Cardiac Investigations

Question 1

List the cardiac investigations that can be done

Answer 1

CXR
ECG
Exercise test
Blood test: cardiac enzymes, troponins, BNP
Echocardiogtam 
Cardiac catheterisation i.e coronary angiogram 
Cardiac magnetic resonance 
Myocardial perfusion scan

Question 2

What view is the best to view the size of the heart in a cxr

Answer 2

Posterior- anteriror view

Question 3

What will a anterior posterior view make the heart look like

Answer 3

Magnified

Question 4

What is the normal size of the heart in a CXR

Answer 4

Borders of the heart should be less than 50% of the chest width i.e the cardiothoracic rato

Question 5

What are the waves on a ECG

Answer 5

P wave
QRS complex
T wave

Question 6

What does the p wave represent

Answer 6

Atrial depolarisation

Question 7

What does the QRS complex represent

Answer 7

Ventricle depolarisation

Question 8

What does the T wave represent

Answer 8

Ventricular repolarisation

Question 9

What is the exercise tolerance test

Answer 9

Stickers are attached to the patients chest and the person walks on a treadmill

Question 10

When is a exercise tolerance test positive

Answer 10

Is angina pain occurs
Bp falls or fails to increase
ST segment shifts of 1+mm

Question 11

When are cardiac troponins released in the heart

Answer 11

During myocyte damage and necrosis

Question 12

What condition does troponins help to diagnose

Answer 12

Myocardial infarction

Question 13

When are BNP produced in the heart

Answer 13

When the ventricles are stretched

Question 14

What is BNP used to diagnose

Answer 14

Heart failure

Question 15

What is an echocardiagram

Answer 15

Ultrasound of the heart

Question 16

What are the forms of echocardiagram

Answer 16

Transthoracic: prove is used to obtain cardiac imaging from the body surface
Trans oesophageal: utilised endoscope like oesophageal probe to obtain a cardiac image very close to the heart

Question 17

What are coronary angiograms

Answer 17

Inserting catheters into the left and right coronary arteries and use contrast to help visualise

Question 18

What information does a coronary angiogram provide

Answer 18

Coronary anomalies
Extent of coronary atheroma
Severity of coronary stenosis
Thrombus

Question 19

During a coronary angiogram how do we go into the coronary artery

Answer 19

By the radial artery- less risk of bleeding and unuder local anaesthetic

Question 20

What are the benefits of a coronary angiogram

Answer 20

You can combine a treatment and diagnosis

Question 21

What are the disadvantages of coronary angiogram

Answer 21

Risk of bleeding
Anaphalyaxis
Damaging the coronary arteris
Radiation from imaging due to the use of x-ray

Question 22

Does a cardiac mri use radiation

Answer 22

No

Question 23

When is a cardiac mri used

Answer 23

Quantify myocardial perfusion, ischaemia, viability
Detects infiltrative condtion affecting the heart
Diagnose inflammatory conditions

Question 24

What is a mycocarial perfusion scan

Answer 24

A scan that looks at mycocardial pefusion at rest and under stress e.g walking on a treadmill or by using medication such as adenosine

Question 25

What does a myocardial perfusion scan help to identify

Answer 25

Severity of coronary heart disease and need for angiography