Cardiovascular Technologists and Technicians

• About 3 out of 4 jobs were in hospitals.
• The vast majority of cardiovascular technologists and technicians complete a 2-year junior or community college program.
• Employment will grow much faster than the average, but the number of job openings created will be low because the occupation is small.
• Employment of most specialties will grow, but fewer EKG technicians will be needed.

Cardiovascular technologists and technicians assist physicians in diagnosing and treating cardiac (heart) and peripheral vascular (blood vessel) ailments. Cardiovascular technologists may specialize in any of three areas of practice: invasive cardiology, echocardiography, and vascular technology. Cardiovascular technicians who specialize in electrocardiograms (EKGs), stress testing, and Holter monitors are known as cardiographic technicians, or EKG technicians.

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 threaded through a patient’s artery from a spot on the patient’s groin to the heart. The procedure can determine whether a blockage exists in the blood vessels that supply the heart muscle. The procedure also can help to 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 their leg near the groin. During the procedures, they monitor patients’ blood pressure and heart rate with EKG equipment and notify the physician if something appears to be wrong. Technologists also may prepare and monitor patients during open-heart surgery and during the insertion of pacemakers and stents that open up blockages in arteries to the heart and major blood vessels.

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 and may record the image on videotape or photograph it for interpretation and diagnosis by a physician. As the instrument scans the image, technologists check the image on the screen for subtle differences between healthy and diseased areas, decide which images to include in the report to the physician, and judge whether the images are satisfactory for diagnostic purposes. They also explain the procedure to patients, record any additional medical history the patient relates, select appropriate equipment settings, and change the patient’s position as necessary.

Those who assist physicians in the diagnosis of disorders affecting the circulation are known as vascular technologists or vascular sonographers. They perform a medical history, evaluate pulses and assess blood flow in arteries and veins by listening to the vascular flow sounds for abnormalities. Then they perform a noninvasive procedure using ultrasound instrumentation to record vascular information such as vascular blood flow, blood pressure, changes in limb volume, 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. An echocardiogram may be performed while the patient is either resting or physically active. Technologists may administer medication to physically active patients to assess their heart function. Cardiac sonographers also may 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. An EKG is printed out for interpretation by the physician. This test is done before most kinds of surgery or as part of a routine physical examination, especially on persons who have reached middle age or who 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 by 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 for analysis by a physician. 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 doctors’ interpretations, maintain patient files, and care for equipment.

Technologists and technicians generally work a 5-day, 40-hour week that may include weekends. Those in catheterization laboratories tend to work longer hours and may work evenings. They also may be on call during the night and on weekends.

Cardiovascular technologists and technicians spend a lot of time walking and standing. Heavy lifting may be involved to move equipment or transfer patients. These workers wear heavy protective aprons while conducting some procedures. Those who work in catheterization laboratories may face stressful working conditions because they are in close contact with patients with serious heart ailments. For example, some patients may encounter complications that have life-or-death implications.

Although a few cardiovascular technologists, vascular technologists, and cardiac sonographers are currently trained on the job, most receive training in 2- to 4-year programs. The majority of technologists complete a 2-year junior or community college program, but 4-year programs are increasingly available. The first year is dedicated to core courses and is followed by a year of specialized instruction in either invasive, noninvasive cardiovascular, or noninvasive vascular technology. Those who are qualified in an allied health profession need to complete only the year of specialized instruction.

Graduates of the 33 programs accredited by the Joint Review Committee on Education in Cardiovascular Technology are eligible to obtain professional certification in cardiac catheterization, echocardiography, vascular ultrasound, and cardiographic techniques from Cardiovascular Credentialing International. Cardiac sonographers and vascular technologists also may obtain certification from the American Registry of Diagnostic Medical Sonographers.

Most EKG technicians are 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. One-year certification programs exist for basic EKGs, Holter monitoring, and stress testing.

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.

Cardiovascular technologists and technicians held about 45,000 jobs in 2004. About 3 out 4 jobs were in hospitals (private and government), primarily in cardiology departments. The remaining jobs were mostly in offices of physicians, including cardiologists or in medical and diagnostic laboratories, including diagnostic imaging centers.

Employment of cardiovascular technologists and technicians is expected to grow much faster than the average for all occupations through the year 2014. Growth will occur as the population ages, because older people have a higher incidence of heart problems and use more diagnostic imaging. Employment of vascular technologists and echocardiographers will grow as advances in vascular technology and sonography reduce the need for more costly and invasive procedures. However, fewer EKG technicians will be needed, as hospitals train nursing aides and others to perform basic EKG procedures. Individuals trained in Holter monitoring and stress testing are expected to have more favorable job prospects than are those who can perform only a basic EKG.

Some job openings for cardiovascular technologists and technicians will arise from replacement needs as individuals transfer to other jobs or leave the labor force. However, job growth and replacement needs will produce relatively few job openings because the occupation is small.

Median annual earnings of cardiovascular technologists and technicians were $38,690 in May 2004. The middle 50 percent earned between $27,890 and $50,130. The lowest 10 percent earned less than $21,790, and the highest 10 percent earned more than $59,000. Median annual earnings of cardiovascular technologists and technicians in May 2004 were $36,890 in offices of physicians and $38,150 in general medical and surgical hospitals.

Cardiovascular technologists and technicians operate sophisticated equipment that helps physicians and other health practitioners to diagnose and treat patients. So do diagnostic medical sonographers, nuclear medicine technologists, radiation therapists, radiologic technologists and technicians, and respiratory therapists.

For general information about a career in cardiovascular technology, contact:

• Alliance of Cardiovascular Professionals, Thalia Landing Offices, Bldg. 2, 4356 Bonney Rd., Suite 103, Virginia Beach, VA 23452-1200. Internet: http://www.acp-online.org/

For a list of accredited programs in cardiovascular technology, contact:

• Committee on Accreditation for Allied Health Education Programs, 39 East Wacker Dr., Chicago, IL 60601. Internet: http://www.caahep.org/
• Joint Review Committee on Education in Cardiovascular Technology, 1248 Harwood Rd., Bedford, TX 76021.

For information on vascular technology, contact:

• Society for Vascular Ultrasound, 4601 Presidents Dr., Suite 260, Lanham, MD 20706-4381. Internet: http://www.svunet.org/

For information on echocardiography, contact:

• American Society of Echocardiography, 1500 Sunday Dr., Suite 102, Raleigh, NC 27607. Internet: http://www.asecho.org/

For information regarding registration and certification, contact:

• Cardiovascular Credentialing International, 1500 Sunday Dr., Suite 102, Raleigh, NC 27607. Internet: http://www.cci-online.org/
• American Registry of Diagnostic Medical Sonographers, 51 Monroe St., Plaza East One, Rockville, MD 20850-2400. Internet: http://www.ardms.org/

• • Source: Bureau of Labor Statistics, U.S. Department of Labor, Occupational Outlook Handbook, 2006-07 Edition,