• Employment will grow faster than the average, but the number of job openings created will be low, because the occupation is small.
• Job prospects will be good due to an aging population and increased need for vascular technology and sonography as an alternative for more costly and invasive heart surgery.
• About 7 out of 10 jobs are in hospitals, in both inpatient and outpatient settings.

Cardiovascular technologists specializing in invasive procedures are called cardiology technologists. They assist physicians with cardiac catheterization procedures in which a small tube, or catheter, is wound through a patient’s blood vessel from a spot on the patient’s leg into the heart. The procedure can determine if a blockage exists in the blood vessels that supply the heart muscle and help diagnose other problems. Part of the procedure may involve balloon angioplasty, which can be used to treat blockages of blood vessels or heart valves, without the need for heart surgery. Cardiology technologists assist physicians as they insert a catheter with a balloon on the end to the point of the obstruction.

Technologists prepare patients for cardiac catheterization and balloon angioplasty by first positioning them on an examining table and then shaving, cleaning, and administering anesthesia to the top of the patient’s leg near the groin. During the procedures, they monitor patients’ blood pressure and heart rate using EKG equipment and notify the physician if something appears wrong. Technologists also may prepare and monitor patients during open-heart surgery and the implantation of pacemakers.

Cardiovascular technologists who specialize in echocardiography or vascular technology often run noninvasive tests using ultrasound instrumentation, such as doppler ultrasound. Tests are called “noninvasive” if they do not require the insertion of probes or other instruments into the patient’s body. The ultrasound instrumentation transmits high frequency sound waves into areas of the patient’s body and then processes reflected echoes of the sound waves to form an image. Technologists view the ultrasound image on a screen that may be recorded on videotape or photographed for interpretation and diagnosis by a physician. While performing the scan, technologists check the image on the screen for subtle differences between healthy and diseased areas, decide which images to include, and judge if the images are satisfactory for diagnostic purposes. They also explain the procedure to patients, record additional medical history, select appropriate equipment settings, and change the patient’s position as necessary. (See the statement on diagnostic medical sonographers elsewhere in the Handbook to learn more about other sonographers.)

Those who assist physicians in the diagnosis of disorders affecting circulation are known as vascular technologists or vascular sonographers. They perform a medical history and evaluate pulses by listening to the sounds of the arteries for abnormalities. Then they perform a noninvasive procedure using ultrasound instrumentation to record vascular information, such as vascular blood flow, blood pressure, limb volume changes, oxygen saturation, cerebral circulation, peripheral circulation, and abdominal circulation. Many of these tests are performed during or immediately after surgery.

Technologists who use ultrasound to examine the heart chambers, valves, and vessels are referred to as cardiac sonographers, or echocardiographers. They use ultrasound instrumentation to create images called echocardiograms. This may be done while the patient is either resting or physically active. Technologists may administer medication to a physically active patient to assess their heart function. Cardiac sonographers may also assist physicians who perform transesophageal echocardiography, which involves placing a tube in the patient’s esophagus to obtain ultrasound images.

Cardiovascular technicians who obtain EKGs are known as electrocardiograph (or EKG) technicians. To take a basic EKG, which traces electrical impulses transmitted by the heart, technicians attach electrodes to the patient’s chest, arms, and legs, and then manipulate switches on an EKG machine to obtain a reading. A printout is made for interpretation by the physician. This test is done before most kinds of surgery and as part of a routine physical examination, especially for persons who have reached middle age or have a history of cardiovascular problems.

EKG technicians with advanced training perform Holter monitor and stress testing. For Holter monitoring, technicians place electrodes on the patient’s chest and attach a portable EKG monitor to the patient’s belt. Following 24 or more hours of normal activity for the patient, the technician removes a tape from the monitor and places it in a scanner. After checking the quality of the recorded impulses on an electronic screen, the technician usually prints the information from the tape so that a physician can interpret it later. Physicians use the output from the scanner to diagnose heart ailments, such as heart rhythm abnormalities or problems with pacemakers.

For a treadmill stress test, EKG technicians document the patient’s medical history, explain the procedure, connect the patient to an EKG monitor, and obtain a baseline reading and resting blood pressure. Next, they monitor the heart’s performance while the patient is walking on a treadmill, gradually increasing the treadmill’s speed to observe the effect of increased exertion. Like vascular technologists and cardiac sonographers, cardiographic technicians who perform EKG, Holter monitor, and stress tests are known as “noninvasive” technicians.

Some cardiovascular technologists and technicians schedule appointments, type doctor interpretations, maintain patient files, and care for equipment.

Cardiovascular technologists and technicians spend a lot of time walking and standing. Those who work in catheterization labs may face stressful working conditions, because they are in close contact with patients with serious heart ailments. Some patients, for example, may encounter complications from time to time that have life or death implications.

Graduates from the 23 programs accredited by the Joint Review Committee on Education in Cardiovascular Technology are eligible to obtain professional certification through Cardiovascular Credentialing International in cardiac catheterization, echocardiography, vascular ultrasound, and cardiographic techniques. Cardiac sonographers and vascular technologists may also obtain certification with the American Registry of diagnostic medical sonographers.

For basic EKGs, Holter monitoring, and stress testing, 1-year certificate programs exist; but most EKG technicians are still trained on the job by an EKG supervisor or a cardiologist. On-the-job training usually lasts about 8 to 16 weeks. Most employers prefer to train people already in the health care field—nursing aides, for example. Some EKG technicians are students enrolled in 2-year programs to become technologists, working part-time to gain experience and make contact with employers.

Cardiovascular technologists and technicians must be reliable, have mechanical aptitude, and be able to follow detailed instructions. A pleasant, relaxed manner for putting patients at ease is an asset.

Some job openings for cardiovascular technologists and technicians will arise from replacement needs, as individuals transfer to other jobs or leave the labor force. Relatively few job openings, due to both growth and replacement needs are expected, however, because the occupation is small.

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