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105 Cards in this Set
- Front
- Back
ASCVD
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Aterosclerotic cardiovascular disease
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CAD
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coronary artery disease
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IHD
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ischemic heart disease
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NTG
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Nitroglycerin
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AMI
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acute myocardial infarction
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CABG
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coronary artery bypass graft
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ACB
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aortocoronary bypass
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CK
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creatine phosphokinase
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CPK
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creatine phosphokinase
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LH
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lactic dehydrogenase
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LDH
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lactic dehydrogenase
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SGOT
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serum glutamic oxalacetic transaminase
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AST
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serum glutamic oxalacetic transaminase
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Type of angina: Symptom of pain caused by myocardial ischemia; provoked by stress, during exercise
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Angina pectoris
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What is another name for variant angina?
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Prinzmetal's angina
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Type of angina:
Chest pain that occurs at rest, people that have preserved exercise capacity |
Prinzmetal's angina/Variant angina
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Type of angina: Worst case scenario; occurs at rest, increase in frequency and duration over time; can lead to myocardial infarction and requires immediate medical attention
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Unstable Angina/Crescendo angina
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What is another name for unstable angina?
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Cresendo angina
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Type of angina: myocardial infarction without any chest pain
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Silent myocardial infarction
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S/S: May be described by the patient as pain, discomfort, tightness, ache or pressure
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Angina
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(S/S): Many patients do not use the word pain
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Angina
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(S/S): Located in the retrosternal area with or without feeling the sensations in the throat, mandible, shoulders, etc.
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angina
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(S/S): Size of the area of discomfort is usually that of a clinched fist or greater
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angina
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(S/S): Lasts 30 seconds to several minutes if the ppt cause is eliminated
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angina
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(S/S): Size of the area of discomfort is usually that of a clinched fist or greater
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angina
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(S/S): Does not last more than 15 minutes
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angina
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(S/S): Can be produced by effort or emotional stress or may occur spontaneously
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angina
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(S/S): May be ppt. by changes in the weather
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angina
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(S/S): An observer may detect facial pallor
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angina
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(S/S): substernal chest pain often accompanied by N/V, diaphoresis, pain that may radiate to back, jaw or left arm
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myocardial infarction
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(S/S): Pain may appear to be like indigestion
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myocardial infarction
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(S/S): anxiety, sob, dizziness, feeling of "impending doom"
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myocardial infarction
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(S/S): S4 gallop, murmurs
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myocardial infarction
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(S/S): ECG changes
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myocardial infarction
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PMH is a lab/diagnostic test used in ____________
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angina and myocardial infarction
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ST segment elevation or depression is a lab/diagnostic test used in ____________
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angina
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Exercise tolerance stress test is a lab/diagnostic test used in ____________
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angina
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Cardiac catheterization is a lab/diagnostic test used in ____________
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angina
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Serial isoenzymes is a lab/diagnostic test used in ____________
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myocardial infarction
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ST segment elevation, T wave inversion, appearance of Q waves is a lab/diagnostic test used in ____________
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myocardial infarction
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What does an ECG reading look like in a pt. with angina?
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ST segment elevation or depression
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What does an ECG reading look like in a pt. with a myocardial infarction?
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ST segment elevation
T wave inversion appearance of Q waves |
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What are some of the symptoms of unstable angina?
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new onset
cresendo angina occuring at rest |
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Definition: Continuted decrease in oxygen delivery resulting in permanent cell injury and death (thrombus formation/occlusion)
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myocardial infarction
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What are the three isoenzymes?
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CK-MB
CK-BB CK-MM |
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Where is CK-MB found?
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myocardium and skeletal muscle
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Where is CK-BB found?
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brain, lungs and GI tract
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Where is CK-MM found?
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skeletal, cardiac muscle
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Normal range of CK in males
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40-200 IU/L
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Normal range of CK in females
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35-150 IU/L
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Normal range for CK-MB
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< 12 IU/L
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Normal range for LDH?
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100-210 IU/L
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Normal range of AST for males
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0-37
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Normal range of AST for females
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1-31
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AST
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aspartate aminotransferase
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Normal range for Troponin I
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< 1.5 ng/ml
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Normal range for Troponin T
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less than or equal to 2 ng/ml
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Which enzyme stimulates transfer of PO4 groups?
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CK
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Which enzyme is concentrated in tissues dependent on aerobic metabolism?
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CK
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In AMI, which enzyme rises sharply in 608 hours after onset, maximizes in 24 hours and normalizes in 3-4 days?
