Myocardial Biopsy

Myocardial biopsy or cardiac biopsy is method that involves using a bioptome (a tiny catheter with a clutching device at the end) to extract a small fragment of heart muscle tissue to send to a laboratory for test.

In other words myocardial biopsy is the extraction of a small piece of heart muscle for study.

Why Myocardial Biopsy is Performed

The physician uses myocardial biopsy to:

  • Analyze or confirm the evidence of rejection post heart transplant.
  • Diagnose myocarditis (irritation of the heart muscle) or the reason of cardiomyopathy (heart muscle disorder).

How Myocardial Biopsy is Conducted

  • Myocardial biopsy is conducted during cardiac catheterization or identical procedure.
  • The biopsy will be conducted in the, cardiac diagnostics section, special procedures ward, or radiological department of a hospital.
  • After you slip into a hospital gown, a medical assistant will place an intravenous (IV) line in your arm to administer medications and fluids during the procedure.
  • You will be instructed to lie on a special table meant for this purpose which will be surrounded with a large camera and various TV monitors.
  • You may be administered a sedative before the procedure to enable you relax, but you will be conscious and in a position to follow instructions all through the test.
  • You will be conscious and awake during the complete biopsy. The doctor will use drugs to numb the location of your neck.
  • A surgical incision will be created in your arm, neck, or groin.
  • A plastic sheath (a short, hollow tube using which the catheter is placed) will be introduced into a blood vessel.
  • A bioptome will be sent through the sheath and threaded to your right ventricle. An X-ray camera may be facilitated to place the bioptome properly.
  • Once in position, this special tool with jaws on the top is facilitated to remove small pieces of tissue from the heart muscle.
  • After the bioptome has taken samples of your heart muscle, (the sample is about the size of the top of a needle), the catheter is taken out and firm pressure is held over the location to stop bleeding.
  • The process may take about 30 to 60 minutes.

How to Prepare for Myocardial Biopsy Test

  • You can wear according to your wish in the hospital, but it is advisable to leave valuables, like jewelry, at home. You will wear a hospital gown all through the procedure.
  • You will have to sign a consent form also.
  • Your doctor or nurse will offer you special instructions about what you are permitted to eat and what you cannot eat or drink prior to the procedure.
  • You will generally be admitted in the morning of the pre-fixed date of biopsy, but in some instances, you may require to get admitted the night before.
  • You can consult your physician about the medications that should be taken on the day of your test.
  • If you are diabetic, get an idea from your doctor how to adjust your drugs on the day of your test.
  • Don’t forget to disclose to your doctor and/or nurses if you are allergic to some drugs or anything else.  
  • Ask someone to take you home after the test.
  • A health care provider will narrate the entire process and its risk factors, if any.

How Myocardial Biopsy Will Feel

You may experience some pressure at the biopsy location. You may have some uneasiness due to lying still for a prolong duration of time.

Why Myocardial Biopsy is Performed

This procedure is conducted after heart transplantation to examine for signs of rejection. Your doctor may also instruct this procedure if you have symptoms of:

  • Alcoholic cardiomyopathy
  • Cardiac amyloidosis
  • Cardiomyopathy
  • Peripartum cardiomyopathy
  • Restrictive cardiomyopathy Myocarditis
  • Hypertrophic cardiomyopathy
  • Ischemic cardiomyopathy

Normal Results

A normal result says there was no unusual heart muscle tissue.

What Abnormal Results Mean

An abnormal result says abnormal tissue was present. This test may divulge the cause of cardiomyopathy. Abnormal tissue can also be witnessed due to:

  • Amyloidosis
  • Transplant rejection
  • Myocarditis

Risks Factors Associated with Myocardial Biopsy

Risks are not severe which may include:

  • Infection
  • Bleeding from the biopsy location
  • Cardiac arrhythmias
  • Pneumothorax
  • Blood clots
  • Vein or artery trauma
  • Injury to the recurrent laryngeal nerve
  • Rupture of the heart (although very rare)
  • Tricuspid regurgitation

Alternative Names

Heart biopsy; Biopsy-heart.