Cardiac Imaging

Question 1

why do CXR not show acute changes in structure?

Answer 1

dilation of chambers takes time to develop

Question 2

indication for CXR

Answer 2

ordered for all chest pain/dyspnea complaints

Question 3

processes that CXR is sensitive to

Answer 3

pulmonary process secondary to cardiac disease- pulmonary markings, edema, pleural effusion

Question 4

risks of CXR

Answer 4

some radiation

Question 5

risks of ECHO

Answer 5

none, also low expense

Question 6

indication for ECHO

Answer 6

for all pts w/ new heart failure or dyspnea w/ unclear etiology

Question 7

what is ECHO ideal for

Answer 7

evaluate structure and fn of heart

Question 8

ECHO is gold standard for…

Answer 8

evaluation of valvular structure and fn

Question 9

utility of nuclear imaging

Answer 9

increases sensitivity/specificity of stress tests for detecting ischemia

Question 10

how to use nuclear imaging

Answer 10

detect isotopes that would indicate areas of hypoperfusion

Question 11

purpose and other name for right heart catheterization (RHC)

Answer 11

Swan Ganz, measure pressures on right side of heart and out into pulmonary artery

Question 12

purpose of left heart cath

Answer 12

perform angiogram in coronary arteries and measure left heart pressure

Question 13

RHC measures pressure of…

Answer 13

right atrium, right ventricle, p artery, p artery wedge pressure (capillary)

Question 14

LCH measures pressure of

Answer 14

aorta, LV

Question 15

what is pulmonary artery wedge pressure used for?

Answer 15

it matches LA pressure, helps estimate LV diastolic pressure (lower risk than arterial access), when elevated- left sided heart failure

Question 16

downsides of cardiac cath

Answer 16

invasive, exposure to radiation and dye, expensive

Question 17

cardiac cath is gold standard for:

Answer 17

assessing CO and intracardiac pressure (RHC Swan Ganz)

and via coronary angiography- defining coronary anatomy and coronary stenosis

Question 18

downsides of CT and MRI

Answer 18

exposure to radiation and dye, expensive (esp MRI)

Question 19

CT indications

Answer 19

any pt suspected w/ thoracic aortic disease- CT w/ vascular protocol

Question 20

MRI indications

Answer 20

when structure and fn unclear from ECHO

Question 21

CT coronary angiography used for

Answer 21

define coronary anatomy, identify severe coronary artery disease

Question 22

MRI gold standard for:

Answer 22

assessing cardiac structure and fn- esp in more complex CHD