Cardiac Diagnostic Tests Flashcards
what is the normal level of hematocrit for females and males?
- females: 37-47%
- males: 40-54%
what is the normal level of hemoglobin for males and females?
- females: 12-16 g/dL
- males: 13-18 g/dL
what is the normal white blood cell count?
4,500 - 11,000 micro liters
at what value is a patient considered hyperkalemic?
K+ > 5.0 mmol/L
what is hyperkalemia?
decreased ability for myocardial contractibility which caused bradycardia issues (low HR)
at what value is a patient considered hypokalemic?
K+ <3.5 mmol/L
what is hypokalemia?
life threatening arrhythmia with tachycardia issues (high HR)
what is the normal values for Na++?
136-143 mmol/L
what is the normal values for Ca+?
4.5-5.3 gm/dL
what level is considered high CO2? what can this result in?
- High CO2 (>30 mmHg)
- result in alkalytic state of muscle weakness
an EKG may be used as a diagnostic tool for what?
- specific arrhythmia that could cause symptoms
- measure disease progression
- measure medication effectiveness
what is a clinical EKG used for?
monitoring and modifying treatment as needed
how many leads are used in cardiac clinic or MD’s office? how many is the hospital, cardiac rehab, etc?
- 12 lead
- 2-3 lead
how is a Holter Monitor used?
- used 24 hrs or up to 2 wks of EKG
- a journal is used to report activity and signs & symptoms
a Holter Monitor is used after what?
- syncope
- repeated arrhythmias
how is a Graded Exercise Stress Test performed?
- testing usually with either a treadmill or a bike to assess patient’s exercise tolerance & ischemia
- patient is attached to telemetry & exercises at various intensities
what is the most common Graded Exercise Stress Test protocol?
Bruce protocol
what is the difference between the Bruce protocol and the Naughton-Balke?
Naughton- Balke is more gradual
when is a stress test used?
- chest pain on exertion
- severe dyspnea
- suspicion of CAD or ischemia
- Risk stratification
what can results of the stress test be used to determine?
need for further testing of location of ischemia or for exercise prescription
what are the reasons that a stress test may be stopped?
- EKG changes ( > 2mm ST segment depression, inverted T wave, significant Q wave)
- Anginal symptoms
- Extreme dyspnea (3-4 on dyspnea scale) LE fatigue
what is an echocardiography?
- ultrasound of the heart
- noninvasive measure of wall motion
what does an echocardiography provide information regarding?
- valve function, size of ventricle, thickness & integrity of interatrial and inter ventricular septum
- shows wall hypertrophy
- gives value of EF
what is the limitations of an echo?
can not see posterior wall structure and motion due to interference from spinal bone
an echo is used after what?
- MI
- CHF
- Unstable angina
- Syncope episode
- cardiomyopathy
what is a Thallium Stress Test?
type of exercise stress test, which uses a radioactive nuclear marker for detection of myocardial perfusion
what does a Thallium Stress Test look at?
ischemia by assessing Thallium in blood flow through the myocardial tissue
what is a Coronary Angiography also called?
- cardiac catheterization
- angiogram
what is a Coronary Angiography? what is it a definite diagnosis for?
- invasive procedure with a 2% risk of stroke
- Definitive diagnosis for CAD, valvular dysfunction & many congenital diseases
how is a cardiac catheterization performed?
- catheter is threaded up the artery (usually radial but can be femoral)
- catheter extends to coronary arteries and injects dye into arteries
- scan then taken to show flow through the coronary arteries
a cardiac catheterization is used after what?
- unstable angina (USA)
- acute MI
- (+) stress test
- (+) echo
CAD blockages up to what percent is considered mild & may be asymptomatic?
CAD blockages of up to 70%
how will CAD blockages greater than 90% be treated?
conservative management tried unless risk of MI is imminent, then surgical intervention
what are the precautions following a cardiac catheterization when using femoral artery entry?
- Bedrest: 6-12 hours with a sandbag or clamp in place to prevent bleeding
- As you initiate OOB: watch for signs of hematoma (bleeding at the site, drop in BP, dizziness, weakness, etc)
what are the precautions following a cardiac catheterization when using a radial artery entry?
if patient uses walker or crutches ask the doctor if any restrictions
How is a Trans Esophageal Echocardiogram (TEE) performed? what does this test give a view of?
- Ultrasound head is fiber optic and is threaded down the patient’s esophagus
- Gives an improved visualization of heart structures & function
when is a TEE used?
patient is obese or they wanna see the posterior view of the heart
what is Position Emission Tomography (PET)?
- nuclear technique; provides visualization
- measure dynamic functioning of myocardium without inducing exercise state
- gives 3-D view of blood flow
what is a PET scan the direct measurement of?
- metabolic functions including glucose metabolism
- fatty acid metabolism
- blood flow to the heart
what are the draw backs of a PET scan?
- very expensive
- not always available
what is Multigated Acquisition Imaging or Gated Pool Imaging (MUGA)?
- noninvasive technique to calculate left ventricular ejection fraction
- used multiple EKG views to look at EF
what is the advantage of MUGA?
less expensive than PET scan
a CT scan is used most for what type of patients?
patients with probable coronary stenosis
what information can a CT scan give you?
cardiac structures and ventricular function
why is a CT scan not used as much?
its more expensive
