A 64-year-old male client with a long history of cardiovascular problems including hypertension and angina is to be scheduled for cardiac catheterization. During pre-cardiac catheterization teaching, Nurse Cherry should inform the client that the primary purpose of the procedure is:
A. To determine the existence of CHD.
B. To visualize the disease process in the coronary arteries.
C. To obtain the heart chambers pressure.
D. To measure oxygen content of different heart chambers.
Correct Answer: B. To visualize the disease process in the coronary arteries.
The lumen of the arteries can be assessed by cardiac catheterization. Angina is usually caused by narrowing of the coronary arteries. Left heart catheterization has a diagnostic as well as therapeutic role. Although it is used for cardiac hemodynamics and assessment of valvular lesions, its main diagnostic role is the assessment of coronary artery disease. In the contemporary era, left heart catheterization, especially selective coronary angiogram, is considered the gold standard test for coronary artery disease diagnosis.
Option A: Determining the existence of coronary heart disease includes tests and procedures such as echocardiogram, coronary angiography, blood tests, ECG, and MRI scans. Echocardiography is an ultrasound of the heart. It is a useful and non-invasive mode of testing that is performed in both acute and chronic and inpatient and outpatient settings. In acute settings, it could tell about wall motion, valvular regurgitation and stenosis, infective or autoimmune lesions, and chamber sizes.
Option C: Heart chamber pressure can be checked through cardiac catheterization but it is not the primary purpose. In non ACS settings, patients with intermediate pretest probability for CAD are usually the right candidates for it. In the ACS setting, all STEMI patients and selected NSTEMI patients get an emergent cardiac catheterization. This procedure is done in a cardiac catheterization lab, is expertise dependent, and is done under moderate sedation. There is contrast exposure in the procedure which could cause serious allergic reactions and kidney injury.
Option D: The oxygen saturation of the blood can be checked through a pulse oximeter. A pulse oximeter can measure oxygen saturation. It is a noninvasive device placed over a person’s finger. It measures light wavelengths to determine the ratio of the current levels of oxygenated hemoglobin to deoxygenated hemoglobin. The use of pulse oximetry has become a standard of care in medicine. It is often regarded as a fifth vital sign.