Cardiac Imaging Flashcards
why do CXR not show acute changes in structure?
dilation of chambers takes time to develop
indication for CXR
ordered for all chest pain/dyspnea complaints
processes that CXR is sensitive to
pulmonary process secondary to cardiac disease- pulmonary markings, edema, pleural effusion
risks of CXR
some radiation
risks of ECHO
none, also low expense
indication for ECHO
for all pts w/ new heart failure or dyspnea w/ unclear etiology
what is ECHO ideal for
evaluate structure and fn of heart
ECHO is gold standard for…
evaluation of valvular structure and fn
utility of nuclear imaging
increases sensitivity/specificity of stress tests for detecting ischemia
how to use nuclear imaging
detect isotopes that would indicate areas of hypoperfusion
purpose and other name for right heart catheterization (RHC)
Swan Ganz, measure pressures on right side of heart and out into pulmonary artery
purpose of left heart cath
perform angiogram in coronary arteries and measure left heart pressure
RHC measures pressure of…
right atrium, right ventricle, p artery, p artery wedge pressure (capillary)
LCH measures pressure of
aorta, LV
what is pulmonary artery wedge pressure used for?
it matches LA pressure, helps estimate LV diastolic pressure (lower risk than arterial access), when elevated- left sided heart failure
downsides of cardiac cath
invasive, exposure to radiation and dye, expensive
cardiac cath is gold standard for:
assessing CO and intracardiac pressure (RHC Swan Ganz)
and via coronary angiography- defining coronary anatomy and coronary stenosis
downsides of CT and MRI
exposure to radiation and dye, expensive (esp MRI)
CT indications
any pt suspected w/ thoracic aortic disease- CT w/ vascular protocol
MRI indications
when structure and fn unclear from ECHO
CT coronary angiography used for
define coronary anatomy, identify severe coronary artery disease
MRI gold standard for:
assessing cardiac structure and fn- esp in more complex CHD
