CARDIAC DIAGNOSTIC TESTS

Diagnostic Definition Procedure Normal Nursing Responsibilities References

Procedure Values/Normal
Findings/values
1.Holter Monitor  A portable, battery- 1. Electrodes (small conducting Normal variations Pre:  http://www.rush.
(ambulatory powered ECG machine patches) are stuck unto the in heart rate edu/rumc/page-
electrocardiogra for continuously chest and attached to a small occur with  Assess if patient has allergy to 1098987311875
phy device) monitoring various recording monitor or the Holter activities. A any tape or other adhesives. .html
electrical activity of the monitor which is carried in a normal result is  Make sure the patient will take  http://www.claria
central nervous system pocket or small pouch worn no significant a shower or bathe before n.org/ADAM/doc
for at least 24-48 hours - around the neck or waist. changes in heart starting the test. /HealthIllustrate
during normal activities. 2. While wearing the monitor, it rhythms or dEncyclopedia/1
Post:
 Indicated to Patients records the heart's electrical pattern. /003877.htm
with heart rhythm activity. Patient should keep a  Gently remove the tape and  http://en.wikiped
irregularities diary of what activities he had other paraphernalia securing ia.org/wiki/Holte
(palpitations) or slow done while wearing the the electrodes r_monitor
(bradycardia) or rapid monitor.  Wipe the patient clean of
(tachycardia) heart 3. After 24 - 48 hours, the electrode gel
rhythms, which are not monitor is returned to the  Inform the patient that the
documented on the doctor's office. The doctor will Holter monitoring
routine look at the records and see if interpretation will be available
electrocardiogram. there have been any irregular in few days
 Helpful in the diagnosis heart rhythms.
of paroxysmal
(intermittent) rhythm
disturbances and
essential for selecting
proper treatment and at
times for evaluating the
subsequent outcome on
 treatment.
2.Electrocardio  A noninvasive test that 1. List medications the patient is Pre:  http://www.ecglib
graphy records the electrical taking on the ECG request  Explain the procedure to the rary.com/norm.ht
activity of the heart, form patient ml
shows abnormal rhythms 2. Tell the patient that, although  Tel l the patient that no food or  http://en.wikipedi
(arrhythmias or this procedure carries no fluid restriction is necessary. a.org/wiki/Electro
dysrhythmias), and discomfort, he or she must lie  Assure the patient that the cardiography#Pla
detects heart muscle still in the supine position flow of electric current is from cement_of_electr
damage. without talking while ECG is the patient. He or she will feel odes
 It determines the size recorded.  Normal nothing during this procedure.  http://www.rush.e
and position of the 4. Patient lies flat on a bed or heart rate(60-  Expose only the patient’s du/rumc/page-
chambers, the presence table. 100 beats/min), chest and arms. Keep the 1098987311875.
of any heart damage and 5. Expose only the patient’s rhythm, and abdomen and thighs html
the effects of drugs or chest and arms. Keep the wave adequately covered.  http://www.medic
devices used to regulate abdomen and thighs deflections  Tell the patient that, although inenet.com/electr
the heart (like a adequately covered.  P wave this procedure carries no ocardiogram_ecg
pacemaker) 6. The skin areas designated for rate 60 - 100 discomfort, he or she must lie _or_ekg/article.ht
electrode placement are bpm with <10% still in the supine position m
prepared by using alcohol variation without talking while the ECG  http://www.
swabs or sandpaper to  normal P is recorded. clarian.org/portal/
remove skin oil or debris. waves Post: Clarian/heart-
Sometimes the skin is shaved o height < 2.5  Remove the electrodes from cardiovascular?
if the patient has a large mm in lead II the patients’ skin and wipe off ContentID=/medi
amount of hair. o width < 0.11 s the electrode gel cal-
Pads with special gel are applied in lead II services/heart-
 Indicate on the ECG strip or
to ensure electrical conduction  normal PR cardiovascular/di
request slip if the patient was
between the skin and the interval - 0.12 agnostic-
experiencing chest pain during
electrodes. to 0.20 s (3 - 5 testing.xml
the study. The pain is
7. Electrodes are applied to the small squares) correlated with an arrhythmia
four extremities. Many  normal on the ECG.
cardiologists recommend that QRS complex -
arm electrodes be placed on < 0.12 s
the upper arm, because fewer duration (3
muscle tremors are detected
 there. small squares)
The chest leads are applied one
at a time, three at a time, or
six at a time, depending on
the type of ECG machine.
These leads are positioned as
follows:
V1: 4TH ICS, right sternal border
V2: 4th ICS, left sternal border
V3: midway between V2 and V4
V4: 5th ICS MCL
V5: 5th ICS left AAL
V6: 5TH ICS left MAL
The test takes about five minutes
and is painless.
3.Cardiac MRI  A noninvasive medical 1. Patient positioned on the Pre:  http://www.radiol
(Magnetic test that uses a powerful moveable examination table.  Assess presence of ogyinfo.org/en/inf
Resonance magnetic field, radio pacemakers, metal plates, o.cfm?
Imaging) frequency pulses and a 2. Straps and bolsters may be pg=bodymr
prosthetic joints and other
computer to produce used to help you stay still and  http://www.claria
metallic implants because they
detailed pictures of maintain the correct position n.org/portal/Clari
can be dislodged during MRI.
organs, soft tissues, bone during imaging. an/heart-
 If the patient is anxious, he may
and virtually all other 3. Small devices that contain be sedated.Position patient in cardiovascular?
internal body structures. coils capable of sending and supine in the table that is placed ContentID=/medi
