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CR2 > Cardiac imaging > Flashcards

Cardiac imaging Flashcards

1
Q

What are the main tests cardiologists request? [4]

A

Main tests:
- Chest X-ray
- Echocardiography (Thoracic/Oesophageal)
- Further Imaging (MRI, Nuclear medicine, Ultrasound, CT) (non-invasive)
- Coronary angiography (invasive)

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2
Q

What is the pathology indicated by this CXR? [1]

A

Pulmonary oedema

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3
Q

What pathology is indicated by this CXR? [1]

A

Mediastinum is wider: thoracic aortic aneurysm

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4
Q

Echocardiography uses what type of imaging to produce images? [1]

A

Ultrasound waves

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5
Q

Which of the following uses ultrasound waves?

Echocardiography
Cardiac MRI
Nuclear MPS
Chest x-ray
CT-coronary angiography

A

Which of the following uses ultrasound waves?

Echocardiography
Cardiac MRI
Nuclear MPS
Chest x-ray
CT-coronary angiography

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6
Q

Which of the following allows for calculating velocities and hence pressure gradients of blood flow

Echocardiography
Cardiac MRI
Nuclear MPS
Chest x-ray
CT-coronary angiography

A

Which of the following allows for calculating velocities and hence pressure gradients of blood flow

Echocardiography: Doppler
Cardiac MRI
Nuclear MPS
Chest x-ray
CT-coronary angiography

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7
Q

What pathologies are Echos good for investigating? [4]

A

Valves: if narrower, then the flow / velocity will increase; endocarditis

Myocardial diseases: MI ; LV thrombus

Great vessels: dilation

Thrombus/infection/tumor

Arrhythmias

Cryptogenic (unknown cause) stroke: Looking for thrombus at apex

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8
Q

What axis is this echo taken from?

long-axis
short-axis
four chamber-plane

A

What axis is this echo taken from?

long-axis
short-axis
four chamber-plane

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9
Q

Label A-C

A

A: long-axis
B: four chamber-plane
C: short-axis

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10
Q

What axis is this echo taken from?

long-axis
short-axis
four chamber-plane

A

What axis is this echo taken from?

long-axis
short-axis
four chamber-plane

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11
Q

What colours do the doppler echo show?

A

Red: towards
Blue: away
Green: areas of turbulence

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12
Q

Which valves are more commonly pathological? [2]

A

Aortic and pulmonary

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13
Q

** ECHO and cardiomyopathy **

A
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14
Q

Which pathologies can preclude useful ECHO assesment? [2]

A

High BMI & COPD can preclude useful assessment

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15
Q

Why are transesophageal cardiograms (TEE) more useful than transthoracic echocardiograms (TTE)?

A

TEE is better because don’t have chest wall to look through: can therefore use higher frequency wavelength: see structures more clearly

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16
Q

What is TEE useful for IDing if TTE is normal or unclear? [4]

A

Post-operative (if particularly invasive: TTE can be disrupted by wound repairs)

Accurate valve assessment (mitral)

Endocarditis

Pre-ablation assessment of left atrial appendage(bc often have a thrombus in LA, if interefere will cause a stroke)

17
Q

What would you be highly suspicious of identifying with a TEE if you had a TTE but no findings? [1]

A

Endocarditis [1] (life-threatening inflammation of the inner lining of the heart’s chambers and valves)

18
Q

Name 3 AEs of TEE

A
  • Oesophageal stricture (tightening) diverticula (outpouching) / tumour
  • Varices
19
Q

What are CT-Coronary angiographys useful for diagnosing?

A

New onset chest pain
If no previous documented CAD
Useful in CABG patients to assess grafts

20
Q

What specifically can CTCAs ID? [2]

A

Zero coronary artery calcification (CAC) score in patients with stable angina has a high negative predictive value for the exclusion of obstructive CAD and is associated with a good medium-term prognosis

Narrowing / stenosis of arteries

21
Q

How do you perform a CTCA? [3]

A

Give BB prior to: clearer image
ECG gating: pick an area after T wave, when heart is at stillest (during diastole) to take image
Breath hold (any movement will cause blurring)

22
Q

Which modality if the gold standard for assessing LV function?

Contrast enhanced echo
Nuclear myocardial perfusion scintigraphy
CT coronary angiography
Cardiac MRI
SPECT imaging

A

Which modality if the gold standard for assessing LV function?

Contrast enhanced echo
Nuclear myocardial perfusion scintigraphy
CT coronary angiography
Cardiac MRI
SPECT imaging

23
Q

What is MRI good for assesing?

A
  • Crystal clear images
  • Useful for distinguishing cardiomyopathy types
  • ## Gold standard for assessing LV function
24
Q

Which modality is useful for assessing cardiomyopathy types?

Contrast enhanced echo
Nuclear myocardial perfusion scintigraphy
CT coronary angiography
Cardiac MRI
SPECT imaging

A

Which modality is useful for assessing cardiomyopathy types?

Contrast enhanced echo
Nuclear myocardial perfusion scintigraphy
CT coronary angiography
Cardiac MRI
SPECT imaging

25
Q

What do you need to check prior to MRI? [2]

A

Patient’s renal function: risk for Retroperitoneal fibrosis. Need to have eGFR < 30

Pacemakers

26
Q

What are MRIs useful for IDing? [4]

A

Discriminating between MI and myocarditis. MI with non-obstructive coronary arteries: MINOCA. (e.g. if present with STEMI / NSTEMI but no diagnosis from CTCA or ECHO imaging. So use MRI)

Cardiomyopathies (Fe / Lipid storage disorders)

Storage disorders

Thrombus/mass discrimination

27
Q

Explain how myocardial perfusion scanning (MPS) works

A

Give someone a tracer, look at differential flow and can infer if narrowing is causing a flow limiting problem in a non-invasive way

Uses nuclear tracers (to determine tissue activity)

28
Q

Which modality is very good for assessing MI?

Contrast enhanced echo
Nuclear myocardial perfusion scintigraphy
CT coronary angiography
Cardiac MRI
SPECT imaging

A

Which modality is very good for assessing MI?

Contrast enhanced echo
Nuclear myocardial perfusion scintigraphy (MPS)
CT coronary angiography
Cardiac MRI
SPECT imaging

29
Q

How do you conduct MPS imaging? [2]

A

Performed during pharmacological stress (give adenosine) and rest

Areas of reduced uptake (and lighting up) suggest ischemia

30
Q

Negatives for MPS? [3]

A

Radiation

Requires stressing agents (some Ptx with asthma can’t have)

Time consuming

CR2 (59 decks)

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