Cardiac Catheterization: A Short Story

During an angiogram a catheter is inserted in the vein or artery of the patient depending on the part of the heart that is being examined. All of the angiograms

“Forgive me for not noticing you Isaac.” She said while chewing. “I’m still not fully awake yet, how did you sleep?”

An extensive study conducted in 2006 by a team of medical researchers sought to establish predictors of vascular complications for patients who have undergone diagnostic cardiac catheterization (CC) and/or percutaneous coronary intervention (PCI). Noting that The American College of Cardiology has set a benchmark rate for vascular complications of "no more than 1% for diagnostic CC and 3% for PCI," the purpose of the study was "to provide baseline data on the number and type of vascular complications post CC and PCI experienced at this institution and the significance of risk predictors for these complications" (Dumont et al., 2006). By utilizing a "retrospective, descriptive, and correlational study of 11,119 patients who underwent CC and/or PCI, with femoral artery access, in the years 2001 to 2003" (Dumont et al., 2006), the researchers concluded that an increased risk for vascular complications applied to female patients over the age of 70, who have a history of renal failure and underwent a PCI procedure.

To perform a cardiac catheterization the cardiologist will insert a sheath, or a short tube usually into the femoral artery. A long very thin catheter will then be fed through the sheath and guided through the arteries until it is in the heart and coronary arteries. The physician uses fluoroscopy equipment to guide the catheter into the coronary arteries. To allow for clear viewing of the coronary arteries, contrast material is injected into the catheter. As the contrast material flows through the heart chambers and coronary arteries x-rays are taken. The

A stent is a small mesh tube that's used to treat narrow or weak arteries, for example, the coronary arteries which supply oxygen-rich blood to your heart. Doctors place stents in arteries as part of a procedure called percutaneous coronary intervention, or PCI, sometimes called angioplasty. In coronary arteries narrowed by the buildup of plaque the procedure opens the blockage and restores blood flow to the heart muscle. Doctors also may place a stent in weak arteries to improve blood flow and help prevent the arteries from bursting. To place a stent in one of your coronary arteries your doctor will make a small opening in a blood vessel in your upper thigh, arm or neck. Through this opening your doctor will thread a thin flexible tube call a catheter.

“I guess we will need a bed,” she commented “we can 't expect anything from her.” She mumbled under her breath.

This Friday at the Cardiac Catheterization Lab was a bit more uneventful than most of the previous days and compared to most of the experiences I have had in the past. My mentor was not there this week, nor will she be here this week but there was still a lot for me to do and I know many of the other employees in the cardiology department so they put me to work which was great. Since I was not here during spring break and the other volunteer that works in the cardiac office on Wednesdays (or Thursdays) was not there either, so all the completed patient files had piled up in the bins and outside of the bins. I normally only have about ten to twenty files to put away, however, I had about forty to fifty or so patient files to file away and it

One of the scariest medical diagnoses a patient can receive from a physician is, their heart is not functioning properly. A malfunctioning heart will eventually lead to death if correction of the issue is not attempted. The heart supplies the entire body with oxygenated blood but also needs its own supply of oxygen rich blood. This is why coronary arteries are vital to the hearts ability to pump. A final option to correcting malfunctioning coronary arteries is a surgical procedure, coronary artery bypass grafting (CABG). Every year approximately 450,000 patients have CABG surgery in the United States (Mullen-Fortino & O 'Brien, 2008). Based on continuing healthcare trends, more and more people each year are having coronary artery issues, causing the need for CABG surgery to rise. Also patient demographics are changing, they are older, sicker, have more extensive coronary artery blockage / damage, and likely have poorer functioning ventricles of the heart (Sidebotham, McKee, Gillham & Levy, 2007). The nursing profession has a critical role in caring for the patients but also teaching and educating them before and after any procedure. Education and teaching has been implemented into evidence-based practice for years to facilitate better patient

Coronary angioplasty is a procedure that improves blood flow to the heart by using a special balloon to open a blocked coronary artery from the inside to restore effective circulation to the muscle. To prevent constant blockage, a small tube called a stent may be inserted in the vessel to keep it open. Coronary artery bypass graft surgery is often successful treatment. Is an operation in which blood flow is redirected around a narrowed area in one or more of individual coronary arteries. This lets blood flow more freely to individual heart muscle. After heart attack is develop or be at high risk of developing abnormal heart rhythms that could be life threatening. A small device can be put into the chest and connected to the heart to treat an

1. Angioplasty: Kereiakes and Wetherill write that “angioplasty is a procedure in which a heart doctor inserts a balloon catheter over a thin wire across an artery. The balloon is inflated and compresses the plaque to clear the arteries of any blockage.”(p. 106-107).

Cardiovascular disease has long been the leading cause of death in the United States and is predicted to affect forty percent of the population by 2030 (Narang et al., 2016). Moreover, research states the cardiovascular workforce is inadequate to meet the rising demands of our aging population (Narang et al., 2016). Nurses caring for patients in the cardiac catheterization laboratory are key members of the cardiovascular workforce. While there is research to support the development of nurses working in the pre- and post-cardiac catheterization laboratory settings; current literature reveals little information about the development of nurses working in the cardiac catheterization laboratory (Currey, White, Rolley, Oldland, & Driscoll, 2015).

Cardiothoracic Surgery is one of the most interesting and rewarding careers in the medical field. It was stated in Saving the Heart by Stephen Klaidman, “In the 1950s surgeons found ways to do quick repairs of congenital heart defects and faulty valves, and then the first heart-lung machine was invented, which made longer operations possible.” Since then, Cardiothoracic surgery has been constantly evolving to incorporate the new technological innovations. This job is described as engaging, challenging, interesting, and life changing. Day by day, the surgeries are getting easier to perform and the recovery time for patients is improving. With 50% of the current cardiothoracic

The heart generates the electrical activity during the cardiac cycle then the electrical activity causes ventricular contractions and atrial. So, in turn, forces blood between the chambers of the heart and around the body. The closure and opening of the heart valves are associated with accelerations and decelerations of blood. That causes vibrations in the entire cardiac structure. These vibrations are heard using heart sounds recorders

Seth Kahn’s (2011), article entitled, “Putting Ethnographic Writing in Context,” identifies ethnography as the study of “relationships, rituals, values, and habits that make people understand themselves as members of a group.” Ethnographers adopt a stance of observation, as well as participation to better understand the discourse among members within a particular group, or discourse community (Khan, 2011). This ethnographic research will “connect what community members know and do, with what they say and how they say it” (Devitt, Bawarshi, & Reiff, 2003). The purpose of this study is to explore how nurses, working in a cardiac catheterization laboratory, learn the ‘local knowledge’ necessary to communicate with a multidisciplinary discourse community successfully. To protect the identity of participants in this study, the name of the laboratory included in the study will be identified as the XYZ Cardiac Catheterization Laboratory.

On positive is that I want to try new activities that are less used. I feel like some of the patients has to do about the thing almost every time for therapy. I spent time going through the cabinets to find what all we could use. There was this old checker board that I found and used with a few of the patients. It was not used in a while as some of the therapy practitioners said that they forgot we even had that! I hope I can make people’s therapy session less monotonous. Another positive that I believe I possess is my kindness and caring personality. One lady was complaining about her legs being so dry and couldn’t reach them even though she had lotion. I applied the lotion to her legs as she was doing a tabletop activity. Then another time I wheeled someone to play bingo at the activity hall. However, the bingo person was not there (even though it was on the activity board). I stayed passed the time and played a board game with her because she was bored. I know I cannot go out of my way for everybody (productivity and such), but it means a lot to the residents.