The images can then be receiving radio waves may be in an enclosed imager that cal-
examined on a computer placed around or adjacent to contain the magnetic field. services/heart-
monitor, transmitted the area of the body being  Instruct patient that a thumping cardiovascular/di
electronically, printed or studied. sound is produced which may agnostic-
copied to a CD. be annoying, so patients may be testing.xml
 MRI does not use ionizing 4. If a contrast material is used offered headsets to hear music.  http://www.
radiation (x-rays). during the examination, it will  A microphone is present in the rush.edu/rumc/pa
 This may be used to be injected into the scanner where the patient can ge-
evaluate the heart valves intravenous line (IV) after an communicate with the staff. 1098987311875.
and major vessels, detect
 coronary artery disease initial series of scans.  During the procedure instruct html
and the extent of damage patient to keep still and do not
it has caused, detect the 5. Additional series of images will
move.
presence of plaque be taken during or following
causing blockages of the the injection.
coronary arteries, 6. When the examination is
evaluate congenital completed, patient waits until
defects, and detect the the technologist or radiologist
presence of tumors or checks the images in case
other abnormalities additional images are needed.
diseases that may not be
assessed adequately with 6. Intravenous line will be
other imaging methods removed.
such as x-
MRI exams generally include
ray, ultrasound or comput
multiple runs (sequences),
ed tomography (also
some of which may last
called CT or CAT
several minutes.
scanning).
 It may be used prior to 7. Depending on the type of
other cardiac procedures exam and the equipment
such as angioplasty or used, the entire exam is
stenting of the coronary usually completed in 15 to 45
arteries and cardiac or minutes.
vascular surgery.
MR spectroscopy, which provides
additional information on the
chemicals present in the
body's cells, may also be
performed during the MRI
exam and may add
approximately 15 minutes to
the exam time.
4. Coro-nary  Cardiac catheterization is 1. The chosen catheter insertion Normal heart- Pre:  http://www.nhlbi.
Angiography/ the passage of a catheter site is prepared and draped in muscle motion,  Instruct the patient to abstain nih.gov/health/dci
Coronary through peripheral arteries a sterile manner normal coronary from oral intake for at least 4 to /Diseases/ca/ca_
Arteriography or veins into cardiac arteries, normal 8 hours before the test during.html
(cardiac chambers and coronary 2. The desired vessel is great vessels,  Mosby’s
 Mark the patient’s peripheral
catheterizatio arteries. Dye is given punctured with a needle and normal Diagnostic and
pulses with pen before
n) through the catheter, and 3. A wire is placed through the intracardiac catheterization. This will Laboratory test
moving x-ray pictures are needle and a sheath is placed pressures and facilitate post catheterization Reference. Ninth
made as the dye travels over the wire and into the volumes assessment of pulses at the Edition
through the heart. vessel affected and no affected  http://www.merck
 These tests define extremities .com/mmpe/sec0
coronary artery anatomy, 4. The angiographic catheter is  Provide appropriate pre 7/ch070/ch070b.
cardiac anatomy, and threaded through the sheath catheterization sedation as html
cardiac function to over a guided wire ordered by the physician  http://www.claria
establish diagnoses and  Instruct the patient to void n.org/ADAM/doc/
5. Once the catheter is in the
help select treatment before going to the HealthIllustrated
desired location, the
 Cardiac catheterization catheterization laboratory Encyclopedia/1/0
appropriate cardiac pressure
can be used to perform  Remove all valuables and dental 03419.htm
and volumes are measured
various tests, including prostheses before transporting
angiography, intravascular 6. Cardiac ventriculography is the patient to the catheterization
ultrasonography, performed with controlled laboratory
measurement of cardiac injection of contrast material  Tell the patient that during the
output (CO), detection and injection he or she may
quantification of shunts, 7. Each coronary artery is
experience severe hot flush.
endomyocardial biopsy, catheterized. Cardiac
This is uncomfortable but lasts
and measurements of angiography is then carried
only for 10 to 15 minutes.
myocardial metabolism. out with controlled injection of
Post:
 Common sites for contrast material
 Monitor patient’s vital signs
selective angiography:
8. During the injection, x-ray films  Apply pressure to the site of
aorta, coronary artery,
are rapidly made vascular access
right and left side of the
 Keep the patient on bed rest for
heart.. 9. The patient’s vital signs must
4 to 8 hours to allow for
be monitored constantly
complete sealing of the arterial
 during this procedure puncture
 Keep the affected extremity
10. If angiography is preformed,
extended and immobilized with
the cardiologist appropriately
sandbags to decrease bleeding
places the catheter and
 Assess the puncture site for
balloon at the stenoic area.
signs of bleeding, hematoma, or
note the following procedural
absence of pulse
steps:
 Assess the patient’s pulses for
a) As the ECG tracing is both extremities. Compare with
observed, the balloon is pre procedure baseline values
inflated and the stenoic areas  Encourage patient to drink fluids
are forcefully dilated to maintain adequate hydration
 Instruct patient to report any
b) If signs of myocardial ischemia
signs of numbness, tingling, pain
develop, the balloon is
or loss of function in the involved
immediately dilated
extremity
c) Usually inflation of the balloon
is continued only for 10
seconds

