Coronary angiography remains the gold standard for detecting coronary artery disease. The technique was first performed in 1958 by Dr. Mason Sones at the Cleveland Clinic. Coronary angiography allows visualization of the coronary arteries, branches, and anomalies to precisely locate lesions. It remains an important diagnostic tool used to evaluate patients with suspected coronary artery disease. The procedure involves accessing the femoral artery and advancing a catheter into the heart to inject contrast and obtain images of the coronary arteries under fluoroscopy. Precise technique and monitoring are required to minimize risks of potential complications.
Basics of Coronary Angiography Hewad Gulzai.pptxHewad Gulzai
Basics of Coronary Angiography for beginners, MD, DNB, DM students, Nurses, cathlab technicians, physicians and other healthcare members .
hope you will learn something from this ppt. 😀
Basics of Coronary Angiography Hewad Gulzai.pptxHewad Gulzai
Basics of Coronary Angiography for beginners, MD, DNB, DM students, Nurses, cathlab technicians, physicians and other healthcare members .
hope you will learn something from this ppt. 😀
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
Acute scrotum is a general term referring to an emergency condition affecting the contents or the wall of the scrotum.
There are a number of conditions that present acutely, predominantly with pain and/or swelling
A careful and detailed history and examination, and in some cases, investigations allow differentiation between these diagnoses. A prompt diagnosis is essential as the patient may require urgent surgical intervention
Testicular torsion refers to twisting of the spermatic cord, causing ischaemia of the testicle.
Testicular torsion results from inadequate fixation of the testis to the tunica vaginalis producing ischemia from reduced arterial inflow and venous outflow obstruction.
The prevalence of testicular torsion in adult patients hospitalized with acute scrotal pain is approximately 25 to 50 percent
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
2. Coronary angiography remains the gold
standard for detecting clinically significant
atherosclerotic coronary artery disease
The technique was first performed by Dr.
Mason Sones at the Cleveland Clinic in 1958
Coronary Angiography
3. To visualize coronary arteries, branches,
collaterals and anomalies
Precise localization relative to major and minor
side branches, thrombi and areas of calcification
To visualize vessel bifurcations, origin of side
branches and specific lesion characteristics
(length, eccentricity, calcium etc)
Goals
4. Coronary artery
Coronary artery is a vasa
vasorum that supplies the
heart.
Coronary comes from the
latin ”Coronarius”
Meaning “Crown”.
4
5. Coronary artery
• The coronary artery arises just
superior to the aortic valve and
supply the heart
• The aortic valve has three cusps –
#left coronary (LC),
#right coronary (RC)
#posterior non-coronary (NC)
cusps.
5
6. Right coronary artery
• Originates from right
coronary sinus of
Valsalva
• Courses through the
right AV groove
between the right
atrium and right
ventricle to the inferior
part of the septum
6
7. Branches of RCA
7
Right coronary artery
Conus artery
Sinu nodal artery
Marginal artery
Post. Descending IV artery
AV nodal artery-
Conus branch
SINU NODAL BRANCH
AV Nodal Branch
8. • Conus branch – 1st branch supplies the RVOT
• Sinus node artery – 2nd branch - SA node.(in 40%
they originate from LCA)
• Acute marginal arteries-Arise at acute angle and runs
along the margin of the right ventricle above the
diaphragm.
• Branch to AV node
• Posterior descending artery : Supply lower part of the
ventricular septum & adjacent ventricular walls.
Arises from RCA in 85% of cases.
8
9. Area of distribution
RT CORONARY ARTERY
1)Right atrium
2)Ventricles
a) greater part of rt. Ventricle except the area adjoining the
anterior IV groove.
b) a small part of the lt. ventricle adjoining posterior IV
groove.
c)Posterior part of the IV septum
d)Whole of the conducting system of the heart, except part
of the left branch of AV bundle
9
10. Left coronary artery
• Arises from left coronary
cusps
• Travels between RVOT
anteriorly and left atrium
posteriorly.
• Almost immediately
bifurcate into left anterior
descending and left
circumflex artery.
• Length – 10-15mm
10
12. LT CORONARY ARTERY DISTRIBUTION
1) Left atrium.
