01.06 Cardiovascular Angiography

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Included In This Lesson

Study Tools

Outline

Overview

  1. Cardiovascular angiography
    1. Contrast into arteries
    2. X-ray
    3. View coronary arteries and heart

Nursing Points

General

  1. Procedure
    1. Catheter inserted into upper leg/groin artery
    2. Threaded up to vessels supplying heart
    3. Contrast dye inserted
    4. X-ray to view vessels
    5. Doctor may intervene as needed (stents to open arteries)
  2. Purpose
    1. View blood vessels supplying heart
    2. Diagnose disease
      1. Valves
      2. Coronary arteries
      3. Blood flow
      4. Blockage
  3. Indications
    1. Chest pain
    2. Heart disease
    3. Valve issues
    4. Heart defects

Assessment

  1. Before
    1. NPO 6-8 hours prior
    2. Ask patient if allergic to contrast
    3. Doctor may hold anticoagulants
    4. Consent signed

Therapeutic Management

  1. During
    1. Clean and shave upper leg/groin area
    2. Sedative through IV (nurse or radiology tech)
    3. Doctor places and threads catheter through leg artery
    4. Monitor vital signs
  2. After
    1. Doctor removes catheter
    2. Apply pressure 10-15 minutes (closing device if needed)
    3. Keep patient flat for 2 hours to prevent bleeding
    4. Keep leg straight for up to 6 hours
    5. Assess for bleeding

Nursing Concepts

  1. Safety -> Radiation
  2. Perfusion -> Coronary arteries and heart
  3. Patient educaton -> Educate on procedure and after

Patient Education

  1. Doctor order when to restart anticoagulants
  2. Okay to resume activity next day
  3. Call doctor if any redness or pain at injection site in leg

Transcript

Hey guys! Welcome to the lesson on cardiovascular angiography. 

During the cardiovascular angiography the doctor inserts a catheter into the inner-upper leg near the groin and threaded to the vessels supplying the heart. Contrast dye is inserted into the catheter and an X-ray is used to view the vessels. Intervention is provided by the doctor as needed like stent placement to open the arteries. Let’s discuss the purpose of this test.

The procedure helps to view the blood vessels supplying the heart to diagnose disease in the coronary arteries or the valves. The doctor will be able to see any obstructions or blockage to the blood flow that may cause a myocardial infarction. Here’s a picture from a cardiovascular angiography showing blockage here and here. Let’s discuss why this test is done. 

The doctor may choose to order this test if the patient has chest pain, heart disease like coronary artery disease, valve issues, or heart defects. Let’s talk about what to do before the procedure. 

Before the procedure, the patient will be kept NPO meaning no food or drink for 6-8 hours. Ask the patient if they have any allergies to contrast because if they do they may not be able to have the test. If the patient is on anticoagulants, ask the doctor if they want the medication held and for how long before the procedure to prevent bleeding. Explain the procedure and have the consent signed by the patient. The consent may be done right before the procedure so the doctor may explain any risks.

During the procedure, you will clean and shave the site on the upper-inner leg near the groin. You will provide an IV sedative to relax the patient before the doctor places and threads the catheter to use for the contrast. You will monitor the vital signs for any deviations from normal while the catheter is in the main arteries. 

After the procedure the doctor will remove the catheter and you will hold pressure for 10-15 minutes. A closing device may be used. Keep the patient flat for 2 hours and keep the leg straight for 6 hours. Assess the site for bleeding, and hold pressure if it does. Next let’s talk about patient education. 

Let the patient know when they are able to restart anticoagulants per doctor order after the procedure. They may resume their normal activities the next day. Tell them to let you know if they notice any red or pain at the injection site. 

The priority nursing concepts for the patient with a cardiovascular angiography are safety, perfusion, and patient education. 

Alright guys, let’s review the key points. The cardiovascular angiography is done to view the heart vessels using contrast and an X-ray to diagnose defects and blockages. Before the scan, the patient will be NPO, you will explain the procedure and have them sign the consent, and ask the doctor about holding the anticoagulants to avoid bleeding. During the procedure you will clean and shave the injection site on the upper inner thigh and groin. You will administer the IV sedative to relax the patient and monitor vital signs during the procedure. After it’s over, you will hold pressure for at least 10 minutes and may use a closing device. The patient needs to stay flat for 2 hours and keep their leg straight for 6 hours to prevent bleeding. Let the patient know when they can restart the anticoagulants and to keep an eye on the injection site for redness or pain. 

Alright guys, that’s it on the cardiovascular angiography! No go out and be your best self today, and as always, happy nursing!