9) Diagnostic Testing Flashcards
Holter Monitor
Used for continuous 24hr ECG monitoring to provide info for dx & management of arrhythmias
Indications for holter monitor use
- Dizziness
- Dysrhythmias
- SOB
- Syncope
- Eval pacemaker fxn
What should pt be doing while wearing a holter monitor?
Document any abn’s
What is electrophysiology (EPS) used for?
Used to investigate the cause & location of abn rhythms to determine the best tx
What is the indication for EPS?
Abn heart rhythms
Echocardiography
Non-invasive US of the heart to get a real-time image to assess performance of the heart, valves, quantify volumes, etc
Indications for EKG
- Pericardial effusion
- Cardiac tamponade
- Diopathic cardiomyopathy
- Mitral valve regurgitation/prolapse
- Aortic regurgitation
- Aortic stenosis
- Vegetation of valves
- Masses
- Ischemia
- Aneurysm
- Thrombus
- Aortic dissection
Describe a transesophageal echo
Scope is put down the throat to get a better pic of the heart
What does a transesophageal echo allow for?
Improved visualization of cardiac structures & fxn
What is a transesophageal echo good for?
Peri- & intraoperative monitroing of the left ventricle
What is transesophageal echo the test of choice for?
Cardioembolic stroke
What is the test of choice for cardioembolic stroke?
Transesophageal echo
Stess echo
Used to eval atypical sx’s such as dyspnea & fatigue or pt’s w/normal ECGS but atypical chest pain syndromes
What does the stress echo eval?
Ischemia-induced heart wall motion abn’s
Describe contrast echo
IV contrast is injected to get improved accuracy to assess myocardial perfusion & ventricular chambers
What are the indications for a contrast echo?
- Assess areas of at-risky myocardium for damage
- Absence/Presence of coronary collateral flow
- Revascularization of occluded arteries after angioplasty
What are imaging modalities used for?
To eval for CAD & cardiac dysfxn
Single-Photon Emission CT
Non-invasive imaging method to detect & quantify myocardial perfsion & contractility defects
SPECT
Single-Photon Emission Computed Tomography
What is SPECT used in conjunction w/?
Radioactive Isotopes
PET
Provides visualization & direct measurement of metabolic fxning (glucose & fatty acid metabolism) of the heart
What is the gold standard for blood flow measurement & metabolic assessment of the heart?
PET
What is PET the gold standard for?
Blood flow measurement & metabolic assessment of the heart
What does the heart use for energy while at rest?
Fatty Acids
CT
Noninvasive method used to ID CV masses, aortic aneurysms, or pericardial thickening
CT Angiography
Highlights coronary arteries to eval for CHD
Spiral CT
3D image used to eval presence of PE
What is the advantage to spiral CT over regular CT?
It detects arterial abn’s w/greater precision & is faster
Does a spiral CT always require contrast?
No
If a pt has a spiral CT, can you tx them that day?
NO!
EBCT
Electron Beam CT
Electron Beam CT
Noninvasive method of detecting & quantifying coronary atherosclerosis by measuring coronary calcification
Multi-Gated Acquisition (MGA) Imaging
Noninvasive technique to calculate left ventricular ejection fraction
MUGA
Multi-Gated Acquisition Imaging
MRI
Evals morphology, cardiac blood flow, & myocardial contractility for valve disease & shunts
Radioactive Nuclide Perfusion Imaging (RNPI)
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RNPI
Radioactive Nuclide Perfusion Imaging
Pharmacologic Stress Test
Stress test while pt is resting
Cardiac Catheterization
Invasive procedure that establishes/confirms a dx of cardiac dysfxn, heart disease, depicts severity of heart disease, or depicts severity of CAD or valve dysfxn
What does cardiac catheterization specifically determine?
- Presence & severity of CAD
- Left ventricular fxn
- Valvular disease
- Pericardial disease
- Guidelines for optimal management of pt
What is cardiac catherization called when it is used as a tx?
Percutaneous Coronary Intervention (PCI)
When can cardiac catheterization/PCI be used as an alternative to CABG?
If only a single vessel is involved
Ergonovine Stimulation
Diagnostic test for coronary spasm
What is bronchoscopy used for?
- Evals & manages some congenital pulmonary anomalies & acquired diseases
- Study normal & variant anatomy
- Study pathological changes of the bronchial wall & lumen
PT implications for pt’s post-cardiac cath/PCI
- Place pressure on area 4-8hrs after procedure
- Pt’s will typically be on bedrest w/LE immobilizer
- Some pt’s may have groin pain
- If the procedure was done through the femoral artery, no PT
What do you need to have to do PT on a pt who has cardiac cath/PCI through the femoral artery?
MD note for clearance
What are the main things to look for when interpreting a cardiac cath?
- EF
- Blocked arteries
- Blockage percentage
- Valve dysfxn
When is bronchoscopy indicated?
- Assess infections that can’t be evaled from a sample
- Clear viscous secretions
- Retrieve foreign object
