A cardiovascular exam is the most basic non-invasive procedure used to assess the heart and blood vessels. In preparation of the cardiovascular exam, the medical assistant will want to obtain vital information including weight, blood pressure, heart rate, respiratory rate, and body temperature. In addition, the medical assistant should prepare cardiovascular history for the physician to review. The medical assistant will obtain a complete list of the patient’s medications with current dosage. This includes any over-the-counter medications, or herbal and vitamin supplements. The medical assistant will find out whether the patient smokes, drinks alcohol, exercises, and whether they have a family history of heart disease.
After the examination, the physician may order an EKG exam. The medical assistant will perform the EKG exam and prepare the readouts to assist the physician’s diagnosis of the patient.
What is an EKG Exam?
The EKG is one of the most valuable diagnostic tools for evaluating the electrical pathways through the heart. According to the American Heart Association, an electrocardiogram (EKG) exam is a test that measures the electrical activity of the heartbeat. With each beat, an electrical impulse travels through the heart. This wave causes the muscle to squeeze and pump blood from the heart. A normal heartbeat on an EKG will show the timing of the top and lower chambers.
Why Perform an EKG Exam?
An EKG exam is a quick and painless way for a physician to check the patient’s heart rhythm, identify the characteristics of blood flow to the heart, diagnose a heart attack, check for abnormalities of the heart, identify the orientation of the heart in the chest cavity, and identify increased thickness of the heart muscle.
An EKG exam gives the medical professional specific cardiovascular system information. By measuring time intervals on the EKG, a physician can determine how long the electrical wave takes to pass through the patient’s heart. Finding out how long a wave takes to travel from one part of the heart to the next shows if the electrical activity is normal. Next, by measuring the amount of electrical activity passing through the heart muscle, a physician may be able to find out if parts of the patient’s heart are too large or are overworked.
The elements that are considered from the EKG exam measurements include rate, rhythm, axis, hypertrophy, ischemia, and infarction.
- Rate – how fast the heart is beating
- Rhythm – regularity of cardiac cycles and intervals
- Axis – position of the heart and direction of electrical movement through the heart
- Hypertrophy – size of the heart
- Ischemia – decrease in blood supply to an area of the heart
- Infarction – death of heart muscles, resulting in loss of function
When is an EKG Exam Performed?
An EKG exam may be performed during a routine physical examination or screening evaluation if the patient is predisposed to cardiovascular issues. The EKG exam is also administered as part of a cardiac exercise stress test. An EKG exam should be ordered if the patient is experiencing any symptoms including chest pain, shortness of breath, dizziness, fainting or palpitations. Finally, the EKG exam can be administered before surgery to make sure the patient’s heart is healthy enough to withstand the surgery.
The Medical Assistant’s Responsibility During an EKG Exam
An EKG exam is used to assess the heart and blood vessels. The medical assistant is responsible for obtaining a good-quality EKG without avoidable artifacts. An artifact is an abnormal signal that does not reflect electrical activity of the heart during the cardiac cycle. The medical assistant must make sure that the patient doesn’t move, there are no mechanical problems with the EKG machine, and the proper technique is used during the EKG exam.
What are the Symptoms of a Heart Disorder?
There are a few symptoms medical assistants should note when taking vital signs or performing an EKG exam with a patient that should be brought to the physician’s attention. Some symptoms of a heart disorder include chest pain, dyspnea, fatigue, diaphoresis, nausea, vomiting, irregular heartbeat, peripheral circulation changes, edema, and changes in skin color.
Common Disorders of the Heart
Some of the symptoms of a heart disorder will help the physician diagnosis disorders of the heart. The most common disorders of the heart include carditis, cardiac arrhythmia, congenital and valvular heart disease, congestive heart failure and myocardial infarction.
Carditis – cardiac inflammation usually caused by an infection of the cardiovascular system.
- Endocarditis – infection or inflammation of the inner lining of the heart.
- Myocarditis – inflammation of the middle layer of the heart wall.
- Pericarditis – inflammation of the sac that covers the outside of the heart.
Cardiac Arrhythmia – an abnormal heart rhythm that may be the primary disorder or caused as a response to a problem in the cardiovascular system.
Congestive Heart Failure – condition where the heart can’t pump effectively. The causes of congestive heart failure include coronary artery disease, myocardial disease, valvular heart disease and hypertension.
Myocardial infarction – death of any part of the heart muscle when one or more of the coronary arteries becomes completely blocked.
Valvular Heart Disease – an acquired or congenital abnormality of the cardiac valves.
Common Disorders of the Blood Vessels
The reading on the EKG exam will help the physician diagnosis disorders of the blood vessels. The most common disorders of the blood vessels include anemia, aneurysm, atherosclerosis, hypertension, pulmonary embolism, stroke, venous thrombosis and varicose veins.
Anemia – deficiencies in hemoglobin or in the numbers of red blood cells.
Aneurysm – a ballooning and weakened area in an artery. Causes of aneurysms include trauma, hypertension, atherosclerosis, some fungal infections, syphilis and congenital defects.
Atherosclerosis – disease of the blood vessels, typically from a build-up of fatty plaque made of calcium and cholesterol inside the walls of the blood vessel. The plaque narrows the opening of the blood vessel and blocks blood flow. This blocks oxygen and nutrients from reaching the body’s tissue. Atherosclerosis can be caused by a diet high in saturated fats and/or genetic predisposition. Other risk factors that increase the chance of atherosclerosis include cigarette smoking, diabetes and hypertension.
Hypertension – diagnosed as a patient with a resting systolic blood pressure above 140 mm Hg and a diastolic pressure above 90 mm Hg.
Pulmonary Embolism – a blood clot located in the pulmonary circulation. Symptoms of a pulmonary embolism include labored breathing, temporary loss of consciousness and severe pleuritic chest pain with respiration.
Stroke – caused by damage in the brain’s blood vessels. The damage blocks circulation and stops oxygen from reaching the brain.
Venous Thrombosis – blood clots in the peripheral or pulmonary veins. The main causes of venous thrombosis are hemolytic anemia and sickle cell disease. Additional causes include long-term immobility, chronic pulmonary disease and defibrillation after cardiac arrest.
Varicose Veins – occurs when the superficial veins of the leg swell. Patients that sit or stand for long periods of time without moving their legs are predisposed to varicose veins.
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