What is the effect of an interventional career on musculoskeletal health? A trainee’s perspective


Take Home Messages
  • Multiple studies have shown a strong association between interventional career and orthopaedic illness.
  • Immediate measures can be taken to prevent orthopaedic injury and physicians having to take a break from the catheter lab due to a health- related issue.
  • Catheter lab staff should be given appropriate advice on core strengthening, wearing supportive shoes, shifting positions in the catheter lab, and optimizing catheter table height and positioning of screen monitors.
  • Core strength and special muscle group training as well as optimal posture training might be what will help us the most.

Fluoroscopically guided interventional procedures performed by cardiologists have become increasingly common and complex. These include percutaneous coronary intervention, structural interventions, pacing and catheter ablations. Given the physical demands of these interventions there is a concern for early retirement due to physical injuries in the interventional cardiology community (1). In this article, I discuss the potential deleterious effects of an interventional cardiology career on the musculoskeletal system and outline some measures to prevent injury. Musculoskeletal injury is a recognized risk in personnel staff performing fluoroscopically guided cardiovascular procedures but prevention of musculoskeletal injuries continues to be one of the areas of unmet needs in interventional cardiology.

Interventional cardiologists perform a broad range of minimally invasive procedures using imaging guidance. These techniques expose the interventionalist to a variety of occupational health concerns including radiation exposure and work- related musculoskeletal injury. We wear protective garments like lead aprons to protect ourselves from harmful radiation in the cardiac catheterization laboratory (cath lab) but it is associated with its downside. Prolonged standing, especially in cases of mechanical extraction of leads, ablations, left ventricular lead implantation and in complex percutaneous interventions such as chronic total occlusion intervention, with few opportunities for rest and poor posture can exacerbate existing back pain.