11. After obtaining all the

required information, the
catheter is removed and a
vascular closure device may
be placed

5.PERICARDIO  Involves aspiration of fluid 1. Patient is placed in the supine Normal findings: Pre:  Mosby’s
CENTESIS from the pericardial sac position Less than 50 ml,  Explain the procedure to the Diagnostic and
with needle, the tissue clear, straw- patient Laboratory test
that surrounds the heart, 2. An area in the fifth to sixth colored fluid Reference.
 Obtain informed consent for this
may be performed for intercostals space at the left without evidence Ninth Edition
procedure
therapeutic and diagnostic sterna margin is prepared and of any  http://www.nlm.
 Restrict fluid and food intake fro
draped.
 purpose 3. After skin anesthesia is bacteria,blood, or at least 4 to 6 hours nih.gov/medline
 The test is performed to performed, a large-bore malignant  Obtain IV access for infusion of plus/ency/article
relieve cardiac tamponade pericardiocentesis needle is fluids and cardiac medications if /003872.htm
by removing fluid and placed on a 50-ml syringe and required
improving diastolic filling. introduced into the pericardial  Administer pretest medication.
sac. Atropine is frequently given to
prevent the vasovagal reflex of
4. An electrocardiographic lead is
bradycardia and hypotension
often attached by a clip to the
Post:
needle to identify any ST-
 Closely monitor the patient’s vital
segment elevations, which
signs.
may indicate penetration into
 Check the dressing frequently for
the epicardium
drainage
5. Pericardial fluid is aspirated  Apply a sterile dressing to the
and placed in multiple catheter if one has been left for
specimen containers continuing pericardial drainage

6. Some patient who have

recurring cardiac tamponade
may require placement of an
indwelling pericardial catheter
for continuous draining fro 1 to
3 days

