What Is a Myocardial Biopsy?
The heart muscle is known as the myocardium. If your doctor suspects a problem with your heart
muscle, you may need a biopsy. This involves removing a small piece of tissue
for examination. A heart biopsy is known as a myocardial biopsy.
A doctor often performs a myocardial biopsy during cardiac catheterization
or other heart tests. However, you can also have this test on its own. The
procedure usually occurs in a hospital.
This biopsy uses a small catheter called a bioptome to remove a small
piece of heart tissue. This is a special type of catheter used to take a
biopsy. It has jaws on the end that can remove a piece of tissue.
After the biopsy, your doctor will send the sample to a
laboratory for analysis.
Why Do I Need a Myocardial Biopsy?
This procedure looks for disease or damage in the heart muscle.
It can help diagnose:
deterioration of the heart muscle, which can be due to a number of conditions
inflammation of the heart muscle
after a heart transplant: your immune system causes tissue damage that
your doctor can see under a microscope
How Do I Prepare for a Myocardial Biopsy?
Your doctor will give you instructions on whether you can eat and
drink before the biopsy. Typically, you shouldn’t consume food or liquid for
six to eight hours before the test.
If you take any medications or supplements, ask your doctor
whether you should stop them before the procedure. If you’re diabetic, your
doctor may need to adjust your medications for the day of the biopsy. Let your
doctor know about any allergies you may have.
You’ll probably enter the hospital the morning of your biopsy. In
rare cases, you may need to go to the hospital the night before.
Bring someone with you to the procedure or have a car service
send a car for you after it’s over. You will not be able to drive yourself
How Is a Myocardial Biopsy Performed?
You will receive a hospital gown to wear during the biopsy. A
nurse will start an intravenous line in your hand or arm. This will deliver
fluids to keep you hydrated. It can also deliver medication if your blood
pressure drops or if your heartbeat becomes abnormal.
You will lie on a table with a large camera above you, along with
several monitors. A surgeon will make an incision in your neck, arm, or groin,
depending on whether you’re having another surgery. If you aren’t having
another procedure, it will probably be in the neck. Location of the incision
also depends on the part of the heart your doctor wants to sample.
You will receive a local anesthetic at the incision site. This
will numb it, since you won’t be unconscious for the procedure. The surgeon
will insert a hollow tube into your blood vessel to hold it open. You may feel
some pressure or discomfort.
Once the tube is in place, the surgeon will insert the bioptome. They
will thread it through your blood vessels until it reaches your heart. The
doctor will guide it there using a special type of moving X-ray called
Once in the correct location, the doctor will take a small sample
of your heart muscle tissue. Then they’ll remove the bioptome and apply
pressure to the insertion site. The whole procedure takes 30 to 60 minutes.
The medical staff will monitor your condition for a period of
time after the procedure. The doctors will want to be sure you’re stable enough
to be on your own. As you won’t be able to drive, someone else will need to
take you home after the biopsy.
What Are the Complications Associated with a
You’ll need to sign a consent form prior to the procedure that
will outline the risks of the biopsy. A myocardial biopsy may seem scary.
However, with an experienced doctor, complications are rare.
Some potential risks include:
- blood clots
- abnormal heart rhythm
- collapsed lung
- injury to the artery
- damage to the nerve that controls speech
- rupture of the heart (extremely rare)
What Do the Results Mean?
The results of a myocardial biopsy will let your doctor know if
there’s any damage to your heart muscle. A number of conditions can cause an
abnormal biopsy, including:
- heart damage from long-term alcohol use
- cardiac amyloidosis, a disease where amyloid
protein builds up in the heart
- various types of cardiomyopathy
- rejection of a heart transplant
If you do have heart muscle damage, treatment will vary depending
on its cause.