.
During certain procedures, doctors may ask you to move your arms, cough, or hold your breath at times.
Afterward, you'll recover in another room and may need to lie flat for a while. You may be able to go home the same day.
Risks
Because it is minimally invasive, there are less risks with a cardiac catheterization than with open heart surgery, and it is generally very safe. However, common risks include bruising, bleeding, arrhythmias, blood clots, stroke, heart attack, infection, allergic reaction, blood vessel perforation, and damage where the catheter traveled or was inserted.
Why Choose Duke
National Leaders
Our cardiac catheterization labs are training centers for interventional cardiologists from across the country, who travel here to learn from our experts about the latest techniques and how to work with new devices and therapies.
Clinical Trials Access
As a Duke patient, you may be eligible to participate in clinical trials testing new therapies or diagnostics that are not yet widely available. Examples include gene therapy for heart failure and pulmonary hypertension, neuromodulation approaches such as splanchnic nerve denervation for heart failure, structural heart interventions such as interatrial shunting, and remote monitoring.
This page was medically reviewed on
06/18/2026
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