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CK
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What is the sensitivity and specificity of CK?
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Sensitivity - 98%
Specificity - 67% |
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What is the sensitivity and specificity limitations of LDH?
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Sensitivity - 98%
Specificity - 30% |
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Which enzyme is more specific for cardiac tissue?
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CK-MB
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In AMI, which enzyme rises sharply in 4-8 hours after onset, mazimizes in 12-20 hours and normalizes in 2-3 days?
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CK-MB
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Which enzyme acts in the final step of glycolysis?
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LDH
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Which enzyme has high concentrations in skeletal muscle, kidneys, liver, RBCs and heart? (virtually everywhere)
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LDH
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Where is LDH found?
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skeletal muscle, kidneys, liver, RBCs, heart, etc.
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In AMI, which enzyme rises 12 hours after onset, maximizes in 2-3 days and normalizes in 8-14 days?
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LDH
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What is the sensitivity and specificity of LDH isoenzyme ratio?
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sensitivity - 81%
specificity - 94% |
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If ratio is greater than 1 it is an indication of acute MI
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LDH Isoenzyme ratio
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Which enzyme is active in amino acid synthesis?
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AST
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Which enzyme is widely distributed throughout the body? (not very specific)
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AST
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In AMI, which enzyme rises within 12 hours after onset, mazimizes in 36 hours and normalizes in 3-4 days?
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AST
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In AMI, which enzyme rises within two hours after onset, but is rapidly cleared b the kidneys?
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myoglobin
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Which enzyme has low specificity?
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myoglobin
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Definition: low molecular weight hemeprotein found in heart and muslce; used for early detection
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myoglobin
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Which enzyme is the new gold standard for cardiac enzymes?
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Troponins
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Which enzyme is highly specific for cardiac muscle?
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Troponins (99%)
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In AMI, which enzyme rises within four hours of onset, mazimizes in fourteen hours and 3-5 days and normalizes in 5-7 days
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troponins
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Why are troponins the new gold standard for cardiac enzymes?
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because they are highly specific (99%) for cardiac muscle
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What is the specificity for troponins?
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99%
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What are the ECG changes in AMI?
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1. T-wave inversion
2. ST-segment elevation 3. Q-wave appearance |
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Identify the ECG change:
nonspecific |
T wave inversion
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Identify the ECG change: often associated with transmural AMI
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T wave inversion
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Identify the ECG change: Indicates acute infarction with continued occlusion
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ST segment elevation
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Identify the ECG change: Diagnostic of AMI if at least mm elevation from baseline
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ST segment elevation
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Identify the ECG change: Indicates persistent occlusion and irreversible necrosis
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Q wave appearance
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Identify the ECG change: Diagnostic of AMI if wave is at least 1mm wide or 1/3 size of QRS complex
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Q wave appearance
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Definition: Uses ultrasound to evaluate the structural anatomy of the heart
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Echocardiography
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T wave inversion
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nonspecific
often associated with transmural AMI |
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ST segment elevation
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-Indicates acute infarction with coninuted occlusion
-Diagnostic of AMI if at least 1mm elevation from baseline |
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Q wave appearance
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-Indicates persistent occlusion and irreversible necrosis
-Diagnostic of AMI if wave is at least 1nm wide or 1/3 size of QRS complex |
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DOPPLER
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-Records velocity and direction for blood flow
-Useful for peripheral ischemia |
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TEE
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Transesophageal Echocardiography
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Transesophageal Echocardiography
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-Visualizes cardiac valves
-Useful for diagnosing endocarditis |
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Visualizes cardiac valves
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Transesophageal Echocardiography
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Useful for diagnosing endocarditis
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Transesophageal Echocardiography
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Records velocity and direction for blood flow
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Doppler
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Useful for peripheral ischemia
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Doppler
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Definition: Used to identify, localize and estimate the size of infarct
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Imaging Studies
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What are imaging studies used for?
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To identify, localize and estimate the size of infarct
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MUGA
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Multiple-Gated Blood Pool Imaging
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What is the most common method to assess ventricular ejection fraction?
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Multiple-Gated Blood Pool Imaging (MUGA)
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What is the major predictor of mortality?
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LVEF
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Uses of Cardiac Catherization/Angiography?
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-Determine the extent of CAD and define anatomy of coronary arteries
-Used in conjunction with baloon angioplasty/percutaneous transluminal coronary angioplasty and stent -Often used with imaging to visualize abnormality |