Cardiac Imaging Flashcards
when should a Chest CT (vascular protocol with IV contrast) be ordered
- for diseases of the THORACIC aorta (e.g. aortic dissection)
uptake of tracer at rest
- uniform uptake
for a boundary to show between structures on CXR
- they must differ in density
CXR of myocardium, valves, and other intracardiac structures
- have densities similar to blood
- CXR won’t image internal cardiac structure
left border of CXR on frontal projection formed by
- left ventricle
- left atrial appendage
how do you calculate cardiothoracic ratio
- compare width of heart to width of thoracic cavity
>50% is enlargerd heart
normal ejection fraction
- 55-60%
posterior border of CXR on lateral projection
- left atrium (superiorly)
- left ventricle (inferiorly)
color flow doppler imaging useful for
- assessing valvular abnormalities (e.g. regurgitation and stenosis)
cardiac silhouette
- radiographs can depict dilatation of individual cardiac chambers
- dilation takes time, not seen in acute processes
anterior border of CXR on lateral projection
- right ventricle
An echo should be ordered for patients who present with
- new heart failure
- dyspnea of unclear etiology
an echo is the initial diagnostic study to evalulate
- structure and function of heart
M mode cardiography based on
- one-dimension analysis of the heart in motion
CT coronary angiography can define
- coronary anatomy
- identify severe coronary artery disease
CXR has high specificity for detection of
- chamber enlargement
MRI should be ordered for
- characterization of structures and function that is unclear by echocardiography
left sided pressures
- aorta
- left ventricle
what is used to measure pressures on the right side of the heart out into the pulmonary lungs?
- right heart cardiac Catherization (swan-Ganz)
color flow doppler imaging identifies
- regions of turbulent flow
uptake of tracer at stress
- poor uptake after stress
the extend of penetration of X rays through the body is inversely proportional to
- tissue density
which is the gold standard for exclusion of intracardiac thrombus (esp. left atrial appendage)
- TEE
CXR has low sensitivity for detection of
- structural heart disease
cardiac catheterization involves exposure to
- radiation
- constrast dye
CXR should be ordered for patients presenting with
- chest pain
- dyspnea
MRI is gold standard for
- assessing cardiac structure and function
- offer some characterization of myocardial tissue
dense materials like bone on CXR
- absorb more X rays
- appear white (or radio-opaque)
CXR is sensitive for detection of
- pulmonary processes that result from cardiac disease
right heart catheterization performed via to measure
- Swan Ganz - venous route - to measure pressures on right side of the heart and into pulmonary artery (lungs)
elevated PCWP indicates
- left sided heart failure
what is the gold standard test for evaluation of valvular structure and function?
- echocardiography
color flow doppler imaging depicts
- blood flow direction and velocity
pressures between RA and PCW (pulmonary capillary wedge)
- are similar
M mode cardiograph can measure
- thickness of ventricular walls
- volumes of cardiac chambers
which access is lower risk
- venous access lower risk than arterial access
pulmonary artery (capillary) wedge pressure used to estimate
- left ventricular diastolic pressure
left heart catheterization performed via - to perform - but can also
- performed via arterial route
- to perform angiogram (shoot dye) into the coronary arteries
- but can also look at pressure on left side of heart
right sided pressures
- right atrium - right ventricle - pulmonary artery
what must the cardiothoracic ratio be for it to be considered an enlarged heart
- greater than 50%
what its the gold standard test for defining coronary anatomy and detecting clinically significant coronary stenosis
- coronary angiography
what does nuclear imaging increase the sensitivity and specificity of
- stress tests for detection of ischemia
right border of CXR on frontal projection formed by
- right atrium
During the Apical 4 chamber view, where do you place the probe?
- probe at PMI over apex of heart
air filled tissues on CXR
- absorb few X rays
- appear black
TEE how it works
- patient is mildly sedated for outpatient procedure
- echo probe is passed down esophagus and into stomach