2) Ventricles
i) Greater part of the left ventricle, except the area
adjoining the posterior IV groove.
ii) A small part of the right ventricle adjoining the anterior
IV groove.
iii) Anterior part of the IV septum.
iv) A part of the left br. Of the AV bundle.
12
13. DOMINANCE
• Determined by the arrangement that which artery
reaches the crux & supply posterior descending
artery
• The right coronary artery is dominant in 85% cases.
• 8% cases - - circumflex br of the left coronary artery
• 7% both rt & lt coronary artery supply posterior
IVseptum & inferior surface of the left ventricle-here
it is balanced dominance.
13
17. INDICATION
1. Diagnosis of CAD in clinically suspected pts.
2. Providing peri-interventional information for
percutaneous coronary intervention
3. Coronary anomalies
4. To exclude stenoses before non-coronary cardiac
surgery (valve surgery after 40 yrs of age)
5. Determine patency of coronary artery bypass grafts
17
18. INDICATIONS
In patients with non–ST-segment elevation acute
coronary syndromes with high-risk features (e.g.,
ongoing ischemia, heart failure)
In patients with acute ST-segment elevation myocardial
infarction (STEMI)
Primary percutaneous intervention (PCI) is usually
performed in the same procedure, immediately after
the diagnostic procedure
19. CONTRAINDICATIONS
Coagulopathy
Decompensate congestive heart failure
Uncontrolled Hypertension
CVA
GI Hemorrhage
Pregnancy
Inability for patient cooperation
Active infection
Renal Failure
Contrast medium allergy
19
20. Before the Procedure
• After patient is properly identified, the
procedure must be explained before consent
can be signed
• Baseline vital signs will be done and as long as
these are within the doctor’s interest, can
proceed with the procedure
• Blood tests must be done including BUN,
creatnine, PTT, INR, insulin/sugar levels
21. Patient Prep
• After patient is put on table, the area being
puncture must be free from hair
• Hair removal done by disposable electric razor
and removed by sticky side of cloth tape
• Patient must be surgically cleaned with
hospital approved sterile surgical prep
solution
22. Sterile Field and Patient
• The technologist working with the cardiologist
must be scrubbed in following basic sterile
surgical technique
• The patient is then draped from neck down
with sterile drapes
• All equipment (radiation shields, image
intensifier, equipment used to manipulate
machine) must be prepped with sterile covers
23. Sterile equipment needed
Procedure tray should include:
-sterile gowns and gloves for scrub
tech and doctor
-sterile towels and drapes for
procedure
-equipment covers
-gauze
-scalpel, needles, scissors, hemostats
-syringes for heparin/saline flush,
lidocaine, and blood draw
-labels with marking pen for any item
filled with a solution
-basin for heparin/saline mixture,
basin for waste fluids, small cup for
lidocaine
-skin prep solution
-high power manifold
-connection tubing
Fig. 2
24. Catheters, wires and sheaths
Fig. 3
-Three catheters are used: JR4 (advances to right coronary arters, JL4 (advances to left coronary
arteries), and 145 degree pigtail catheter (to advance into ventricles
-One 135cm wire
-Sheath corresponds with catheter size (5F cath gets 5F sheath etc.)
-Size of catheter depends on doctor’s preference but generallly 6F is used
25. Medications Used
• Patient relaxed with Versed or Fentanyl,
sometimes both
• Two 500mL bags of saline infused with 2,000
units (2cc) heparin each for flushing all tubing,
catheters, sheaths
• Lidocaine for tissue numbing
• Visipaque contrast unless otherwise specified
26. START PROCEDURE
When doctor and tech are scrubbed and all equipment and supplies are
ready, the procedure may begin
27. Arterial Puncture
• Access is easiest from right side of
patient due to aortic bend
• Puncture is generally done via the
femoral artery
• Alternative sites include the radial and
brachial arteries of the arm
28. Catheter introduction
After puncture of femoral, radial or brachial artery (primarily on right side of
patient), a catheter is advanced into the aorta and then the coronary arteries
29. Steps to Insert Catheter
• After numbing the groin area, the femoral
artery is palpated and a needle is inserted in
that direction
• When blood comes out of needle, the artery
has been accessed
• A small, flexible guidewire is then inserted
into the lumen of the needle
• The needle can then be removed but the wire
must maintain position
30. Inserting Catheter
• After removing the needle, a flexible plastic
tube can be placed over the wire and
introduced into the artery. This is called a one-
way sheath (allows insertion of catheters and
wires without blood escaping)
• The catheter is then inserted over the
guidewire but through the sheet and
advanced into placement to the aorta.
