(3)
Where and by whom performed.
(4)
Disposition of specimen, if taken.
(5) Significant observations on patient's reaction such as pain, discomfort,
and apprehension.
(6)
Patient's vital signs before and after the procedure (when these are
required).
1-12. FLUOROSCOPY
Fluoroscopy shows the heart in action and is used more often than other x-ray
methods in cardiologic examinations. Fluoroscopy is used to look for abnormal
configuration, tumors, and calcifications in the heart, aorta, and pulmonary vessels, to
find congestion of the lungs, and to detect pleural or pericardial effusions. During
examination of the heart under fluoroscopy, barium is given by mouth so the outline of
the esophagus can be seen. An enlarged left atrium pushes the esophagus aside as it
becomes larger. There is no preparation of the patient for this examination.
1-13. INTRAVENOUS ANGIOCARDIOGRAPHY
This is a procedure in which an opaque medium is injected into a vein followed
by a rapid series of x-ray pictures taken of the course of the medium through the heart,
to the lungs, back to the heart, and out through the aorta. The dosage of contrast media
is calculated according to the kilograms of body weight. The solution is injected through
a large bore (12 gauge) needle held in position in the vein, usually by a "cut down."
Speed of injection is imperative, since the solution must pass through the heart in a
large bolus to make possible a good examination. The solution is injected after the
patient has been instructed to inhale deeply. The inspiration is held for the entire series
of x-rays.
a. This diagnostic method is recognized for precision in detecting congenital
cardiac defects. Individual chambers of the heart are visualized, pathways for the blood
stream are demonstrated, and chamber enlargement can be seen.
b. The opaque medium may cause a flushing sensation as it flows through the
body. If necessary, the studies may be conducted under mild anesthesia. After one
complete circulation, the opaque media is so diluted that it is no longer visible by x-ray.
c. No special preparation of the patient is necessary unless anesthesia is to be
given. In that event, food may be withheld prior to the studies. A record of the patient's
weight should be sent to the x-ray department with him.
MD0917
1-13