Cardiovascular Diagnostic Tests - Summary

Presenter

• Cathy, Level Up RN

Topics Covered

1. Overview of Cardiovascular Diagnostic Procedures
2. Electrocardiogram (EKG)
3. Echocardiogram
4. Transesophageal Echocardiogram (TEE)
5. Hemodynamic Monitoring
6. Coronary Angiogram (Cardiac Cath)

Electrocardiogram (EKG)

• Provides a graphic representation of the heart's electrical activity.
• Useful for diagnosing a variety of heart conditions.
• Additional resources: EKG flashcards and video playlist.

Echocardiogram

• Uses ultrasound waves to visualize cardiac structures, especially heart valves.
• Measures ejection fraction (normal: 55-70%).
• Reduced ejection fraction indicates heart failure.

Transesophageal Echocardiogram (TEE)

• A more detailed view of cardiac structures via a transducer placed down the esophagus.
• Conducted under conscious sedation.

Hemodynamic Monitoring

• Provides direct measurement of pressures in the heart and great vessels through an arterial line.
• Measures include:
  • Central Venous Pressure (CVP): 2-6 mmHg
  • Pulmonary Artery Wedge Pressure (PAWP): 4-12 mmHg
  • Cardiac Output

Coronary Angiogram (Cardiac Cath)

• Used to determine blockages or narrowing of coronary arteries.
• Procedure:
  • Catheter inserted at femoral artery and threaded to the heart.

Pre-Procedure Nursing Care

• Patient NPO for 8+ hours.
• Assess for allergies to iodine and shellfish (though evidence on this is mixed).
• Assess kidney function (creatinine and BUN levels).
• Mark distal pulses (dorsal pedis, posterior tibial).

Post-Procedure Nursing Care

• Check insertion site for bleeding.
• Check extremity distal to insertion site for pulse, capillary refill, color, and temperature.
• Monitor vital signs per facility policy:
  • Every 15 min for the first hour.
  • Every hour for the next four hours.
• Encourage increased fluid intake to flush out contrast dye.
• Patient should lay flat for 4-6 hours.

Quiz Questions

1. What procedure uses ultrasound waves to visualize cardiac structures and measure ejection fraction?
   • Answer: Echocardiogram
2. What lab values are used to assess a patient's kidney function prior to a cardiac cath?
   • Answer: Creatinine and BUN (Creatinine is more important)
3. How should a patient be positioned after a cardiac cath?
   • Answer: Lay flat for 4-6 hours.

Next Steps

• Next video will cover dysrhythmias.

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