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Related Flashcards
Cards In This Set
| Front | Back |
 CARDIAC DIAGNOSTICS Chest X-Ray |
Cardiac Silhouette
AP Cardiac Ratio > 50% Chamber Dilatation Aortic Enlargement / Calcifications Pulmonary manifestations of heart disease Congestive Heart Failure |
 CARDIAC DIAGNOSTICS Pulmonary Edema |
Pulmonary Edema
Cephalization (10-15mmHg) Kerly B Lines (15-20mmHg Pulmonary Interstitial Edema (20-25mmHg Alveolar Edema > 25mmHg Pleural Effusion |
 CARDIAC DIAGNOSTICS Echocardiography |
Transthoracic vs Trans-esophageal
Ventricular Assessment: Wall Motion Ejection Fraction Valvujlar Disorders (Test of choice) Chamber Size (LVH) Cardiomopathies Pericardial Disease Estimates: Pulmonary Artery Wedge Pressure Cardiac Output Ejection Fraction |
 CARDIAC DIAGNOSTICS Cardiac Catheterization (The "Gold Standard") |
Right versus Left
Fluoroscopy Pressure Measurements Blood Flow Resistance Angiography (Cardiac Catheterization) |
 CARDIAC DIAGNOSTICS Stress Testing |
Initial work up for patients:
With chest pain Intermediate pre-test probability for CAD Intermittent chest pain in past with activity No current chest pain |
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CARDIAC DIAGNOSTICS
Stress Testing |
Exercise vs Chemical
EKG vs Imaging Exercise Treadmil Progressive (Bruce) Signs or symptoms (Chest pain, SOB, Syncope) + if angina reproduced or if ST depressions Sensitivity: 65-70% Treadmil Score: Low, moderate or high risk. |
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CARDIAC DIAGNOSTICS
Stress Testing |
Cannot perfomr exercise stress test if:
LBBB LVH with strain pattern WPW Digitalis If unable to exercise Aortic Stenosis |
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CARDIAC DIAGNOSTICS
Stress Testing |
Stop test for:
Hypotension Exercise limiting angina ST elevations Near syncope Ventricular Dysrhythmias |
 CARDIAC DIAGNOSTICS Stress Testing |
Nuclear Immaging Studies
High risk patinets (Women) Techneium - 99 or Thalium 201 (Injected before and during exercise. Collects in "viable" cells at variable uptakes Hot / Cold Rest images and stress images are taken and compared |
 CARDIAC DIAGNOSTICS Nuclear Imaging Studies |
Normal: Perfused at rest and exercise
Ischemia: Perfused at rest / hypo-perfused during exercise Infarct: Hypo-perfused at rest and exercise |
 CARDIAC DIAGNOSTICS Echocardiogram |
Baseline ST/T wave abnormalities
Equivocal baseline stress test Can assess left ventricular wall motion and contractility At rest Immediately after exercise |
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CARDIAC DIAGNOSTICS
Pharmacologic Stress Test |
If unable to exercise
LBBB Aortic Stenosis Given and Inotropic Agent (Dobutamine) Substitute for exercise May induce ischemia and / or arrythmias Given Vasodilators (Dipyridamole, adenosien, regadenoson) Can only dilate "healthy" vessels Thus it can cause a "steal" effect |
 CARDIAC DIAGNOSTICS Other Imaging Radionuclide Ventriculography (MUGA) |
Accurate non-invasive ejection fraction
Cardiotoxic chemo 1st pass (shunts) |
 CARDIAC DIAGNOSTICS Other Imaging Cardiac CT |
Great vessels
Pericardial disease Ventricular aneurysm Non invasive angiography Calcium scoring |
 CARDIAC DIAGNOSTICS Other Imaging cMRI |
Congenital abnormalities
Aortic root Non invasive angiography |