7. With certain types od

pericarditis, medications may
be instilled during
pericardiocentesis

6. Exercise  A graphic **Can be performed in the Normal  Do not eat or drink 3 hours prior  http://www.
ECG/ stress representation of the doctor's office or at the electrocardiogram to the test. This will prevent the cardioconsult.co
test electrical activity of hospital. tracings and heart possibility of nausea, which may m/DiagnosticTec
the heart muscle as 1. A trained technician will place rate, blood accompany vigorous exercise hniques/Exercise
Or Treadmill it contracts and several electrodes (small pressure within after eating. If you are diabetic ECG.php
relaxes. sticky patches) on your chest the normal range, and take medications for  http://www.
 A test that is given and shoulders to allow and no angina, diabetes, get special instructions rush.edu/rumc/pa
while a patient walks recording of the ECG during unusual from your doctor. ge-
on a treadmill or exercise. Wires link the dizziness, or  If you are currently taking any 1098987311875.
pedals a stationary electrodes to an ECG shortness of heart medications, check with html
bike to monitor the machine. breath your doctor. You may be asked  http://www.
heart during to stop certain medications a surgeryencyclop
exercise. Breathing 2. A cuff will be applied to your edia.com/St-
day or two before the test. This
and blood pressure arm to monitor your blood Wr/Stress-
can help get more accurate test
rates are also pressure during the test. Test.html
results.
monitored. 3. Patient will be shown how to  Wear loose, comfortable
 A stress test may be step onto the treadmill and clothing that is suitable for
used to detect how to use the support railings exercise. Men usually don't wear
coronary artery to maintain your balance. The a shirt during the test, and
disease, and/or to treadmill starts slowly, and women generally wear a bra and
determine safe then the speed and incline are a lightweight blouse or a hospital
levels of exercise increased gradually. gown. You should also wear
following a heart comfortable walking shoes or
attack or heart 4. Blood pressure will be checked sneakers.
surgery. every few minutes, and the
 This test is useful in ECG will be carefully watched  Before the test, you will be
detecting problems for abnormal changes. 5. 5. given an explanation of the
that may not be Patient will be instructed to test and asked to sign a
apparent while the report any symptoms, such as consent form. Feel free to ask
heart is at rest. chest pain, shortness of any questions about the
breath, leg fatigue, or procedure.
dizziness.  Several areas on your
chest and shoulders will be
**The test may end when you cleansed with alcohol and an
become too tired to continue abrasive lotion, to prepare the
or when you experience skin for the electrodes. Men
significant symptoms. Other may need to have areas of
times, the test may be stopped their chest shaved, to ensure
 when you reach your peak that the electrodes stay in
heart rate or when your ECG place
shows abnormal changes.

6. After the exercise portion of

the test is over, you'll be
helped to a chair or a bed.

7. Blood pressure and ECG will

be monitored while you
recover.

8. The technician will remove the

electrodes and cleanse the
electrode sites. The test
typically takes between 45
minutes to one hour, which
includes preparation for the
test, the exercise portion, and
the recovery period.

7. Magnetic  Used to assess blood 1. Wear any medicine patches. Normal findings: PRE:  http://www.merc
resonance volumes of interest (eg, The MRI may cause a burn at No evidence of k.com/mmpe/se
angiography blood vessels in the chest the patch site. pathology  Assess presence of allergy to any c07/ch070/ch07
(MRA)  or abdomen); all blood 2. Patient lie very still inside the medicines. 0g.html
 Assess presence of any other
flow can be assessed MRI machine  http://www.web
simultaneously. 3. Medicine to help the patient health conditions, such as kidney md.com/heart-
 MRA can be used to relax may be administered. be problems or sickle cell anemia, disease/magneti
detect aneurysms, that may prevent the patient from c-resonance-
stenosis, or occlusions in having an MRA using contrast angiogram-mra
the carotid, coronary, material.  Mosby’s
 Ask if the patient is or might be
renal, or peripheral Diagnostic and
arteries. Use of this pregnant. Laboratory test
 Instruct the patient to also, tell
technique to detect deep Reference.
 venous thrombosis is your doctor he worked around Ninth Edition
being studied. metal or if you have recently had
 A powerful magnetic field, angioplasty with a stent.
radio waves and a  Instruct the patient to have a
computer produce the pacemaker, implantable
detailed images. MR cardioverter-defibrillator (ICD),
angiography does not use artificial limb, any metal pins or
ionizing radiation (x-rays). metal parts in your body
 MR angiography may be (especially in your eyes), metal
performed with or without heart valves, metal clips in your
contrast material. If brain, metal implants in your ear,
needed, the contrast tattooed eyeliner, or any other
material is usually injected implanted or prosthetic medical
using a vein in the arm. device (such as a medicine
infusion pump).
 Ensure that an intrauterine device
(IUD) in place. An IUD may
prevent you from having the MRA
test done.
 Instruct the patient that he needs
to lie very still inside the MRI
machine.

