Cardiology Procedures

By Dr Ananya Mandal, MD

There are several diagnostic and therapeutic procedures that are performed in cardiology. Some of the main procedures include:

  • Pulse palpation and auscultation – Examination by palpation is carried out to detect the pulse and a stethoscope is used to listen to breathing and sounds in the chest (auscultation).
  • Shygmomanometer – A sphygmomanometer is used to measure the blood pressure.
  • Electrocardiogram – An electrocardiogram (ECG) is carried out to measure the electrical activity of the heart. The ECG records the electrical impulses generated by the heart over a period of time and creates a pattern of the heart’s rhythm and rate. ECG monitoring may be continued throughout the day using a device called a Holter monitor, which is worn around the neck and rests against the heart recording electrical activity over 24 hours. This reveals more occasional abnormalities of heart function that would be difficult to identify over a shorter period of time.
  • Echocardiogram – An echocardiogram uses high frequency sound waves to create an image of the heart, much like an ultrasound procedure.
  • Cardiovascular magnetic resonance - Magnetic resonance imaging (MRI) provides a detailed image of the heart that can be used to examine the heart’s anatomy as well as its function. This helps diagnose specific diseases such as cardiomyopathies (heart muscle diseases) or diseases of the outer lining of the heart (the pericardium).
  • A cardiac stress test is used to check the heart’s response to external stress, which may be induced through drugs or exercise.
  • Blood levels of some cardiac enzymes such as creatinine phosphokinase and troponin T are raised in cases of heart injury, as these enzymes leak from damaged heart muscle into the bloodstream.
  • Cardiac catheterization is a procedure performed to gather important information about the heart. X-rays of the heart may be taken in a procedure called coronary angiography; a fractional flow reserve test may be performed to assess pressure differences across a narrowed artery; or an intravascular ultrasound may be used to visualize the vascular endothelium.
  • Biventricular pacing – Also called cardiac resynchronization therapy, this involves using a pacemaker to help the left and right ventricle pump in harmony to improve the overall output capacity of the heart.
  • Carotid artery ultrasound uses an ultrasound probe to evaluate the structure and function of the carotid arteries that deliver blood from the heart to the brain.
  • Dobutamine nuclear imaging – This procedure is used to evaluate patients who cannot exercise. Dobutamine is a drug that makes the heart pump faster and harder. A nuclear imaging material is also injected that enables pictures of the heart to be generated which helps determine whether stenosis or disease is restricting blood flow to any parts of the heart.
  • Pacemaker implantation – Patients with abnormal electrical activity of the heart may be given a pacemaker to regulate the heart’s rhythm and rate. A pacemaker is a battery-powered pulse generator that is implanted under the skin and connected to the heart.
  • Rotational atherectomy is a procedure where a small rotating blade is used to open up a narrowing in an artery and restore blood flow to or from the heart. A small mesh tube called a stent is often inserted into the artery to keep it open and prevent it from narrowing again.
  • Percutaneous transluminal coronary angioplasty (PTCA) – This procedure is carried out to open up blocked coronary arteries and restore blood flow. The narrowing is initially held open by inflating a small balloon to widen the passage and a stent is then inserted to hold the vessel open. These stents are often coated with specific drugs that prevent re-narrowing of the vessel.

Reviewed by Sally Robertson, BSc

Sources

  1. http://www.ualberta.ca/~loewen/Toronto%20Notes/Cardiology.pdf
  2. http://ecgepm.files.wordpress.com/2012/01/cardiology-explained.pdf
  3. http://ccmhye.com/100%20Questions%20in%20Cardiology.pdf
  4. http://www.angelfire.com/md2/liaquatian/Cardiology.pdf
  5. http://oregon.providence.org/ptkattachments/FormsInstructions/providence%20st.pdf

Further Reading

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