Basic Course Information Catalog 2017-2018 [ARCHIVED CATALOG]
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CVT2421 - Invasive Cardiology II
3 hours Lecture, 3 credit(s)
Lower-Division College Credit
Prerequisite(s): CVT 2420
AA Elective: No
Academic Dean’s Contact InformationLAKELAND DEAN’S OFFICE: LLC 2255 PHONE: (863) 297-1024
WINTER HAVEN DEAN’S OFFICE: WSC 101 PHONE: (863) 297-1020
Course Description:
This course provides students with a study of the relationship between various cardiac disease processes and the interventions used to correct them. The effects of coronary artery disease, myocardial infarction, angina, heart failure, cardiomyopathies, pericardial issues, valvular disease, and congenital anomalies are covered with each event’s effect on hemodynamic monitoring. Various formulas and calculations are used in the catheterization lab to determine cardiac output, vascular resistance, valve areas, and shunts with detailed analysis of arterial and venous pressure waveforms of the heart and periphery. Students routinely differentiate between pressure waveforms of the heart, as well as the appropriate scale used to record information with regard to hemodynamic monitoring. Students analyze and differentiate normal and abnormal waveforms, and explore the cause and effect of each.
Polk State College Mission and Program OutcomesPolk State College, a quality driven institution, transforms lives through the power of education by providing access to affordable associate and baccalaureate degree programs, career certificates and workforce employment programs, delivered by diverse, qualified faculty and staff. In line with this purpose, Polk State’s Associate in Science and baccalaureate degree programs develop competence in career areas. This course focuses on the development of competencies related to the following program outcomes:
Students will be able to:
- Demonstrate to information and skills necessary for employment in cardiac catheterization labs while assisting physicians during diagnostic and interventional cardiac and peripheral procedures.
- Distinguish between normal versus abnormal conditions that affect cardiac and peripheral systems.
- Determine the professional role of the CVT and his or her responsibility to the patient, the physician, and other catheterization team members using effective learning domains.
- Demonstrate the information, skills, and abilities necessary to acquire the Advanced Cardiac Life Support (ACLS) certification and Registered Cardiovascular Invasive Specialist (RCIS) credential.
- Demonstrate high standards of professional judgment, ethical standards, and critical-thinking skills necessary for an entry-level invasive cardiovascular technologist.
Course Objectives:
After completing the course, the student will have acquired the ability to:
1. Demonstrate recognition of the differences between arterial and venous waveforms.
2. Expand on proper transducer setup and how it affects pressure, and troubleshoot sources of error and artifact.
3. Correlate deflections within the waveforms in relation to specific portions of the electrical heart cycle.
4. Identify normal and abnormal pressures, as well as pressure waveforms.
5. Identify pullbacks and associated gradients in regard to valvular stenosis and cardiac insufficiencies.
6. Identify dampened pressure waveforms to determine if the pressure is factual or artifact, with means of correcting the latter.
7. Perform several calculation methods from cardiac outputs, ejection fractions, and regurgitation fractions, to valve areas and shunt evaluation.
8. Relate cardiac disease processes with the specific interventions used to fix each.
9. Select the proper scale for recording cardiac waveforms in relation to the specific location in which the catheter is placed.
