Cardiology Tests Flashcards
Cardiology Department
Responsible for performing procedures on the heart; measures electrical activity at rest and when patient paces stress on heart; useful in diagnosing cardiac diseases.
Electrocardiogram
ECG
- A graphic recording of the heart’s electrical activity.
-Generated by conduction system of heart.
-Electrical impulses are picked up and conveyed to the electrocardiogram by electrodes or leads that are placed on various points of the body.
-A regular ECG has 12 leads.
-Ordered the same day unless specified.
-POS: Kx, RMO
-If STAT or Urgent contact Cardio Department to send tech (Cardio Aware POS).
-No prep.
Holter Monitoring
-Electrodes are attached to the patient and the heart sounds are recorded on a small tape recorder worn by the patient as they carry on with their daily routine while recording activities in a diary.
-Tracing and diary are analyzed or read by cardiologist to aid in diagnosis.
-Usually ordered by physician when discharged from hospital.
-It is a continuous ECG tracing recorded on tape for 24-48 hours.
-May be useful to evaluate chest pain or abnormal heart rhythm.
- POS: Kx, RMO (STAT or Urgent, call Cardio department, and add Cardio Aware).
-No prep.
Cardiac Event Monitor
-Event monitors are slightly smaller than Holter Monitors.
-Event Monitors record heart rhythm problems when the patient activates them.
-Can be worn for weeks or until symptoms occur.
-Mostly worn like Holter Monitors (clipped to belt or carried in pocket).
-When symptoms occur patient pushes button to start recording.
-POS: Kx, RMO (STAT or Urgent, Call Cardio Department and put Cardio aware on Kx).
-No prep.
Stress Test/Treadmill Test/ Exercise Tolerance Test (ETT).
- A stress test is the graphic reading of the heart’s electrical activity at rest and during exercise.
- A treadmill or stationary bicycle is used to increase the heartbeat and to place the heart in a stress condition.
- Exercise endurance can tell a physician a lot about the existence and severity of coronary artery disease and other heart disorders.
- Monitors a patient’s ECG and blood pressure during exercise can reveal problems that would not appear at rest.
- UC must call Cardio Department to book the test giving time and date (Classroom purposes will be next day unless specified).
-POS: Kx, RMO.
-Prep (Write prep on Kx beside test).
MIBI or Persantine Stress Test
-MIBI and Persantine Stress Test is similar to regular Stress Test in that the patient has a Stress Test on a treadmill or stationary bicycle in the Cardiology Department.
-At the end of the ETT a radioactive substance is injected into the vein, which is quickly distributed through the body.
-After a short period of time the patient returns to Nuclear Medicine Department where a scan is done of the heart.
-Patient is given a return time to come back later for another injection of radioactive substance and more scans to see the heart at rest.
-UC will Cardio Department to book an appointment who will then collaborate with Nuclear Medicine and give date and time for procedures (Classroom purposes T+1 unless stated).
-POS: Kx, RMO, (Need 2 REQS for MIBI Nuclear Medicine REQ and ETT REQ).
-Prep (Write prep on Kx beside test).
Echocardiogram ECHO
-Uses high frequency ultrasound waves (doppler) emitted by a recording probe (transducer) and bounces off structures in the heart and blood vessels to produce moving image.
-Image appears on a screen and is recorded on a videocassette.
-By varying the placement and angle of the probe a doctor can view the heart and major blood vessels from various angles to get an accurate picture of the heart structure and function.
-EF: Ejection Fraction refers to the function of the heart.
-Normal EF is 50%-60%.
-POS: Kx, RMO.
-No Prep.
Transesophageal Echocardiogram TEE
-A tee uses sound waves to get a moving picture of the heart structures; transducer is placed in the esophagus rather than on chest.
-Esophagus is much closer to the heart and the cardiologist can get a much better picture.
-Patient is sedated to relax and given oxygen; throat is numb and tube inserted.
-POS: Kx, RMO.
-Prep (Write prep on Kx beside test).
Telemetry Monitoring
-A telemetry monitoring unit is a patient care area where the activity of a Holter Monitor worn by patients is registered at the nurse’s station than on a tape recorder; transmission of information via an electronic device.
-Nurse can print out strip of continuous ECG for interpretation if nurse detects abnormality.
-Patients are usually monitored over a two or three day period.
-Telemetry monitoring is generally used on patients coming in through Emergency complaining of chest pain or patients being transferred out of ICU but still need to be monitored for a short period of time.
-UC : Bed booking will let UC know if there is bed available for the patient to be transferred in the Telemetry Unit; admission and transfer process.
-NUC working a unit that has both Tele pts and Non Tele pts need to indicate on Kx if they are on Tele.
Heart Studies
Heart Attack: MI: Myocardial Infraction > part of heart muscle does not get enough blood.
Cardiac Arrest> sudden loss of heart function, breathing and consciousness.
Cardiac Catheterization
-Insertion of a catheter into a blood vessel and guiding it into the interior of the heart.
-Done to see a problem with the heart
> Locate narrowing or blockages in blood vessels that could cause chest pain.
>Measure pressure and oxygen levels in different parts of the heart.
> Check pumping function of heart.
>Take sample of tissue from heart (Biopsy).
>Diagnose heart defects present from birth (CHD).
>Look for problems in heart valves.
-Done at RCH, not Fraser River.
-Done in Cath Lab.
-Require Consent Form.
Procedure:
1. Given and IV and Anesthetic.
2. Tube is inserted through groin or arm to reach heart’s blood vessel.
3. Dye is injected into blood vessels so they’ll appear on x-ray.
4. Doctor will look for blockages and any other issues.
5. Catheter can also be used to clear blockages and make repairs.
Angiogram
-Coronary arteries supply your heart w/ blood.
-They can become clogged from a buildup of cholesterol, cells, or other substances (plaque).
>reduces blood flow to heart.
>blood clot could lead to MI.
-Angiogram checks for narrowing in arteries of heart caused by buildup.
-Involves injection of contrast medium into artery so X-rays may be taken of blood flow.
-Requires Consent Form.
-RCH, VGH,…not Fraser Valley.
Angioplasty
-Dilation of blocked or narrowed artery using balloon catheter/stent.
-Done to restore blood flow through arteries to heart.
-Doctor threads a thin tube though a blood vessel into the arm or groin that has a tiny balloon on the end.
-RCH, not Fraser Valley.
-Requires Consent Form.
Electrophysiology Studies
-Studies test the electrical conduction of the heart.
-Investigates cause, location of, origin and best treatment for various abnormal heart rhythms.
-Performed by Electrophysiologist.
-RCH.
-Medical Imaging REQ.
UC Responsibilities For Angiogram, Angioplasty, Cardiac Catheterization, and Electrophysiology Studies.
- Contact hospital that will do the procedure and book procedure. They will tell you date and time appt will be booked. Physician will fill out REQ.
- Kardex under diagnostic with date requested and date scheduled.
- Kardex under appointment section all relevant info of appt, pick up time, return time and so on.
- Book transportation for patient to attend appointment.
- Book nurse escort if needed (Usually PCC does this step).
- Copy Patients chart to go with patient.
- POS: K, Rn Aware, write appt booked and date of appt on the right side of order.
