Medical assistant's role in cardiovascular treatments and patient care
Assisting with treatments
Patients with cardiovascular diseases and disorders are prescribed a variety of medications. The following are some of the more common classifications of medications:
- Antiarrhythmic: Used to treat arrhythmias
- Anticoagulant: Used to prevent blood clots from forming
- Antihypertensive: Used to lower and control the blood pressure; several categories include the following:
- Beta-blocker: Reduces the heart rate, the workload, and the output of the heart
- Angiotensin-converting enzyme (ACE) inhibitor: Decreases angiotensin production, which causes blood vessels to dilate
- Angiotensin II receptor antagonist: Blocks the effects of angiotensin, and blood vessels dilate
- Calcium channel blocker: Prevents calcium from entering the heart and arteries’ smooth muscles; decreases contraction force, dilates blood vessels, and reduces the heart rate
- Alpha-blocker: Dilates arteries
- Antiplatelet: Used for post-treatment of stroke, heart attack, or angina
- Cholesterol-lowering agent: Reduces low-density lipoprotein (LDL) and triglycerides; increases high-density lipoprotein (HDL)
- Diuretic: Increases urinary output and lowers the blood pressure
- Hematopoietic: Treats anemia in patients undergoing chemotherapy
- Hemostatic: Controls acute or chronic blood-clotting disorder; promotes the formation of an absorbable, artificial clot
- Thrombolytic (fibrinolytic): Dissolves an existing blood clot (e.g., during an acute heart attack or stroke); distinct from anticoagulants and antiplatelets, which only prevent new clots from forming
Medical assistants should be familiar with medications that are prescribed to patients.
Pacemakers and implantable cardioverter-defibrillators
A pacemaker uses low-energy electrical pulses to assist the heart when arrhythmias, tachycardia, or bradycardia occurs. There are two types of pacemakers:
- Temporary pacemaker: Used in an emergency until the permanent pacemaker can be placed. Also used for temporary conditions (e.g., heart attack and medication overdose).
- Permanent pacemaker: Surgically inserted into the chest. Patients can use technology (e.g., smartphones) to transmit their pacemaker data to their providers.
An implantable cardioverter-defibrillator (ICD) is similar to a pacemaker in that it uses low-energy electrical pulses to treat arrhythmias. However, ICDs differ from pacemakers because they can also use high-energy pulses when a life-threatening arrhythmia occurs.
Patients with a pacemaker or ICD need to have the device checked on a routine basis. The batteries usually last 5 to 7 years, and a replacement requires a surgical procedure. When using a pacemaker or ICD, the person needs to keep strong magnets and electrical fields a safe distance away; cell phones and similar personal electronics should be kept at least 6 inches from the device (and used on the ear opposite the implant), while stronger sources such as MRIs, microwave-emitting equipment, power-generating equipment, and some security metal detectors call for advance notice to the provider or screening staff. They should carry identification that indicates they have a pacemaker or an ICD.
Patient coaching
According to the CDC, heart disease is the leading cause of death for adults. About 1 in 5 deaths (roughly 20%) are related to heart disease each year. Genetics, predisposition, and lifestyle factors - such as smoking, lack of exercise, and poor diet - play significant roles in the development of heart disease. Successful management of cardiovascular disease requires major lifestyle changes for most patients. The medical assistant can help by providing encouragement and support and using community resources to help the patient find assistance with these changes.
Sources for information include the American Heart Association and the US Department of Agriculture USDA and My Plate. Because many patients learn best through visual aids, providing them with pictures, brochures, and pamphlets is an effective means of helping them in this learning process. Education interventions are always documented so that the provider or medical assistant can clarify or expand on the information upon a return visit.
Legal and ethical issues
Diagnostic procedures can have a marked effect on the patient’s treatment. When entrusted with performing testing procedures, the medical assistant assumes responsibility for the test’s accuracy and for performing the test precisely. This is an important role because the results submitted could strongly influence the plan of treatment. Diagnostic procedures such as cardiac catheterization, CT angiography, and Doppler studies are covered in Medical assistant’s role in cardiovascular examinations and diagnostics.
Patient-centered care
Two important aspects of patient-centered care are information and education. Many of the more common cardiovascular diseases require patients to be on medication for treatment. It is important that patients know the following:
- Name of the medication
- Reason for the medication
- Side effects/adverse reactions to report to the provider
When a patient is put on a new medication, providing information on the medication is important. The medical assistant should review the information with the patient. Also, giving the patient a handout to take home and a phone number to call if questions arise will promote patient-centered care.