Cardiac Testing Flashcards
What is an ambulatory event monitor?
Monitor longer than a holter monitor
Can be taped events or monitored from a distance
Can be patient triggered or automatic recording with abnormalities
Loop recorder - can be implanted for up to 2 years
Serum testing for acute MI
Troponin (only need 1 elevated troponin for diagnosis)
CK-MB (rises 2-4 hours after onset of s/s, peaks at 24 hours)
how long does it take for a troponin to elevate
2-3 hours
what are the contraindications for a stress test
CHF, uncontrolled arrhythmia, aortic stenosis, angina,
MI, PE, Severe pulmonary HTN, Aortic dissection
What do you need for a stress test
ACLS equiptment
12 lead ECG
NPO 4 hours prior
IV access for chemical stress test
L sided heart cath can look at what and used for what
Looks at vessels, mitral valve, aortic valve, L ventricular ejection fraction
Used to insert stents, balloons, ect
R sided heart cath is for what
Looks at pressures in heart, blood flow problems, valve disease, pulmonary HTN
what is an echocardiogram used for
Looks at the inside of the heart - valves, walls, septum, pericardium, tamponades, rupture of wall after MI, decreased or dead wall function
determines systolic and diastolic functions
An echocardiogram does not diagnose ______
Cardiovascular disease
An echocardiogram is recommended for patients with long standing _____
HTN
What is a transesophageal echocardiogram used for
Closer to the back of the heart Can visualize better Shows vegetation (infection) better Looks for embolic source (afib) Acute dissection
what is a stress echocardiogram used for
can show problems with blood flow that isnt visible when resting
What is confirmed with a bubble or contrast echocardiogram
Atrial-septal defect
what is a normal ejection fraction
50-80%
A decreased ejection fraction can indicate
LV systolic dysfunction - needs interventions such as medication, pacemaker, ICD.
If EF is normal but a pt has a clinical s/s of heart failure look for______
R sided heart failure or diastolic dysfunction
Wall motion abnormality on echocardiogram indicates
Ischemia or muscle damage
can indicate a AMI or post MI
preferred method to look at valvular abnormalities
echocardiogram
If a pt has a new murmur, what do you order?
echocardiogram
What are some causes of Aortic stenosis?
congenital, calcification, abnormal formation of valves, should have 3 parts
What happens to heart and lungs in aortic stenosis
causes back up of flood into LV - rest of heart and lungs. LV size increases (LA increases - can cause afib
symptoms of aortic stenosis
syncope, dyspnea, angina, low pulse pressure (instead of 120/80 you have 110/90), sudden death
electrophysiology study is what?
done by specialist
catheters are inserted into veins and threaded to the heart so that they can sense the electrical activity
Electrical impulses are sent through one of the catheters and the response is watched on another
You might see this in afib
CT scan of the heart looks at what
can look at calcium plaques on the vessels
Dye used to look at patency of coronary arteries
other scans used on heart
PET scans - MUGA Scans
MRI/MRA