• MC Catheter used is Judkins.
31. Catheter Placement
• Movement of catheter is monitored under
fluoroscopy with the cardiologist manipulating
its movements
• The fluoroscopic machine is manipulated by a
qualified, scrubbed in, radiologic technologist
• When catheter is in place, wire can be
removed and contrast administered
34. Important safety aspects
• It is essential that the catheter tip does not
wedge into a narrow coronary ostium and cause
occlusion of flow.
• The catheter tip must be axially oriented in
proximal vessel rather than being angulated
against the side wall, which may cause intimal
damage.
• Contrast injection with catheter tip impacted to
side wall of coronary artery can cause osital
dissection.
• Above mentioned are the fatal complications.
35. Contrast Media
• Contrast media-Low osmolarity, Non-ionic
• Dose-3-10 ml;320-370 mg of iodine/mg, using a
hand-held syringe filled from a reservoir.
• Left coronary artery is filled with 6-8 ml, right
coronary artery is filled with 3-5 ml usually
35
36. Angiographic projection
• The heart is oriented obliquely in the thoracic cavity,
the coronary circulation is generally visualized in the
RAO & LAO projection to furnish true PA & LAT views
of the heart. using both cranial & caudal angulations.
• For LCA branches, views -
-AP ,RAO, LAO with cranial tilt
• For RCA branches, views reqd. are
-AP,RAO ,LAO ĉ or ĉout cranial
40. Pitfalls of coronary angiography
1. Inadequate vessel opacification- May give
impression of ostial stenoses, missing side branches or
thrombus.
2. Eccentric stenosis- Coronary atherosclerosis often
leads to eccentric or slit–like narrowing than central
narrowing; so if the long axis of the vessel is projected,
the vessel may appear to have a normal or near normal
caliber.
3. Superimposition of branches
4. Foreshortening of the stenotic segment due to
projectional defect
40
41. Rotational CA
• X-ray system rotates around the patient during the
acquisition of a single run
• Significant reduction in both contrast agent usage and
radiation dose of up to 30%, without compromising
image quality
• Contrast medium is injected automatically (3 mL /s for
the LCA and 2 mL/s for the RCA) range 12-18 cc
• After this preload, rotation of the C-arm was started
automatically and X-rays taken
41
42. Possible complications
• Femoral : Dissection of femoral / iliac artery or
aorta , Haematoma
• Aorta : Damage to aortic intima , Embolus to
head and neck vessels, aortic root dissection.
• Coronary : Ostial dissection, coronary embolus,
arrhythmia due to catheter wedging or contrast
medium, spasm due to catheter or contrast
medium.
• General : Hypotension, left heart failure –
contrast overload, Contrast allergy
43. 43
Tight stenosis noted involving the
mid segment of right coronary
artery. Distal branches are normal.
A partially obstructive
narrowing noted in the
proximal segment of the
LAD
52. Pigtail catheter
in left ventricle
to measure
ventricular
pressure
Aortagram
used to assess
ascending and
descending
aorta
53. Fluoroscopy machine
• The x-ray machine is suspended from the
ceiling. It can be manipulated in multiple
angles and views to achieve a desired picture.
The x-ray comes from the bottom of the
machine and the image intensifier that
transmits the image is above the patient.
Lead shielding and a radiation badge is
required for all personnel in the room during
the procedure.
54.
55.
56. Finished Procedure
• The procedure is complete when the
radiologist or cardiologist has seen all the
views and anatomy desired and all pressures
recorded.
• The catheter can be removed and manual
pressure must be applied to entry site for 15
minutes.
57. Post Procedure Instructions
• The patient must lie flat and supine for a
minimum of two hours to ensure the artery
does not reopen.
• Dressing must remain dry, no lifting over five
pounds for three days.
• No shower for 24 hours.