holter monitor

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Holter Monitor

ambulatoryelectrocardiography

deviceA type of portable

heart monitor that isa small

electrocardiogram(EKG) device wornin a pouch aroundthe neck or waist.
http://www.medterms.com/script/main/art.asp?articlekey=1944http://en.wikipedia.org/wiki/File:Alex_CM4000.jpghttp://www.medterms.com/script/main/art.asp?articlekey=1944


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keeps a record of the heart rhythm,

typically over a 24-hour period, andthe patient keeps a diary of activitiesand symptoms.

useful for identifying heartdisturbances that are sporadic andnot readily identified with a restingEKG.

named for physicist Norman J. Holterwho invented telemetric cardiac

monitoring in 1949.
http://en.wikipedia.org/wiki/Norman_Holterhttp://en.wikipedia.org/wiki/Norman_Holter


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Why the Test is Performed

Holter monitoring is used to determinehow the heart responds to normalactivity. The monitor may also be

used: After a heart attack

To diagnose heart rhythm problems

When starting a new heart medicine


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May be used to diagnose:

Atrial fibrillation/flutter

Multifocal atrial tachycardia

Palpitations Paroxysmal supraventricular

tachycardia

Reasons for fainting Slow heart rate (bradycardia)

Ventricular tachycardia


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Normal Results Normal variations in heart rate occur with

activities. A normal result is no significantchanges in heart rhythms or pattern.

What Abnormal Results Mean Abnormal results may include

various arrhythmias. Changes may mean

that the heart is not getting enough oxygen.The monitor may also detect conduction

block, a condition in which the atrialelectrical activity is either delayed or doesnot continue into the ventricles of the heart.

RisksThere are no risks associated with the test.

However, you should be sure not to let themonitor get wet.


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Considerations

Electrodes must be firmly attached to thechest so the machine gets an accuraterecording of the heart's activity.

While wearing the device, avoid: Electric blankets High-voltage areas Magnets Metal detectors

It is very important for you to keep a diaryof symptoms. The diary should include thedate, time of day, type, and duration ofsymptoms.


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Angiography or Arteriography

medical imaging technique used tovisualize the inside, or lumen, ofblood vessels and organs of the

body, with particular interest in thearteries, veins and the heartchambers.

traditionally done by injecting aradio-opaque contrast agent intothe blood vessel

imaging using X-ray based


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helps your physician determine thesource of the problem and the extentof damage to the blood vessel

segments that are being examined.


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Purpose

To locate and assess narrowing,occlusions, and other abnormalitiesof various arteries, especially

the femoral arteries of the legs; thecarotid arteries in the neck; and thearterial systems of the brain, heart,

and kidneys. It also displays thevascular anatomy to organs such asthe brain, liver, and gastrointestinal

tract.


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Advantages:- provides the most accurateinformation about the state of thearteries.

Disadvantages- The test is invasive and carries a riskof serious complications, including an

allergic reaction to the contrastmaterial, hemorrhaging, stroke, cardiacarrhythmias, arterial occlusion, andinfection.- expensive and should be performedonly by an experienced angiographer.


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Uses

Coronary angiography- One of most common angiograms

performed is to visualize the blood inthe coronary arteries.

Microangiography

- commonly used to visualize tiny bloodvessels.

Neuro-vascular angiography

- Another increasingly commonangiographic procedure is neuro-

vascular digital subtraction


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Peripheral angiography

- identify vessel narrowing inpatients with leg claudicationor cramps.

- caused by reduced blood flow downthe legs and to the feet; in patientswith renal stenosis.


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Complications Coronary angiography

- common and major complications.Include:-Cardiac arrhythmias

-Kidney damage

-Blood clots-Hypotension-Pericardial effusion

Minor complications include:-Bleeding or bruising-Allergic reaction


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Cerebral angiography

Include:

- Stroke

- Allergic reaction to the anaesthetic

- Blockage or damage to one of theaccess veins in the leg, or thrombosis

- Embolism formation.Minor Complications:

- Bleeding or bruising


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Where It's Done Outpatient clinic, radiology lab, or hospital.Who Does It

Radiologist or other doctor.How Long It Takes 1-3 hours.Discomfort/Pain Some pain as anesthetic is injected; prolonged lying

on X-ray table may be uncomfortable; dye causesflushing sensation.Results Ready Often within a few hours.Special Equipment

Catheter, X-ray machine, and fluoroscopic equipment;video monitor; other equipment varies according tothe purpose of the test.

When Risks/Complications Bleeding and a bruise where artery is punctured;

allergic reaction to dye; slight risk of stroke, kidney

failure, or sudden arterial occlusion.


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Medications

Do NOT take any aspirin or anyproducts containing aspirin.

Do NOT take dipyridamole (Persantine)

or warfarin (Coumadin) within 72hours before the test, and 24 hoursafter the test.These medications areoften referred to as blood thinning pills.

DO take your other medications onschedule as usual, especially anymedications for high blood pressure.


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ARTERIOGRAPHY

Radiologic examination of arteries usinga contrast medium that is injected intoan artery to make arteries visible.

Performed most often using x-ray,although magnetic resonance imaging(MRI) and computed tomography (CTscan) may also be used.

When an x-ray or CT scan study isperformed, a liquid, radio-opaque dye isused.


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Usually performed under localanesthesia.

It may also be performed in theoperating room under generalanesthesia during arterial graftsurgery.


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ComplicationsThe most common complication of

arteriography is formation of a bloodclot (thrombus) in the artery at theentry site.

Other complications include:

- an allergic reaction to the dye,- bleeding from the puncture site,- dislodgment of plaque from the insideof the artery (embolization),

- separation of the wall of the artery(dissection),- infection- stroke.


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Restrictions/Accommodation

Ordinary walking and a return to work thesame day or the next day are usuallyallowed. If work involves lifting more than20 pounds or a lot of bending , 2 or 3 days

off work are recommended to reduce thechance of re-bleeding from the entry site.

Bending of the groin or elbow at whateversite was used for performance of the

arteriography should be avoided for 1 day. A longer restriction of activity may be

required if an individual sustained acomplication from the procedure.


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holter monitor

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