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35 Cards in this Set
- Front
- Back
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what are you looking at in an ultrasound (echo)?
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reverberant echos.
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what are the two ways to use echocardiography (US) for cardiac endeavors? which one is most common?
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transthoracic--> safe, good images (gen), readily available--> MC
Transesophageal --> relatively safe, excellent picture, more detail |
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what two things obstruct the vision via US for the heart?
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air and fat
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what do we look at in an echocardiography?
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structural things:
wall motion/ thickness chamber size valvular structure and motion masses or thrombi in chambers aortic root dissection septal defects pericardial effusion |
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what is the test of choice to determine a pericardial effusion?
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echocardiogram
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what is the test of choice to determine to size of the ventricles?
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echocardiography
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what does a wall motion abnormality indicate?
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ischemia or infarction
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what is a vegetations?
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nodule of bacteria, fibrin and platelets that sticks on a valve.
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what does an anatomic wall defect tell you?
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ASD, VSD, etc
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what does echo show us? (2)
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structural changes and wall motion
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when would you use a doppler test?
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murmur assessment
detecting regurgitant lesions detect and quantify shunts quantify stenoses quantify regurgitant volumes |
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what does a doppler show us?
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motion of blood through the heart.
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what are the disadvantages of a stress echocardiography?
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subjectiveness of wall motion abnormality (whoever is reading the echo)
image quality |
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what is the advantage of a stress echocardiography?
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makes ECG more accurate
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what are the 3 methods of stress testing?
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treadmill, bicycle, arm ergometry
(in order of effectiveness) |
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what are the reasons to do a stress test? which one is the #1 reason?
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evaluate chest pain (#1 reason) and dyspnea
evaluate arrhythmias MI risk stratification rehabilitation evaluation post angioplasty evaluation |
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what are the absolute contraindications for stress testing?
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acute MI
acute myo- or pericarditis progressive unstable angina uncontrolled CHF severe aortic stenosis uncontrolled arrhythmia |
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what are the relative contraindications for stress testing?
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IHSS w/ significant obstruction
severe HTN physical limitations acute noncardiac illness |
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when do you stop the stress test?
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angina
fatigue heart block advanced arrhythmia dropping BP severe HTN reaching target |
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what is the target rate of stress testing?
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85% of your maximal heart rate.
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ST segment depression of _____ is 60% specific, ______ mm is 90% specific
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.5mm
1.5mm |
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what percentage of women have a False Positive?
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50% FP
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what things can cause abnormalities of the ST segment on a stress test that are False positives?
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women
electrolyte imbalance autonic dystonia respiratory variation LV aneurysm early repolarization drugs (digoxin) |
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what three ECG abnormalities will cause a poor stress test result? (can't read the stress test)
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BBB
hypertrophy WPW |
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what things cause abnormalitis of the ST segment on a stress test that are false negatives?
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women
poor exercise tolerance nitrate therapy b-blocker therapy antiarrhythmic meds |
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what are you looking at in nuclear medicine cardiac imaging? what do you add this to? what two agents are used for the nuclear imaging?
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uptake in the myocardium; echo.
Use: technetium and thallium |
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what are the advantages of nuclear medicine cardiac imaging?
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increase sensitivity/specificity of stress testing
asses quantity of ischemia useful where pt unable to exercise To asses LV and RV function |
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what are we looking for in a nuclear medicine cardiac imaging?
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cold spot imaging--> seen in areas of ischemia or scar
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what is a holter? what can it detect? when is it useful?
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it records all beats over 24 hour period. able to detect arrhythmias causing symptoms. able to detect ischemia. Useful only if problem occurs very frequently.
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what is an event recorder? what does it do? how long can you use it for? what is it useful for?
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long term ambulatory monitor
-records only when activated by pt can be used for 30 days. used for intermittent sxs |
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what is a continuous loop? how long can you use it? where is it?
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device may be worn externally (implanted under skin) for 30 days
records only when activated |
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pt presents w/ previous episodes of syncope, which long term ambulatory monitoring device will you give them?
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continuous loop
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what is a way to evaluate for CAD w/o stress test or a coronary catheritization?
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CT angiography
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what is the fxn of CT angiography? what's the problem with this?
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reconstructs a 3-D image of the coronary arteries. It is not effective in determining lesion flow limitations.
MUST USE DYE |
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what is the fxn of cardiac MRI? what's the issue with this?
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reconstruction of all cardiac structures in 3-D. Less effective in visualizing coronary vessel lesions now.
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