A heart biopsy helps specialists in our Interventional Cardiology Program diagnose a range of complex heart conditions or monitor you after a heart transplant. We use minimally invasive techniques to safely obtain tissue samples.
What is an Endomyocardial Biopsy (EMB)?
An endomyocardial biopsy, also called a heart biopsy or cardiac biopsy, is a minimally invasive procedure to remove a small amount of heart tissue for evaluation under a microscope. A biopsy looks for cell changes that indicate heart damage or another heart problem.
An interventional cardiologist uses flexible, hollow tubes (catheters) inserted through your blood vessels and up into your heart. They place a small device through the catheter that retrieves tiny pieces of heart tissue. An endomyocardial biopsy is a type of procedure called cardiac catheterization.
Who Might Need a Heart Biopsy?
People who have had a heart transplant often need periodic heart biopsies after the procedure. These biopsies check for early signs that the body is treating the new heart like a foreign invader (organ rejection). A heart biopsy can help us detect organ rejection even before symptoms develop.
Cardiologists may also use heart biopsies to diagnose conditions such as:
- Cardiac amyloidosis, a rare disease in which proteins build up in the heart and replace normal heart tissue
- Cardiomyopathy, a heart muscle disease in which the heart can't pump blood as efficiently as it should
- Cardiotoxicity, heart damage caused by chemotherapy or other cancer treatments
- Heart cancer, extremely rare clusters of irregular cells (tumors) that form in the heart
- Heart failure, when the heart doesn't pump enough blood to meet the body's needs
- Myocarditis (heart tissue inflammation), inflammation in the myocardium, the middle layer of the heart wall
- Sarcoidosis, a rare disease that causes small clusters of inflammatory cells (granulomas) to form throughout the body
Preparing for an Endomyocardial Biopsy
Your care team will give you specific instructions to prepare for an endomyocardial biopsy. Tell your provider about all medications you take regularly, including over-the-counter medicines and supplements. You may need to stop taking certain medicines, such as blood thinners, for a brief period before the procedure. The care will likely tell you to stop eating or drinking several hours before the biopsy.
What to Expect During a Cardiac Biopsy
A cardiac biopsy usually lasts around one hour. An interventional cardiologist, interventional echocardiographer and an anesthesia specialist work together to perform the procedure.
You receive anesthesia to keep you calm and comfortable while remaining awake during the procedure. Feeling some discomfort or pressure is normal, but you shouldn't feel any pain.
During a cardiac biopsy, an interventional cardiologist:
- Makes a small incision in your groin or wrist, inserts a catheter through a blood vessel and guides it to your heart
- Places a small device shaped like forceps (bioptome) through the catheter
- Uses the bioptome to remove a small sample of heart tissue
- Withdraws the catheter and applies pressure and a bandage to the insertion site
- Sends the sample of heart tissue to a laboratory for analysis
Heart Biopsy Recovery
You typically stay in a recovery room for a few hours after a heart biopsy. Your care team monitors you for any signs of complications. Heart biopsies are outpatient procedures, so you can return home the same day. You'll need to avoid strenuous activities for 24 hours and most people resume their usual activities the next day. You may have some bruising around the catheter insertion site.
Benefits and Risks of a Heart Biopsy
A heart biopsy gives you provider precise information about your heart that isn't possible to obtain with imaging alone. It can help find the root cause of a heart condition or determine how well your heart is responding to certain treatments.
As a minimally invasive technique, heart biopsy offers less pain and fewer complications with a shorter hospital stay than an open-heart procedure.
Heart biopsies are generally low-risk procedures. However, all medical procedures have some risk of complications. The risks of a heart biopsy may include:
- Arrhythmias (irregular heart rhythms)
- Blood clots
- Blood vessel damage
- Heart valve damage
- Hemothorax, bleeding between your lungs and chest wall
- Infection
- Nerve damage
- Pneumothorax, a collapsed lung
- Punctured heart tissue
Heart Biopsy: The Penn Medicine Advantage
Penn interventional cardiologists are among the nation's leaders in catheter-based procedures. When you choose our team, you benefit from:
- State-of-the-art technology: We perform endomyocardial biopsies in our advanced imaging and cardiac catheterization laboratory (cath lab). Our interventional imaging specialists are highly skilled in a range of techniques and tools that allow us to diagnose and treat heart problems with exceptional visualization and precision.
- Extensive diagnostic testing: We use the full range of interventional techniques to evaluate the heart, including heart biopsies. Our array of diagnostic testing options leads to accurate diagnoses that inform targeted treatment plans.
- Treatment for complex cases: We are a major regional referral center, taking on the most complex and severe cases. If you have high risks associated with surgery or have been turned down for open-heart surgery, our interventional cardiologists offer advanced, minimally invasive treatments.
Make an Appointment
Please call 800-789-7366 or request a callback.