Diagnostic Procedure - Coursework Example

Diagnostic Procedure s Ambulatory electrocardiogram keeps track of all heart rhythm when a patient goes about his/ her normal activities. Ambulatory monitors can be divided into two categories: Continuous monitors and intermittent monitors. The continuous monitors record heart’s electrical signals for a period of one to three days. The Holter monitor lies in this category. On the other hand, intermittent monitors are used when irregular heart rhythm occurs after a long period of time. Therefore, intermittent monitoring tends to take a longer time than continuous monitoring (Colin, nd). There are two types of intermittent monitors: Loop recorders and Event monitors. A loop recorder monitors the heart rate at all times. When the patient begins to feel symptoms, he/she may activate the monitor to record the new heart rate. However, loop recorders also do presymptom recording; that is before activation. This special feature ensures that recording is done even when a patient is unconscious. Event monitor on the other is activated when the symptoms occur. It only records when it is activated and does not do presymptom recording (American Heart Association, 2011). Holter Monitors Holter monitor keeps track of all electrical activities of the heart of a patient. The monitor is worn for a period of 24 hours and it keeps all records of heart rhythms continuously for all the periods in which they are worn. Many irregular heartbeats occur during activities like bowel movements, eating, sleeping and stress that may not be prevalent during stress testing. Monitoring a person’s activity continuously for a whole day may lead to the detection of irregular heart rhythms (Erica, 2011). Unlike ECG stress testing that record only 50 heartbeats per session, the continuous monitor records more than 10000 heartbeats for 24 hours. A special type of this monitor is implanted in the chest region for longer durations, usually more than a year to keep a record of all heart activities. Holter monitor is slightly larger than a deck of cards with several wires connected to it. At the end of each wire is an electrode that is attached to the skin. The monitor is housed in a small pouch that is worn around the neck. Patients keep records in a notebook of all the activities they were doing and the time they took place. The doctor will then relate certain behaviors and activities to changes in the heart rate (Colin, nd). For the monitor to function properly, it should be kept dry; it should not be worn in the shower. It is recommended that the patient takes a shower before attaching the gadget to his/her chest. The patient should not apply oil on the chest region as it may affect the electrode’s attachment. Electrical and magnetic fields also affect the way the gadget functions and should be avoided at all costs. Holter monitor can be used to diagnose Palpitations, Atrial fibrillation, bradycardia (slow heart rate), paroxysmal supraventricular tachycardia and ventricular tachycardia. (Erica, 2011) Event Recorders Event monitors keep a record of a heart rhythm when a patient experiences symptoms. The symptoms include palpitations, chest pains, fainting spells, dizziness and lack of breath. Irregular heart rhythms occur fast and may not be recognized by an electrocardiogram, event recorders are used in this case. The patient activates the monitor when he/she begins to experience the symptoms listed above. The recorded data is then sent to the doctor for analysis. The event recorders are small and portable and come in different forms like wrist watches and beepers. Some are wireless while others are connected to the chest via wires and patches (American Heart Association, 2011). The gadgets are worn for a long period of time, usually weeks or even months. Patients are encouraged to wear the monitors as they go about their normal routines (except during showers), but they can only activate the gadgets once they experience the symptoms. Precautionary measures of this gadget are similar to those of the Holter monitor. Showers should be taken before the electrodes are attached, loose shirts and blouses should be worn, jewelry and clothes with metallic buckles and buttons and bras should be avoided (Erica, 2011). Stress Testing These are tests carried out on the heart to determine the highest stress levels that it can manage before ischemia or an abnormal rhythm is witnessed. There are various tests but the one widely used is the exercise stress test. Also known as the Treadmill test or the exercise electrocardiogram (ECG), the exercise test involves monitoring the blood pressure, electrocardiogram and heart rate during exercises like riding an immobile bike at fluctuating levels of difficulty and walking in a treadmill as its name suggests. When the ECG changes or chest pains are witnessed during these exercises, then it can be concluded that the blood stream to the heart is very low (American Heart Association, 2011). However, in cases where a person cannot exercise, the Adenosine stress test is a test used. This test involves giving a drug to a person; this drug tricks the heart into believing that the person is exercising when in reality he or she isn’t. Monitoring is then done to the heart. This test can also be referred to as the Dobutamine stress test. Another type of test is the Stress Echocardiogram. It involves visualizing hearts response during stress. It graphically shows pumping action and heart’s movement. It is more accurate than other tests due to its ability to reveal the slightest change in blood flow that may not be recognized by other tests (Colin, nd). Echocardiogram images are much clearer than the X-Ray images and do not expose the patient to radiation dangers. Transthoracic echocardiogram involves using a transducer which emits high frequency sound waves. It is pressed on the breast bone and then picks sound wave echoes and converts them to electrical impulses and transports them to ECG monitor. In cases where sound waves and echoes do not form images, then a Transesophageal ECG is used. It involves numbing the throat and then inserting a scope into it. Once a technician has shoved it carefully to the lower part of the esophagus, the scope is used to emit sound waves. Echocardiogram helps to diagnose pulmonary hypertension, damage of the heart muscles, infection of the heart tissues and valves, congenital heart disease, abnormal heart valves, blood clots and atrial fibrillation (American Heart Association, 2011). The last test is the Nuclear stress test. A small quantity of radioactive material is injected into the bloodstream. A special camera is then used to capture clear visual images of the heart through the rays emitted from the radioactive material. The pictures are taken when the patient is exercising and when he or she is resting. Blood flow problems can easily be detected using this test. This test is also used to detect areas of the heart that are not functioning properly (Erica, 2011). Before stress tests are carried out, a patient ought to avoid the followings habits several hours prior to the tests. The patient should abstain from eating and drinking for at least four hours with the exception of water, he or she should abstain from caffeine related foods as it interferes with the results, and heart medications should not be taken on the same day as the tests. However, a diabetic is allowed to take half the dosage in the morning accompanied by a light meal few hours before the tests are done. Blood sugar control pills should be taken after the tests (Colin, nd). Role of Healthcare Technician/EKG Before placing electrodes on the patient’s chest, the technician cleans ten areas on the chest where the patches will be stuck. The electrodes which are connected to the electrocardiograph monitor, transmits all heart’s electrical activity to the EKG, which the latter records. The technician will performs ECG to the patient before the tests and also measure his or her blood pressure. He/she will then direct the patient to walk on a treadmill. He/she will then increase the level of difficulty while keeping a closer look at the patient’s response to stress on the EKG monitor. The technician is also responsible for close monitoring of the patient; he should be able to detect when the patient is fatigued or is feeling discomfort to either end the test or reduce the level of difficulty. Lastly, the technician stores the patient’s ECG patterns for future comparisons (American Heart Association, 2011). Functions of EKG include: looking for and recording irregular heart rhythms, finding the root cause of heart problem symptoms like fainting and chest pains, checking for poor blood flow (Ischemia), and checking if treatment for the irregular heartbeat works. Once the data have been collected for a period of time the doctor can then analyze the data and then make prescriptions for the patient. Event recorders are much more effective than other ECG monitors as they record the data over a longer period of time. All patient’s activities are monitored closely and this makes it easy for the doctor to recognize the triggers of the symptoms. There are no serious side effects associated with all stress tests. However, medication may alter results and therefore the patient ought to inform the doctor if he/she is under medication (Erica, 2011). References 1. Erica R. (2012). 24-Hour Holter Monitoring. Retrieved from http://www.healthline.com/health/holter-monitor-24h... health line 2. Colin T. (n.d.). Ambulatory ECG Monitoring and Related Investigations. Retrieved from http://www.patient.co.uk/doctor/ambulatory-ecg-monitoring-and-related-investigations 3. American Heart Association (2011). Exercise Stress Test. Retrieved from http://www.heart.org/HEARTORG/Conditions/HeartAttack/SymptomsDiagnosisofHeartAttack/Exercise-Stress-Test_UCM_307474_Article.jsp Read More