Cardiac IV: Cardiac Special Tests Flashcards
What test is an inexpensive noninvasive tool that provides valuable cardiopulmonary information in healthy and diseased populations?
Exercise Stress Test
What test is most commonly used for diagnosing coronary artery disease (CAD)/identifying ischemia?
Exercise Stress Test
What test:
- Aids in developing appropriate exercise prescriptions (EP)
- Monitoring ECG activity while patient exercises?
Exercise Stress Test
What problem may the exercise stress test pose?
patient may be unable to tolerate or perform the exercise
During the exercise stress test procedure involves: (4)
- resting EKG with HR & BP monitoring
- exercise intensity is slowly increased
- technician will ask about patient symptoms and watch for EKG changes
- test aborted if patient experiences symptoms or EKG changes are present
What symptoms will be monitored closely during the exercise stress test? (6)
- chest, arm, and/or jaw discomfort
- dyspnea
- dizziness
- lightheadedness
Exercise stress test report will include what main types of information? (3)
Reason for examination: chest pain, SOB
Description of procedure: The patient exercised on Bruce Protocol for 8 min.
Impression: average exercise capacity, normal BP response
A standardized protocol that could be used to monitor cardiac function in exercising patients is known as the _____ ____.
Bruce protocol
Stress test results indicates what condition in this patient?
reversible ischemia
What test uses standard two-dimensional, three-dimensional, and Doppler ultrasound to create images of the heart?
Echocardiography
What test is used in the diagnosis, management, and follow-up of patients with any suspected or known heart diseases?
Echocardiography
What test reveals the size and shape of the heart (internal chamber size quantification) ?
Echocardiography
What test reveals the pumping capacity and the location and extent of any tissue damage?
Echocardiography
What estimates of heart function does the echocardiography test provide? (3)
cardiac output
ejection fraction
diastolic function (how well the heart relaxes)
What test produces accurate assessment of the blood flowing through the heart, using pulsed or continuous wave Doppler ultrasound which allows assessment of both normal and abnormal blood flow through the heart?
Echo
When is the use of echocardiography recommended? (2)
- For initial diagnosis when there is a change in the patient’s clinical status.
- When new data from an echocardiogram would result in changing the patient’s care.
What are the types of echocardiography? (5)
- Transthoracic
- Transesophageal
- Stress
- 3D
- Contrast
This is an example of what test being performed?
Transthoracic Echocardiography (TTE)
In this test, the echocardiography transducer (or probe) is placed on the chest wall (or thorax) of the subject, and images are taken through the chest wall.
This is a non-invasive, highly accurate and quick assessment of the overall health of the heart.
This test is: ________.
Transthoracic Echocardiography (TTE)
This test reveals the aorta, pulmonary artery, valves of the heart, both atria, atrial septum, left atrial appendage, and coronary arteries.
Transesophageal Echocardiogram (TEE)
What test reveals this image?
Transesophageal Echocardiogram (TEE)
Transesophageal Echocardiogram (TEE) reveals what structures of the heart? (7)
- aorta
- pulmonary artery
- valves of the heart
- both atria
- atrial septum
- left atrial appendage
- coronary arteries
TEE has a very high sensitivity for locating a blood clot inside the left atrium. True or false?
true
Is sedation usually needed for a transesophageal echocardiogram (TEE)?
Yes
What tests are known as Myocardial Perfusion Scans?
Nuclear Medicine Tests
Radioactive tracer (Thallium) is injected into a vein.
A special camera, called a gamma camera, used to look at Thallium uptake by the myocardium.
This test is known as what?
Nuclear Medicine Test
Combined with a vasodilator (dipyridamole or adenosine), this test can help determine if there is adequate blood flow to the heart during activity versus at rest.
What test is this?
Nuclear Medicine Test
The medication used during the nuclear medicine test, dipyridamole or adenosine, increases the heart rate. True or false?
False.
The medication does not increase heart rate. The medication dilates blood vessels leading into the heart, increasing blood flow, therefore simulating exercise for patients unable to exercise on a treadmill.
What test is preferred for those unable to exercise on a treadmill?
Nuclear Medicine Test
One study found that a reversible defect found on exercise stress test studies was the most significant predictor of post-operative ischemic events. True or false?
False.