8. PET  PET can demonstrate 1. Inject a small amount of Normal findings: Pre:  Mosby’s
(Positron myocardial perfusion and radioactive tracer into the Normal patterns  Instruct patient not eat or drink Diagnostic and
emission metabolism . bloodstream. of tissue liquids other than water six hours Laboratory test
tomography)  It is an imaging test that 2. Patient may be asked to drink metabolism prior to your scan. Take any Reference.
uses a substance called a a small amount of oral medications with water only. Ninth Edition
tracer to look for disease contrast to aid in the CT  If patient is breastfeeding at the  http://www.claria
in the body. portion of the scan. time of your procedure, it may be n.org/portal/Clar
 Unlike MRIs and CT 3. Patient rest quietly and avoid prudent to pre-pump milk for use ian/heart-
scans, which reveal the talking for approximately one until the tracer is safely out of cardiovascular?
structure of organs, a PET hour while the tracer is your body (usually up to 24 ContentID=/med
 scan shows how the distributed throughout your hours). ical-
organs and tissues are body.  Instruct patient, if available, bring services/heart-
functioning 4. Patient lie still on a table that any previous X-ray, CT, PET and cardiovascular/d
passes slowly through the MRI (magnetic resonance iagnostic-
scanner. imaging) results and images with testing.xml
5. When the exam is complete, you to our facility.  http://www.radio
patient is taken out of the  Instruct patient to remove metal logyinfo.org/en/i
scanner. objects, such as jewelry and nfo.cfm?
6. Occasionally, additional hairpins, may interfere with the pg=angiomr
images may be required. CT scan and should be left at
home.
 Tell the patient that actual scan
generally takes about one hour to
complete, but you should expect
to be at our facility for two to
three hours.

9.  This is an invasive 1. After being transported to the Normal findings: Pre:  Mosby’s
ELECTROPH procedure wherein cardiac catheterization Normal  Instruct patient to fast for 6 to 8 Diagnostic and
YSIOLOGIC multiple electrode laboratory, the patient has conduction hours before the procedure. Laboratory test
STUDY catheters are electrocardiographic leads intervals, Usually fluids are permitted until Reference.
fluoroscopically placed attached refractive periods, 3 hours before the test Ninth Edition
through a peripheral vein 2. The catheter insertion site, and recovery  Encourage patient to verbalize  http://www.claria
and into the right atrium usually the femoral vein, is times any fears regarding this test n.org/ADAM/doc
and or ventricle or less prepared and draped in a  Inform the patient that the /HealthIllustrate
often through an artery sterile manner. discomfort from catheter insertion dEncyclopedia/1
into the left atrium and or 3. Under fluoroscopic guidance is minimal /003867.htm
ventricle to determine the the catheter is passed to the Post:
details of abnormal atrium and ventricle.  Keep the patient on bed rest for
heartbeats, or 4. Baseline surface intracardiac approximately 6 to 8 hours
arrhythmias. ECGs are recorded  Evaluate the venous/arterial
5. Various part of the cardiac access site for swelling and
*With close cardiac electroconduction system are
monitoring, the electrode bleeding
stimulated by atrial or  Monitor patient’s vital signs for at
 catheters are used to pace ventricular pacing least 2 to 4 hours
the heart and potentially 6. Mapping of the
induced arrhythmias. electrocardiogram conduction
systems and its defects is
performed.
7. Arrhythmias are identified
8. Drugs may be administered to
assess their efficacy in
preventing EPS-induced
arrhythmias
9. Because dangerous
arrhythmias can be prolonged,
cardioversion must be readily
available.
10. Not only are vital signs and
the heart monitored but also
the patient is constantly
engaged in light conversation
to assess mental status and
consciousness.
10. CT:  Spiral  These can produce an 1. Patient is taken to the Normal findings: Pre:  http://www.merck
(helical) image in less than a radiology department and No evidence of  Explain the procedure to .com/mmpe/sec0
second and thus can asked to remain motionless in pathologic the patient 7/ch070/ch070g.
obtain images of the heart a supine position because any conditions  Obtain informed consent if html
and its blood vessels motion will cause blurring and required by the institution  Mosby’s
(coronary vessels). streaking of the final picture  Assess the patient for Diagnostic and
 May be used to evaluate 2. An encircling x-ray camera allergies to iodinated dye Laboratory test
pericarditis, congenital (body scanner) takes pictures or shellfish Reference. Ninth
cardiac disorders at varying intervals and levels  Keep the patient NPO for 4 Edition
(especially abnormal over the chest area. Often IV hours before the test in the  http://en.wi
arteriovenous dye is administered to event the contrast dye is kipedia.org/wiki/
connections), and enhance the chest image, and administered. Helical_cone_be
disorders of the great the x-ray studies are repeated.  An emesis basin should be am_computed_to
vessels (eg, aortic ready available. Some
 aneurysm, aortic patient may experience a mography
dissection), cardiac salty taste, flushing and
tumors, acute pulmonary warmth during the dye
embolism, chronic injection
pulmonary Post:
thromboembolic disease,  Encourage patient who
and arrhythmogenic right received dye injection to
ventricular dysplasia. increase their fluid intake
 CT requires a radiopaque because the dye is
dye, which may limit its excreted by the kidneys
use in patients with renal and causes diuresis
impairment.

