Cardiac Catheterization Procedures Flashcards
7 cards from real CVT practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 Cardiac Catheterization Procedures flashcards as text
A 68-year-old patient on metformin is scheduled for coronary angiography with contrast. What is the standard recommendation regarding metformin use?
Answer: Hold metformin 48 hours post-procedure due to risk of lactic acidosis
Contrast-induced nephropathy can impair metformin excretion, causing dangerous lactic acid accumulation, so metformin is held 48 hours post-procedure.
During right heart catheterization using a balloon-tipped flotation catheter, the balloon ruptures in the right ventricle. What is the most appropriate next action?
Answer: Withdraw the catheter and replace it with a new one
A ruptured balloon cannot safely float into the pulmonary artery and risks air embolism; the catheter must be withdrawn and replaced.
What is the primary advantage of intravascular ultrasound (IVUS) over coronary angiography during a catheterization procedure?
Answer: It provides real-time cross-sectional imaging of plaque burden and vessel architecture
IVUS provides detailed cross-sectional imaging of plaque composition, vessel wall architecture, and stent apposition not visible on angiography.
A patient develops chest pain, ST elevation, and hemodynamic instability during PCI. Angiography shows abrupt vessel closure at the stent site. What is the most likely mechanism?
Answer: Coronary artery dissection with luminal compromise
Abrupt vessel closure during PCI is most commonly caused by coronary artery dissection that creates a flow-limiting intimal flap.
Which radiation protection measure is most effective at reducing scatter radiation exposure to the cardiac catheterization team?
Answer: Increasing the distance from the X-ray source
Radiation exposure follows the inverse square law — doubling distance from the source reduces exposure by 75%.
During a diagnostic catheterization, the operator notes that left ventricular end-diastolic pressure (LVEDP) is 28 mmHg. Which clinical condition does this most strongly suggest?
Answer: Left ventricular diastolic dysfunction or heart failure
An LVEDP above 18-20 mmHg indicates elevated filling pressure consistent with left ventricular diastolic dysfunction or heart failure.
A CVT is assisting with a diagnostic catheterization and notices the pressure waveform transitions from a ventricular pattern to a pulmonary artery waveform without fluoroscopy confirmation. What should the technologist do next?
Answer: Confirm catheter position with fluoroscopy before proceeding
Catheter position should always be confirmed fluoroscopically when waveform changes are ambiguous to prevent perforation or misplacement complications.