Myocardial biopsy

• Illustrations
• Alternative names
• Definition
• How the test is performed
• How to prepare for the test

• How the test will feel
• Why the test is performed
• Normal Values
• What abnormal results mean
• What the risks are

Alternative names    Return to top

Definition    Return to top

Myocardial biopsy is a diagnostic procedure in which a small piece of heart muscle tissue is removed for examination.

How the test is performed    Return to top

Myocardial biopsy is performed similarly to (or as part of) cardiac catheterization. The skin is scrubbed and a local anesthetic is injected into the skin. A catheter (thin tube) is inserted through a vein or artery, depending on whether cardiac tissue is needed from the right or left ventricle, respectively.

When myocardial biopsy is performed by itself, the jugular vein in the neck is most commonly used. The catheter is then carefully threaded into the heart, using a type of x-ray images called fluoroscopy to guide the insertion. A catheter with jaws in its tip, called a bioptome, is then introduced. Once the bioptome is in place, three to five small pieces of tissue are removed from the heart muscle.

How to prepare for the test    Return to top

Food and fluid are restricted for 6 - 8 hours before the test. The procedure takes place in the hospital. Generally, you will be admitted as either an outpatient or an inpatient the morning of the procedure. In some cases you may need to be admitted the night before.

A health care provider must explain the procedure and its risks. You must sign a consent form.

A mild sedative is usually given 1/2 hour before the procedure. You will wear hospital clothing.

Infants and children:

The preparation you can provide for this test depends on your child's age, previous experiences, and level of trust. For general information regarding how you can prepare your child, see the following topics:

• Infant test or procedure preparation (birth to 1 year)
• Toddler test or procedure preparation (1 to 3 years)
• Preschooler test or procedure preparation (3 to 6 years)
• Schoolage test or procedure preparation (6 to 12 years)
• Adolescent test or procedure preparation (12 to 18 years)

How the test will feel    Return to top

The procedure takes place in a radiology department, special procedures room, or cardiac diagnostics laboratory within a hospital. You will be given sedation to relax prior to the procedure, but you will remain awake and able to follow instructions during the test. You will remain on a stretcher or flat on a radiology table for the duration of the test.

An incision will be made into a vein in your arm, neck, or groin for threading the catheter into your heart. You will be given a local anesthesia for the insertion of the catheter, and the only sensation should be one of pressure at the site.

You may feel some discomfort due to lying still for a prolonged period of time. The procedure may last from one to several hours.

Why the test is performed    Return to top

This test is performed routinely after heart transplantation, to detect potential rejection. It may also be performed when cardiomyopathy, myocarditis, cardiac amyloidosis, or other disorders are suspected.

Normal Values    Return to top

• Normal heart muscle tissue
• No abnormal tissues

What abnormal results mean    Return to top

This test may reveal:

• Causes of cardiomyopathy
• Myocarditis
• Amyloidosis
• Transplant rejection

Additional conditions under which the test may be performed:

• Alcoholic cardiomyopathy
• Hypertrophic cardiomyopathy
• Idiopathic cardiomyopathy
• Ischemic cardiomyopathy
• Peripartum cardiomyopathy
• Restrictive cardiomyopathy

What the risks are    Return to top

Risks are moderate and include cardiac arrhythmias, trauma to the vein or artery, infection, blood clots (thrombosis) in the vein, bleeding from the biopsy site, pneumothorax, injury to the recurrent laryngeal nerve, and rupture of the heart (very rare).