CARDIAC IMAGING Flashcards

1
Q

CONTRAINDICATION TO EXERCISE STRESS TEST.

A
  • Acute MI within 2 days
  • Ongoing unstable angina
  • Uncontrolled hmd significant arrhythmia
  • Active endocarditis
  • Symptomatic severe AS
  • Decompensated HF
  • Acute PE
  • Pulmonary infarction
  • DVT
  • Acute myocarditis/pericarditis
  • Acute Aortic dissection
  • Physical limitations
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2
Q

POSITIVE STRESS TEST

A

> 1mm STE
1 mm STD ( horizontal or downslowping)

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3
Q

high risk features on stress test

A

– Duke Treadmill Score -11 or less
– <5 METs achieved
– Low threshold angina / ischemia
– STE
– Severe STD ≥ 2mm
– Ischemia on ≥ 5 leads
– Ischemia ≥ 3 mins into recovery
– Abnormal BP response
[failure to achieve SBP>120, drop in BP >10, drop below baseline]
– Ventricular arrhythmia

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4
Q

most common pharmacological stress test

A

 Dipyridamole (aka persantine) most commonly used for nuclear stress

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5
Q

most common substance used for stress echo

A

dobutamine

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6
Q

drug interaction with dipyridamole

A
  • caffeine
  • theophyline
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7
Q

false negative non-pharmacological stess test

A
  1. severe flow limiting ( triple vessel/left main disease)
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8
Q

contraindications to pharmacological stresss test

A
  1. severe asthma/copd ( as dypiridamole can cause born chospasm)
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9
Q

reversal agent for dipyridamole

A

aminophylline

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10
Q

indication for Coro CT angio

A
  • CAD dx w/ low intermediate probability patients
  • risk stratification with stable CAD
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11
Q

whend o you do a coronary calcium score

A
  1. furhter risk stratificaton of intermediate risk patients ( FR 10-19%)
  2. asx patients >40y not candidate for statin
  3. fhx premature CV disease
  4. genetic dyslipidemia
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12
Q

CI to coronary angio CT

A
  1. ACS
  2. Strucutral heart disease ( AS/HCM)
  3. contrast allergy
  4. pregnancy
  5. renal failure
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13
Q

CAC score above 100, what do you start

A

statin

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14
Q
A
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