Cardiac Catheterization of Left Heart Medication

Updated: Apr 13, 2016
  • Author: Roger B Olade, MD, MPH; Chief Editor: Karlheinz Peter, MD, PhD  more...
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Medication Summary

The goals of pharmacotherapy are to reduce morbidity and prevent complications.


Anticoagulants, Hematologic

Class Summary

Anticoagulants prevent recurrent or ongoing thromboembolic occlusion of the vertebrobasilar circulation.


Heparin augments the activity of antithrombin III and prevents conversion of fibrinogen to fibrin. It does not actively lyse but is able to inhibit further thrombogenesis. It prevents the recurrence of a clot after spontaneous fibrinolysis. Because of the smaller-diameter arteries in the upper extremity (and, thus, the more occlusive nature of the catheters), anticoagulation is required for the procedure, and unfractionated heparin is used frequently. Many operators also administer heparin when access is obtained from the femoral artery, especially if the procedure is prolonged and several catheter exchanges are required.


Metabolic & Endocrine, Other

Class Summary

Agents in this class may prevent worsening of renal insufficiency in certain patients.

Acetylcysteine (Acetadote)

Acetylcysteine premedication in addition to hydration has been shown in one study to prevent worsening of baseline renal insufficiency. It is not indicated in all patients or in patients allergic to contrast. Acetylcysteine may scavenge oxygen-derived free radicals and improve endothelium-dependent vasodilation.