Cardiovascular technologists
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Cardiovascular technologists and technicians assist physicians in diagnosing and treating cardiac (heart) and peripheral vascular (blood vessel) ailments. Cardiovascular technologists may specialize in any of three areas of practice: invasive cardiology, echocardiography, and vascular technology. Cardiovascular technicians who specialize in electrocardiograms (EKGs), stress testing, and Holter monitors are known as cardiographic technicians, or EKG technicians.
Cardiovascular technologists specializing in invasive procedures are called invasive cardiovascular technologists. They assist physicians with cardiac catheterization procedures in which a small tube, or catheter, is threaded through a patient’s artery from a spot on the patient’s groin to the heart. The procedure can determine whether a blockage exists in the blood vessels that supply the heart muscle. The procedure also can help to diagnose other problems. Part of the procedure may involve balloon angioplasty, which can be used to treat blockages of blood vessels or heart valves without the need for heart surgery.
Invasive cardiovascular technologists assist physicians as they insert a catheter with a balloon on the end to the point of the obstruction. Invasive cardiovascular technologists prepare patients for cardiac catheterization and balloon angioplasty by first positioning them on an examining table and then shaving, cleaning, and administering anesthesia to the top of their leg near the groin. During the procedures, they monitor patients’ blood pressure and heart rate with EKG equipment and notify the physician if something appears to be wrong. Technologists also may prepare and monitor patients during open-heart surgery and during the insertion of pacemakers and stents that open up blockages in arteries to the heart and major blood vessels.
Technologists who use ultrasound to examine the heart chambers, valves, and vessels are referred to as cardiac sonographer. They use ultrasound instrumentation to create images called echocardiograms. An echocardiogram may be performed while the patient is either resting or physically active. Technologists may administer medication to physically active patients to assess their heart function. Cardiac sonographers also may assist physicians who perform transesophageal echocardiography, which involves placing a tube in the patient’s esophagus to obtain ultrasound images.
Those who assist physicians in the diagnosis of disorders affecting the circulation are known as vascular technologists, vascular specialists or vascular sonographers. They perform a medical history, evaluate pulses and assess blood flow in arteries and veins by listening to the vascular flow sounds for abnormalities. Then they perform a noninvasive procedure using ultrasound instrumentation to record vascular information such as vascular blood flow, blood pressure, changes in limb volume, oxygen saturation, cerebral circulation, peripheral circulation, and abdominal circulation. Many of these tests are performed during or immediately after surgery.
Cardiovascular technicians who obtain EKGs are known as electrocardiograph (or EKG) technicians. To take a basic EKG, which traces electrical impulses transmitted by the heart, technicians attach electrodes to the patient’s chest, arms, and legs, and then manipulate switches on an EKG machine to obtain a reading. An EKG is printed out for interpretation by the physician. This test is done before most kinds of surgery or as part of a routine physical examination, especially on persons who have reached middle age or who have a history of cardiovascular problems.
EKG technicians with advanced training perform Holter monitor and stress testing. For Holter monitoring, technicians place electrodes on the patient’s chest and attach a portable EKG monitor to the patient’s belt. Following 24 or more hours of normal activity by the patient, the technician removes a tape from the monitor and places it in a scanner. After checking the quality of the recorded impulses on an electronic screen, the technician usually prints the information from the tape for analysis by a physician. Physicians use the output from the scanner to diagnose heart ailments, such as heart rhythm abnormalities or problems with pacemakers.
For a treadmill stress test, EKG technicians document the patient’s medical history, explain the procedure, connect the patient to an EKG monitor, and obtain a baseline reading and resting blood pressure. Next, they monitor the heart’s performance while the patient is walking on a treadmill, gradually increasing the treadmill’s speed to observe the effect of increased exertion. Like vascular technologists and cardiac sonographers, cardiographic technicians who perform EKG, Holter monitor, and stress tests are known as “noninvasive” technicians.