Procedures to Evaluate the Cardiovascular System
1. Angiography – intravenous injection of radiopaque solution or contrast for the purpose of studying its circulation through the patient’s heart, lungs and great vessels.
- Used to check the competency of the heart valves, diagnose congenital septal defects, study heart function and structure before cardiac surgery, detect occlusions of coronary arteries.
2. Cardiac catheterization – insertion of a radiopaque catheter into a vein to study the heart great vessels.
- Used to confirm diagnosis of heart disease and determine extent of disease, measure pressures in the heart chamber and great vessels, obtain estimate of cardiac output, and obtain blood samples to measure oxygen content.
a. Right heart catheterization – catheter is inserted through a cut-down in the antecubital vein into the superior vena cava, through the right atrium and ventricle and into the pulmonary activity.
b. Left-heart catheterization- catheter maybe passed retrograde to the left ventricle through the brachial and femoral artery, it can be passed through the left atrium after right-heart catherization by means of a special needle that punctures the septa; or it may be passed directly into the left ventricle by means of a posterior puncture.
Specific nursing considerations:
1Preprocedure patient teaching:
a. Fatigue is a common complaint due to lying still for 3 hr
b. Feeling of fluttery sensation while the catheter is passed back into the left ventricle
c. Flushed, warm feeling may occur when contrast medium is injected.
Postprocedure observations:
a. monitor ECG pattern for arrhythmias
b. check extremities for color and temperature, peripheral pulses for quality.
3. Angiography (Arteriography) – injection of a contrast medium in to the arteries to
study the vascular tree.
- Used to determine obstructions or narrowing of peripheral arteries.