11. TILT  It evaluates your blood 1. The patient lies supine on a Normal findings: Pre:  http://www.claria
-TABLE pressure as it responds to horizontal tilt table < 20 mm Hg  Instruct patient to fast for 6 n.org/portal/Clari
TESTING simple stresses and can 2. Obtain the patient’s blood decrease in to 8 hours before the an/heart-
help doctors determine pressure and pulse as systolic blood procedure. Usually fluids cardiovascular?
why you are fainting or baseline values before tilting is pressure and < are permitted until 3 hours ContentID=/medi
coming close to fainting . carried out 10 mm Hg before the test cal-
 It is to determine if the 3. Monitor these vital signs during increase in  Encourage patient to services/heart-
patient is prone to sudden the procedure diastolic blood verbalize any fears cardiovascular/di
drops in blood pressure or 4. Question the patient as to the pressure. Heart regarding this test agnostic-
slow pulse rates with presence of symptoms of rate increase  Inform the patient that the testing.xml
position changes. dizziness and should be less discomfort from catheter  http://www.
 It is sometimes performed lightheadedness than 10 beats/min insertion is minimal rush.edu/rumc/pa
with an electrophysiologic 5. The table is progressively tilted Post: ge-
cardiac study and is to 60 to 80 degrees while  Keep the patient on bed 1098987311875.
provocative test used to patient is being monitored. rest for approximately 6 to html
diagnose vasopressor Alternatively, the patient is 8 hours
syncope syndrome. asked to sit or stand.  Evaluate the
Patient with syndrome venous/arterial access site
usually for swelling and bleeding
demonstratesymptomatic  Monitor patient’s vital signs
hypotension and syncope for at least 2 to 4 hours
 within a few 30 minutesof
being tilted upright by
approximately 60 to 80
degrees.
 This is used to assess the
efficacy of prophylactic
pacing in some patients
with vasopressor syncope.

12.  A procedure that involves 1. Patient will lie on a special A normal result Pre:  http://www.medi
MYOCARDI using a bioptome (a small table. If you look above. means there was cinenet.com/my
AL BIOPSY catheter with a grasping 2. The skin is scrubbed and a no abnormal  Assess presence of ocardial_biopsy/
device on the end) to local numbing medicine or heart muscle allergies. article.htm
obtain a small piece of sedativE (anesthetic) is given tissue.  Tell patient not to eat or  http://www.claria
heart muscle tissue to to help patient relax, may be drink anything for 6 - 8 n.org/ADAM/doc
send to a laboratory for given but you will remain hours before the test. /HealthIllustrate
analysis. awake and able to follow  Explain the procedure and dEncyclopedia/1
 Done during cardiac instructions during the test. its risks. Let the patient /003873.htm
catheterization or similar sign a consent form.  http://www.nlm.
procedure. 3. A bioptome will be inserted  Start an intravenous (IV) nih.gov/medline
through the sheath and line in your arm so that plus/ency/article
threaded to your right medications and fluids can /003873.htm
ventricle. be administered during the
4. An X-ray camera may be used procedure.
to position the bioptome
properly. Post:
5. A surgical cut will be made
 Ensure and or instruct the
your arm, neck, or groin. The
patient not to drive alone
health care provider inserts a
rather have someone who
thin tube (catheter) through a
would drive the patient
vein or artery, depending on
home.
whether tissue will be taken
from the right or left side of the
heart.
 6. If the biopsy is done without
another procedure, the
catheter is usually placed
through a vein in the neck and
then carefully threaded into
the heart.