10. Calculate arterial blood gases.
Course Content:
1. Pressure measurement system/scales
-Left side of heart
-Aorta (AO), Left Ventricle (LV)
-100, 200, or 400 scale according to systemic blood pressure/potential present pathology
-Normal resting pressure
-AO <150 mmHg Systolic
<90 mmHg Diastolic
-LV <150 mmHg Systolic
<15 mmHg Diastolic
-Right side of heart
-Right Atrium (RA), Right Ventricle (RV), pulmonary artery (PA), and Pulmonary Capillary
Wedge (PCW)
-25, 50 or 100 scale depending on venous pressure/potential present pathology
-Normal resting pressure
-RA 0-8mmHg
-RV 15-30 mmHg Systolic and 0-8 mmHg Diastolic
-PA 15-30 mmHg Systolic and 8-15 mmHg Diastolic
PCW (Left atrium (LA)) 4-12 mmHg
2. Artifacts affecting hemodynamic tracings
-Air bubbles
-all connections tightened
-all ports continuously flushed with saline and free of air
-Human error
-proper positioning or leveling of transducer (mid-axillary line)
-calibration/zeroing of transducer
-proper stopcock position
-noise artifact
-patient movement
-catheter position/whip
-damping
-system fidelity
3. Pressure waveforms
-AO systemic pressure (peak pressure from LV; after QRS complex)
-Dicrotic Notch (closure of Aortic valve)
-LV pressure
-EDP (End Diastolic Pressure)
-a wave (mitral valve closure)
-RA pressure
-a wave (atrial contraction; p wave of ECG)
-c wave (Tricuspid valve closure; end of QRS of ECG)
-x descent (fall in pressure from atrial contraction and beginning of ventricle contraction
-v wave (atrial filling; end of t wave of ECG)
-y descent (lowering pressure from blood filling ventricle)
-mean pressure (peak of a and v waves and ½ way of x and y descent)
-RV pressure
-peak systolic pressure (RV contraction at t wave of ECG)
-EDP (pressure before ventricular contraction at R deflection of ECG)
-PA pressure
-peak systolic pressure (pulmonary artery filling at beginning of t wave of ECG)
-dicrotic notch (pulmonary valve closes)
-PCW pressure (LA pressure)
-v wave (LA filling at p wave of ECG)
-y descent (LA pressure becomes greater than LV EDP and mitral valve opens)
-a wave (LA contraction at QRS complex of ECG)
-c wave (closure of mitral valve)
-x descent (LA relaxation)
-mean pressure (peak of a wave and ½ way on x descent)
4. Pathology and how it affects pressure wave forms
-atrial fibrillation
-tricuspid and pulmonary valve stenosis/insufficiency
-RV hypertrophy
-pulmonary hypertension
-heart failure
-COPD (Chronic Obstructive Pulmonary Disease)
-mitral and aortic valve stenosis/insufficiency
-Cardiomyopathies
-Dilated
-Hypertrophic
-Restrictive
-Toxin related
-left to right shunts
-myocardial disease
-endocardial disease
-pericarditis
-cardiac tamponade
-ischemia
-hypervolemia
-hypovolemia
5. Pullbacks and their significance in regard to pathology
-LV to AO pullback
-Aortic stenosis/insufficiency/calcified valve
-approaches without pullback for Aortic valve disease
-Langston catheter
-dual catheter approach
-both groins accessed with catheter in LV and a catheter in the aortic root
-mitral valve stenosis/insufficiency
-Right heart pullback (PCW>PA>RV>RA)
-pulmonary and tricuspid valve stenosis/insufficiency
6. Recognize and identify causes of pressure dampening
-severe CAD or PAD
-physiologic affects from medication
-improper zeroing or transducer location
-improper catheter placement/position
-air bubbles within the system
-small intraluminal size of catheter
-connection tubing length (<48”)
7. Hemodynamic calculations and formulas
-Valve area
-Gorlin method
-Hakke method
-Cardiac output
-FICK method
-Hgb O2 content
-Hgb O2 capacity
-Cardiac Index
-Thermodilution method
-Quantitative method (LV)
-Ejection fraction
-Stroke volume
-Vascular resistance
-Systemic
-Pulmonary
-Poiseuille’s Law/Modified Ohm’s Law
8. Pulmonary functions
-Ventilation/Flow:
-Lung Volume
-Poiseuille’s Law
-Gas Laws:
-Boyle’s Law
-Gay-Lussac’s Law
-Fick’s Law
-Oxygen Transport:
-components of blood
9. Acid-base balance
-pH scale
-ratio of HCO3 to CO2
-Interpretation of Arterial Blood Gases (ABG):
-Respiratory Acidosis
-Respiratory Alkalosis
-Metabolic Acidosis
-Metabolic Alkalosis
Textbook and Other RequirementsTextbook information is provided in the course syllabus, at the campus bookstore, on the campus bookstore website (www.polk.bncollege.com), or via the “Shop Textbook” button on the PASSPORT schedule of classes.
The Gordon RuleThis is not a Gordon Rule course.
Student HelpThe professor is available for help during posted hours and by appointment during other non-class hours. Students are encouraged to seek assistance from the professor. To further the educational process, the campus Learning Resources Centers, comprised of the Teaching/Learning and Computing Center (TLCC) JDA Student Success Center, and library, are available for student use. Each resource provides qualified staff and up-to-date equipment and facilities to promote students’ academic success. The TLCCs and JDA Student Success Center provide tutoring services, computing resources, and other instructional support. The library provides information resources, individual and group study space, research assistance, information literacy instruction, and computing resources. Each facility provides free wireless access to the Internet. Polk State College Library, Student Success Center, and TLCC hours of operation and tutoring schedules are posted at each facility and on the College website.
