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 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 X-ray images called fluoroscopy to guide the insertion. A bioptome (catheter with jaws in its tip) is then introduced. Once the bioptome is in place, three to five small pieces of tissue are removed from the heart muscle.

Adults:
Your food and fluids are restricted 6 to 8 hours before the test. You may be admitted to the hospital the night before the test, or admitted as an outpatient or inpatient the morning of the procedure. A health care provider must explain the procedure and its risks. You must sign an informed consent form. A mild sedative is usually given 1/2 hour before the procedure. You will wear hospital clothing.

Infants and children:
The physical and psychological preparation you can provide for this or any test or procedure depends on your child's age, interests, previous experience, and level of trust. For specific information regarding how you can prepare your child, see the following topics as they correspond to your child's age:

• 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)

The procedure takes place in a radiology department, special procedures room, or cardiac diagnostics laboratory within a hospital.

You are sedated prior to the procedure, but are 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.

You are given local anesthesia to insert the catheter, so the only sensation is one of pressure at the site. Discomfort may arise from having to remain still for prolonged periods of time. The procedure may last from 1 to several hours.

• normal heart muscle tissue
• no abnormal tissues

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