Cardiovascular Technologist Job Specifics
What are the job duties of cardiovascular techs?
Cardiovascular technologists, often referred to as CVTs, assist cardiologists in performing diagnostic and interventional procedures in the field of invasive cardiology. These professionals use specialized equipment under the direction of a physician, to perform procedures on patients that result in diagnosis or treatment of congenital or acquired heart disease. The work of a cardiovascular technologist takes place in a cardiac catheterization laboratory (CCL, or more commonly referred to as a “cath lab”).
More specifically speaking, these professionals gain access to blood vessels using a catheter. Cardiovascular technologists do not work in the operating room where a person is actually opened up for a procedure such as a bypass surgery. The specific job responsibilities of these professionals include: reviewing a baseline patient assessment, evaluating patient response to diagnostic and interventional procedures, providing patient care and administration of medication in a catheterization lab under the supervision of a physician, performing basic and advanced cardiac life support, and operating all diagnostic and interventional equipment used for procedures.
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During cardiac procedures, what roles does a cardiovascular technologist play?
When invasive cardiac procedures are necessary, there are a number of medical professionals in the room, including a cardiologist, several cardiovascular technologists, and oftentimes a radiologic technologist and registered nurse. When assisting cardiologists with procedures in the cath lab, there are four different roles a cardiovascular tech may play.
- A Scrub Assistant “scrubs in” with the physician and helps with catheters, guidewires, preparing PTCA balloons and stents. They may also help with positioning the x-ray camera and/or performing the contrast injections into the coronary artery.
- A circulating person gives medications to the patient and collects the necessary supplies and passes them off in a sterile fashion. These supplies include catheters, sheaths, balloons and stents. Some states mandate that only RNs can administer medication.
- A recorder/monitor stays in the control room behind solid leaded glass and maintains a procedural report of everything that is done including all supplies that are used and all medications involved. This person also has the important task of monitoring heart rhythms and the patient’s blood pressure so they’re able to alert the staff of changes.
- An individual who operates the imaging equipment. Some states regulate who can operate this equipment and require a radiologic technologist to play this role. In other states a CVT can serve in this capacity.
What do pre-procedural patient assessments include?
Fully understanding a patient and their background is vitally important as a cardiovascular technologist. The following information is included in gathering a patient’s history.
- Chief complaint
- History of present illness and current medications
- Past medical history including any allergies, if they are a smoker, if they are diabetic, do they have high blood pressure or high cholesterol, have they had this procedure done previously
- Family and social history
- Labwork, including CBC, BMP, Coags, lipid profile, and cardiac enzymes
- ECG and chest x-ray
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What sort of treatments do cardiovascular technologists use for their patients?
Cardiovascular technologists’ duties are split between diagnostic studies and intervention treatments. Diagnostic studies are used to investigate the arteries and determine if a problem exists. Interventions are for blockages in the coronary artery and are always performed in conjunction with a physician.
In the Cardiac Cath Lab, commonly referred to as the Invasive Cardiology Department, diagnostic procedures are primarily performed for three main reasons. One reason involves examining the coronary arteries and checking for blockages. Another reason is to evaluate the function and patency of heart valves. Finally, the heart muscle itself may be evaluated. Within each of the three categories, there are multiple methods used to perform the evaluation.
- Coronary Angiogram--This involves injecting contrast dye into coronary arteries under x-ray.
- Intravascular Ultrasound--For this procedure, an ultrasound transducer attached to a catheter is advanced into the coronary artery and images are recorded.
- Fractional Flow Reserve (FFR)--This involves advancing a guidewire into the coronary artery and measuring flow pressure on either side of a suspected blockage.
Heart valves, heart failure, structural defects
- Right heart catheterization--This procedure involves advancing a specialized catheter in the venous circulation or the "right side" of the heart. There are a few reasons for performing a right heart cath:
- To measure pressure gradients on either side of the valve in question.
- To determine a patient’s cardiac output.
- To measure pressure at various locations within the heart.
- To measure pressure in the lungs for evaluation of Congestive Heart Failure or Pulmonary Hypertension.
- To evaluate the significance of congenital heart defects that cause shunting of blood from one side of the heart to the other through a structural defect rather than normal circulation. through a structural defect rather than normal circulation.
- Left ventricular angiography--This procedure involves placing a catheter inside the left ventricle (the main pumping chamber of the heart) and injecting a quantity of contrast under x-ray to evaluate how well the heart muscle squeezes. This procedure will identify any abnormal heart muscle function that may have been caused by either a heart attack or another disease pathology.
- Coronary Stent--This is a metal mesh device collapsed onto a balloon that is positioned where the blockage is. The balloon is inflated to expand the stent into position, and then withdrawn while the stent stays in place.
- Balloon Angioplasty (PTCA)--This is the Inflation of a balloon at the blockage site to expand the lumen, which is the internal opening of the artery or any blood vessel, allowing blood to flow through the artery. The balloon is withdrawn after the inflation.
- Intra-aortic Balloon Pump (IABP)--This is a cardiac assist device that is advanced through the arterial system into the abdominal aorta. Inflation of a large balloon in the aorta is timed to the patient’s own heart beat providing increased blood flow and decreased work load of the heart.
- Rotational Atherectomy--This is a specialized catheter that is advanced through the coronary artery that has a rotational burr on the head of the catheter that cuts away the calcified blockage into micro particles.
- Coronary Thrombectomy--This is a catheter that is advanced into the coronary artery and has the ability to aspirate fresh, soft thrombus that is blocking the artery.