Nuclear medicine tests, not exercise stress tests reveal this information.
A nuclear medicine test will provide what information on the report? (6)
- Description: Thallium stress test
- Indications: Chest pain.
- Stress technique: exercised for 5 minutes
- Image technique: injected with thallous
- Image analysis: normal LV perfusion
- Conclusions: Normal ECG stress
What test is minimally invasive procedure to access the coronary circulation and blood filled chambers of the heart using a catheter?
Coronary Angiography
What test involves a catheter being threaded into the heart through femoral artery, dye injected and is watched as it moves through the heart and coronary arteries?
Coronary Angiography
What is the gold standard in evaluating coronary artery disease?
Coronary Angiography
Important internal heart and lung blood pressures, not measurable from outside the body, can be accurately measured during a coronary angiography. True or false?
True.
What test determines if patient may benefit from angioplasty or CABG?
Coronary Angiography
Coronary Angiography is associated with a high complication rate. True or false?
False.
Low complication rate
What portable device for continuously monitoring various electrical activity of the cardiovascular system for at least 24 hours (often for two weeks at a time)?
Holter monitor
What is useful for observing occasional cardiac arrhythmias which would be difficult to identify in a shorter period of time?
Holter monitor
For patients having transient cardiac arrhythmia symptoms, a holter monitor which can be worn for a month or more can be used. True or false?
False.
A cardiac event monitor can be used.
What is a projection radiograph of the chest used to diagnose conditions affecting the chest, its contents, and nearby structures?
chest x-ray, or radiograph
What test is used to diagnose many conditions involving the chest wall, bones of the thorax, and structures contained within the thoracic cavity including the lungs, heart, and great vessels?
Chest x-ray (CXR)
Pneumonia and congestive heart failure are very commonly diagnosed by chest radiograph. True or false?
True.
What test reveals:
- Airway hilar adenopathy or enlargement
- pleural effusions
- pneumothorax
- fibrotic apices
- lung parenchyma
- lung failure such as alveolar air space disease
Chest Xray
As systematic approach to evaluating CXR film:
ABCD’s
- A = Airway: are the trachea and mainstem bronchi patent
- B = Bones: fractures, lytic lesions
- C = Cardiac silhouette: is the diameter of the heart > ½ thoracic diameter (enlarged)?
- D = Diaphragm: are the costophrenic and costocardiac margins sharp? is one hemidiaphragm enlarged over another? is free air present beneath the diaphragm?
A systematic approach to a CXR continued:
What are the EFGH’s?
- E = Effusion/empty space: is it present?
- F = Fields (lungs): are there infiltrates, increased interstitial markings, masses?
- G = Gastric bubble: is it present
- H = Hilar : is there increased hilar lymphadenopathy?
A systematic approach to a CXR continued:
What are other areas to look at? (5)
- Soft Tissue - Breast shadows, supraclavicular regions, axillae, chest wall thickness
- Behind the heart
- Apices
- Under the clavicles
- The costophrenic angle
Air bubbles and dark spots indicate what on the CXR?
subcutaneous emphysema
Bright spots indicate what on the CXR?
calcifications
What test uses a magnetic field and pulses of radio wave energy to make pictures of organs and structures inside the body?
Magnetic Resonance Imaging (MRI)
What test is used to find problems such as tumors, bleeding, injury, blood vessel diseases, or infection?
Magnetic Resonance Imaging (MRI)
Because of the strength of the magnet, any of the following may prohibit use of
MRI: (7)
- Brain aneurysm clips
- Kidney disease or dialysis (contrast)
- Artificial heart valves
- Heart defibrillator or pacemaker
- Inner ear (cochlear) implants
- Recently placed artificial joints & vascular stents
- Neurostimulator or drug infusion pump
What test generates cross-sectional views of anatomy?
Computed Tomography (CT)
Iodine-containing contrast material is sometimes used in CT scanning. Patients with a history of allergy to iodine or contrast materials should notify their physicians and radiology staff. True or false?
True.
What test is used to:
- Diagnose an infection
- Guide a surgeon to the right area during a biopsy
- Identify masses and tumors, including cancer; cancer staging
- Study blood vessels
CT scan
What are the risks of a CT scan? (2)
Allergic reaction to contrast dye
Being exposed to radiation
