ANGIOGRAPHY Cardiac catheterization is usually performed with angiography, a technique of injecting a contrast agent into the vascular system

to outline the heart and blood vessels. When a particular heart chamber or blood vessel is singled out for study, the procedure is known as selective angiography. Angiography makes use of cineangiograms, a series of rapidly changing films on an intensified fluoroscopic screen that record the passage of the contrast agent through the vascular site or sites. The recorded information allows for comparison of data over time. Common sites for selective angiography are the aorta, the coronary arteries, and the right and left sides of the heart. Coronary artery bypass surgery, also coronary artery bypass graft surgery, and colloquially heart bypass or bypass surgery is a surgical procedure performed to relieve angina and reduce the risk of death from coronary artery disease. Arteries or veins from elsewhere in the patient's body are grafted to the coronary arteries to bypass atherosclerotic narrowings and improve the blood supply to the coronary circulation supplying the myocardium (heart muscle). This surgery is usually performed with the heart stopped, necessitating the usage of cardiopulmonary bypass; techniques are available to perform CABG on a beating heart, so-called "off-pump" surgery.

Dysrhythmias. Ectopic rhythms arise in or near the borders of intensely ischemic and damaged myocardial tissues. Damaged myocardium ay also interfere with the conduction system, causing dissociation of the atria and ventricles. Supra ventricular tachycardia (SVT) sometimes occur as a result of heart failure. Spontaneous or pharmacologic reperfusion of a previously ischemic area may also precipitate ventricular dysrhythmias Cardiogenic Shock accounts for only 9% of deaths from AMI, but more than 70% clients in shock die of it. Causes include decreased myocardial contraction with diminished cardiac output, undetected dysrhytmias, and sepsis. Clinical manifestations include systolic blood pressure significantly below the clients normal range, diaphoresis, rapid pulse, restlessness, cold and clammy skin, grayish skin color. Shock can be prevented with sufficient IV fluids to prevent circulatory collapse and the identification of dysrhythmias Heart Failure and Pulmonary Edema. The most common cause of in-hospital death in clients with cardiac disorders is heart failure. Heart failure disables 22% of male clients and 46% of female clients who experience an AMI and is responsible for one third of deaths after an AMI. Heart failure may develop at onset of the infarction or may occur weeks later. Clinical manifestations include dyspnea, othopnea, weight gain, edema, enlarged tender liver, distended neck veins and crackles. Pulmonary Embolism may develop secondary to phlebitis of the leg or pelvic veins (venous thrombosis) or from atrial filtration or fibrillation. PE occurs in 10% to 20% of clients of same point, during either the acute attack or covalescence.

Recurrent Myocardial Infarction. Within 6 years after an initial AMI, 18% of men and 35% of women may experience recurrent MI. Possible causes include overexertion embolization, and further thrombotic occlusion of a coronary artery by an atheroma. The clinical manifestation is the return of agina. Pericarditis. In up to 28