Pacemakers are important cardiac support devices that require constant management after placement. Because pacemakers are inserted transvenously, their placement can cause trauma to the blood vessels if not monitored and managed. Sonography plays an important part in assessing the correct placement of the pacemaker, as well as assessing if any damage was done to the vessel wall.
Cardiac management through pacemakers
One of most common cardiac diseases that plague society is cardiac arrhythmias. Arrhythmias are irregular heart rhythms that can be caused by electrolye imbalances or poor electrical conductivity in the heart muscle. Pacemakers are inserted in the chest or abdomen and send electrical impulses to the heart muscle to keep it beating regularly. With a pacemaker, the signs and symptoms of arrhythmias such as fatigue are easily managed. They can be used in short-term or long-term management for acute and chronic heart problems.
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Pacemaker implantation
Pacemaker implantations are routinely done transvenously, through the subclavian vein. However, the implantation of the pacemaker can cause damage to the blood vessel wall. It can cause a condition known as thrombosis, where plaque builds up on the damaged area, constricting blood flow. Conditions like this are typically asymptomatic but worse symptoms can develop if left unmanaged for too long.
Management through sonography
Sonography – particularly duplex sonography – is able to visualize the subclavian vein after pacemaker implantation. It is able to assess if there is inflammation or damage to the vein from the implantation. The sonogram is able to detect pathologic changes to the blood vessel, primarily:
According to studies conducted regarding the effectiveness of sonography in the management of pacemakers, sonography is invaluable when used before changing leads or their placement. Conducting duplex sonography on the area prior to changing the leads is strongly recommended by physicians because it is able to detect occlusion of the vessel. However, because thrombosis is quite rare in cases of pacemaker implantation, it is difficult to ascertain if sonography will be effective in its diagnosis. You can find more information regarding sonography in Lisa P’s articles through the link.
- Increase in venous diameter
- Lack of or poor modulation of the vessel wall
- Absence of or decreased valvular function
According to studies conducted regarding the effectiveness of sonography in the management of pacemakers, sonography is invaluable when used before changing leads or their placement. Conducting duplex sonography on the area prior to changing the leads is strongly recommended by physicians because it is able to detect occlusion of the vessel. However, because thrombosis is quite rare in cases of pacemaker implantation, it is difficult to ascertain if sonography will be effective in its diagnosis. You can find more information regarding sonography in Lisa P’s articles through the link.
Studying diagnostic medical sonography
The latest sonography skills are taught in all the CAAHEP-accredited schools. There are currently 211 schools accredited in the US in 2014. You can choose to study a short certification course that runs for 12 months or longer courses that run for 2 to 4 years.
Students are taught how to use sonography for a variety of cases, not just OB-GYNE and abdominal problems. They have proven quite valuable in the diagnosis of pacemaker-related problems.
Students are taught how to use sonography for a variety of cases, not just OB-GYNE and abdominal problems. They have proven quite valuable in the diagnosis of pacemaker-related problems.