Heart Matters: Saving hearts with coronary angioplasty
Kathleen T. Ogle PhD, RN, FNP-BC

$3.95 		Nursing Made Incredibly Easy!
October 2011 
Volume 9  Number 5
Pages 9 - 11
 
  PDF Version Available!

ABSTRACT
Mr. E, 60, arrives in the ED complaining of increasing chest pain over the past few days. On arrival, his BP is 158/92 mm Hg, with a heart rate of 92 beats/minute and a respiratory rate of 20 breaths/minute. Mr. E has a history of poorly controlled hypertension; he's overweight and doesn't exercise regularly. He states that in addition to the chest pain he has experienced some nausea, increased sweating, and difficulty breathing with exertion. His 12-lead ECG shows T wave inversion in leads II, III, and aVF. Lab testing in the ED reveals normal levels of creatinine kinase (CK), CK-MB, and troponin. He's placed on oxygen, given I.V. pain medication, and is monitored for changes.Based on these findings and his history, Mr. E is quickly taken to the interventional cardiology lab and prepared for a coronary angiogram. You're able to provide information and education about the procedure before he goes to the lab.Mr. E asks you what to expect when he goes to the lab and why the procedure is being done. You explain to him that a coronary angiogram examines the arteries that supply blood to the heart. When those arteries become narrowed or clogged, it can lead to chest pain; if severe, it can lead to heart muscle damage.Mr. E can expect that a spot on his groin or arm will be numbed and a small tube or catheter will be inserted into an artery. This thin tube is then threaded along the artery until it gets to one of the coronary arteries. Dye is injected into the arterial system so the cardiologist can see if there are any blockages. Mr E. may experience some flushing or a warm feeling while the dye is being injected, but he should let the team know immediately if he experiences any chest pain.After you answer all of Mr. E's questions, it's time to prepare him for the procedure. His orders indicate that an angioplasty will be performed if necessary. The standard preparation for your patient undergoing angiography and possible angioplasty includes: * checking lab results, including

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