Cardiac Diagnostic Studies Lecture Powerpoint Flashcards
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Most important tool in evaluating cardiac patient
History and physical
10 year old experiencing palpitations suddenly, what are the 5 big tests would you order for diagnosis?
- EKG #1
- Echocardiogram
- Holter monitor
- Event recording
- Symptom diary and pulse checks
Holter Monitor definition and one big disadvantage
5 lead EKG recording that records every heartbeat up to 48 hours, provides avg heart rate as well as minimum and max heart rate, patients should self record symptomatic moments to correlate to the arrhythmia
-Disadvantage: short time frame relatively speaking so many patients will not have symptoms
Holter Monitor indications
-Evaluate symptoms such as palpitations, chest pain, syncope caused by dysrythmia, or evaluate medical therapy being used to suppress dysrhythmia
Event recorders definition and one big disadvantage
- Devices that continously monitor ECGs for 30-60 days, device has a memory that will store a triggered event (regardlss of if patient is aware or if patient triggers device manually) as well as the previous 10 minutes
- Disadvantage is that patient must wear for a month and change patches
Event recorders indications
Suspected dysrhythmia not occurring on a daily basis
Implantable cardiac monitor
Implanted on upper chest wall subcutaneously, hand held device activator placed over device to mark and save rhythms before, during, and after event, new models can automatically send transmission to physician
Tilt table test
Older test that is used for evaluation of vasovagal syncope opposed to a cardiac syncope, thru strapping patient to table that moves from horizontal to vertical position while monitoring heart rate and blood pressure and assessing for syncope
65 year old presenting to cardiologist complaining of intermittent dyspnea related to activity, what are 4 tests you would order?
- EKG
- Echocardiogram
- Stress Test
- Chest X ray
Echocardiography and 3 subtypes
- 2D mapping allows for evaluation of anatomy, hemodynamics, function of cardiac structures, assessment for clot presence, tumor, or pericardial effusion
- Transthoracic echo, transesophageal echo, or doppler
White on an echocardiogram represents ____ and black represents ___
muscle, lumen
Doppler imaging
A continuous wave doppler that can measure the velocity of the fluid in the heart helpful in diagnosing stenosis or other conditions (color flow mapping)
Benefits and limitations of echocardiography
Benefits - non invasive, inexpesnive, mobile
Limitations - poor windows, technologist dependent, subjective interpretations by physicians
Poor windows
Refers to when there is extra tissue (adipose, muscle, etc) that makes it difficult to obtain clear echocardiogram images
65 male with mildly elevated cholesterol presents with chest tightness when walking, what 4 tests do you order?
- EKG
- echocardiogram
- exercise stress test
- Holter monitor