Withdrawing From a CourseStudents may officially withdraw from course(s) during any given term, provided they follow the appropriate policy and procedure. Following the conclusion of the Drop/Add Period, a student may officially withdraw without academic penalty from any credit course, provided he or she has submitted the appropriate forms to the Student Services Office no later than the published deadline. The published deadline reflects approximately (but no more than) 70% of the term, based upon the course’s scheduled duration. It is the student’s responsibility to submit these withdrawal forms; failure to do so may result in a grade of F in the course. Under the Forgiveness Policy, a student is allowed only three attempts in any one course: one initial enrollment and two repeats. A student is not allowed to withdraw from a third course attempt. Limited admission programs may have specific guidelines regarding course withdrawal that vary from this policy. Individuals should refer to the student handbook for that program for more information. If a student stops attending class, the grade earned, usually an F, is assigned and posted. Prior to withdrawing from a course, the student should consult with the Financial Aid Office to determine what impact, if any, withdrawal from the course will have on his or her financial aid status. A student cannot use course withdrawal to avoid academic dishonesty penalties. A student who has been penalized for academic dishonesty in a course is not eligible to withdraw from the course.
A student who withdrawals or fails any CVT course during their first semester of the first year may return the following year on a “clinic space availability” basis with permission from the Program director (remedial activities may be given at this time). A student who withdrawals or fails the same CVT course two times will be dismissed from the program. The student may reapply through the readmit application process within one year and is subject to the “clinic space available” basis with permission from the Program director. A student must successfully demonstrate the appropriate level clinical skills to the Clinical Coordinator prior to returning to the clinical setting after an absence of one semester or more.
Repeating a CourseUnder the Forgiveness Policy, a student is allowed only three attempts in any one college credit course: one initial enrollment and two repeats. Under certain circumstances, a student may petition to repeat a credit course beyond the three attempts. Limited admission programs may have specific guidelines regarding repeating a course that vary from this policy. Individuals should refer to the student handbook for that program for more information. The student should be aware that repeating a course may result in a higher course cost. A course cannot be repeated unless the previously earned grade is a D, F, or W (the Polk State College Catalog provides further details regarding this process). Prior to repeating a course, the student should consult with the Financial Aid Office to determine what impact, if any, repeating the course will have on his or her financial aid status.
Academic DishonestyEach student is responsible for his or her work. It is assumed that each student is honest and will abide by this standard; however, in the event that there is an indication or suspicion of cheating/plagiarism, the situation shall be dealt with in accordance with the published College policy. Copies of this policy are available in the Student Services Office. Students should also refer to the course syllabus for more specific information.
Information Technology Access/Use PolicyAll individuals who employ the information technology resources provided by Polk State College (this includes, but is not limited to, telephones, computers, the Polk State College Local Area and Wide Area Networks, and the Internet) must use these resources for academic purposes only. Use of these resources is a privilege, not a right. Inappropriate use can result in revocation or suspension of this privilege.
Equal Access/OpportunityPolk State College is an equal access/equal opportunity institution committed to excellence through diversity in education and employment. The College complies with all state and federal laws granting rights to students, employees, and applicants for employment or admission to the College. Polk State College does not discriminate on the basis of race, color, national origin, ethnicity, sex, age, religion, sexual orientation, marital status, veteran status, genetic information, disability, or pregnancy in its programs, activities, or employment.
The following person has been designated to handle inquiries regarding the non-discrimination policies:
Valparisa Baker
Director, Equity & Diversity (Title IX Coordinator)
999 Avenue H NE
Winter Haven, FL 33881-4299
Office: WAD 227, 863.292.3602 Ext. 5378, vbaker@polk.edu.
Equal Opportunity For Students With DisabilitiesThe College complies with The Americans with Disabilities Act and provides equal educational opportunity for qualified individuals. A student with a disability who requires special accommodations or auxiliary aids under The Americans with Disabilities Act (ADA) should contact the Student Services Office on either campus and speak with a Disability Services Advisor or the Coordinator of Disability Services. Note: Limited admission programs may have performance restrictions that apply. Restrictions (where applicable) are outlined in each program’s student handbook.
Evaluative Criteria:
Multiple choice tests, quizzes, equipment/procedure check-off, individual assignments and projects, group activities, and professional behavior.
Lecture= 50%
Tests & Quizzes= 40%
Professional Behavior= 10%
Grading Scale:
92.5 - 100 A
88.5 - 92.4 B+
83.5 - 88.4 B
80.5 - 83.4 C+
75.5 - 80.4 C
70.5 - 75.4 D+
65.5 - 70.4 D
Below 65.4 F
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