7. The doctor uses moving x-

ray images (fluoroscopy) to
guide the catheter to the
correct area.

8. Once in position, a special

device with jaws on the tip is
used to remove small pieces
of tissue from the heart
muscle.

**The procedure may last 1 or

more hours.

13.  A test in which a small 1. Intravenous sedation is Normal findings: Pre:  http://www.brons
Transesopha transducer is passed commonly provided with short- Normal position,  Explain procedures to the onhealth.com/gre
geal down the esophagus to acting benzodiazepine. Other size, and patient ystone/content/a
Echocardiogr provide a clearer image of sedation may be provided movement of the  Instruct patient to fast fro 4 dult/cardiac/diagt
aphy (TEE) heart structures. 2. Apply ECG leads and heart muscle, to 6 hours before the test est.htm
 This provides a clear continually monitor rhythm valves, and heart  Tell the patient to remove  http://www.claria
picture of your heart 3. Apply a blood pressure cuff chambers all oral prostheses n.org/portal/Clari
because it is just in front and monitor blood pressure Post: an/heart-
of the esophagus. periodically  Observe the patient for cardiovascular?
 This is more invasive than 4. Pulse oximetry is monitored to approximately 1 hour after ContentID=/medi
a traditional determine oxygen saturation procedure until the effects cal-
echocardiogram and is in sedated patients of sedation have worn off. services/heart-
only used if your heart 5. The pharynx is anesthetized cardiovascular/di
image is unclear due to a with local topical agent to agnostic-
 barrel chest, congestive depress the gag reflex testing.xml
obstructive pulmonary 6. The patient is placed in the left  Mosby’s
disease, or obesity. lateral decubitus position Diagnostic and
7. Intubation is carried out Laboratory test
through the mouth and into Reference. Ninth
the upper esophagus Edition
8. The patient is asked to
swallow, and the transducer is
advanced into position behind
the heart
9. The room is darkened, and the
ultrasound images are
displayed on a monitor. Views
can be obtained of the
ultrasound image after desired
images are visualized.
14. Chest x-  It is often useful as a 1. Instruct the patient to remove Normal lungs and Pre Mosby’s Diagnostic
rays starting point in a cardiac clothing to the waist and to put heart and  Explain the procedure to And Laboratory
diagnosis. Posteroanterior on an x-ray gown. surrounding the patient. Test Reference 9th
Edition (Pagana)
and lateral views provide 2. Inform the patient to remove structures.  Tell the patient that no http://www.merck.c
a gross view of atrial and all metal objects so that they fasting is required. om/mmpe/sec07/c
ventricular size and shape do not block visualization of  Instruct the patient to h070/ch070g.html
and pulmonary part of the chest. remove clothing to the http://www.clarian.
vasculature, but additional 3. Tell the patient that he or she waist and to put on an x- org/ADAM/doc/Hea
tests are almost always will be asked to take a deep ray gown. lthIllustratedEncycl
required for precise breath and hold it while the x- opedia/1/003804.ht
 Inform the patient to m
characterization of cardiac ray films are taken. remove all metal o9bjects
structure and function. Instruct men to ensure that their so that they do not block
 View of the chest, lungs, testicles are covered and visualization of part of the
heart, large arteries, ribs, women to have their ovaries chest.
and diaphragm. covered, using a lead shield to  Tell the patient that he or
prevent radiation-induced she will be asked to take a
abnormalities. deep breath and hold it
4. After the patient is correctly while the x-ray films are
 positioned, tell him or her to taken.
take a deep breath and hold it  Instruct men to ensure that
until the x-ray films are taken. their testicles are covered
Note that x-ray films are taken by and women to have their
a radiologic technologist in ovaries covered, using a
several minutes. lead shield to prevent
Inform that patient that no radiation-induced
discomfort is associated with abnormalities.
chest radiography. During:
 After the patient is correctly
positioned, tell him or her
to take a deep breath and
hold it until the x-ray films
are taken.
 Note that x-ray films are
taken by a radiologic
technologist in several
minutes.
 Inform that patient that no
discomfort is associated
with chest radiography.
Post:
 Note that no special care is
required following the
procedure.