Endomyocardial biopsy is removal of a small sample of heart tissue to check it for signs of damage caused by organ rejection or cause of disease involving muscle of the heart. Endomyocardial biopsy can be performed under local anesthesia with x ray or echocardiogram guidance. The doctor will insert the catheter into your blood vessel (vein) in your neck or in your leg and then pass the second catheter with the scissor at the end through the vein to the right heart to get small pieces of heart muscle. Normally, 4 pieces of heart muscle are required to examine microspcically.

You need to be fasted for at least 4 hours before the test. The complications are rare, however, these include heart rupture requiring surgery, air trapped in the lung sac requiring chest tube drainage, or infection /bleeding at the needle sites.

If the doctor chooses vein in the neck for the biopsy, you are required to check for any air trapping by chest x ray evaluation before home dismissal.