Cardiac tests

Question 1

Cardiac stress testing

Answer 1

Electrodiagnostic

Provides information about patient’s cardiac function
Heart is stressed in some way and then evaluated during the stress
Exercise, chemical, pacing
Ischemic changes indicate coronary disease
Often done preoperatively

Question 2

Electrocardiography (EKG)

Answer 2

Electrodiagnostic

Records electrical impulses that stimulate heart to contract
Evaluate arrhythmia, conduction defects, myocardial injury
Can assist with diagnosis of electrolyte abnormalities, drug level abnormalities, pulmonary disease

Question 3

Electrophysiologic study (EPS)

Answer 3

Electrodiagnostic
Studying evoked potentials within the heart
Syncope, palpitations, or arrhythmias
Identify location of conduction defects
Can also be used therapeutically to stop arrhythmias

Question 4

Holter monitor

Answer 4

Electrodiagnostic
Records patient’s heart rate and rhythm for more than 1 days
Indicated in syncope, palpitations, atypical chest pains, dyspnea
Patients should journal symptoms to see if there is any cardiac correlation

Question 5

Pericardiocentesis

Answer 5

Performed to determine cause of pericardial effusion
Can be done therapeutically to relieve intrapericardial pressure; cardiac tamponade
Usually performed by physician in cardiac cath lab or operating room

Question 6

Cardiac Nuclear Scan

Answer 6

Nuclear scan

Evaluate coronary vascular disease, coronary surgery/angioplasty, chest pain, SOB, elevated cardiac enzymes
Includes myocardial perfusion, MUGA, cardiac flow, nuclear SPECT, exercise stress test
Most accurate method to determine coronary occlusive disease

Question 7

Vascular ultrasound studies (venous and arterial)

Answer 7

ultrasound

Rule out DVT or arterial occlusion
Evaluate PVD – patency of venous system, suspected arterial insufficiency, varicose veins
ABI <0.85 indicates significant arterial occlusive disease

Question 8

Echocardiography (ECHO)

Answer 8

ultrasound

Ultrasound of heart
Evaluates wall motion abnormalities, valvular disease, pericardial fluid

Question 9

Transesophageal echocardiography (TEE)

Answer 9

ultrasound

Evaluates structures that are difficult to evaluate via transthoracic echocardiogram
Provides imaging from retrograde vantage point
Can be used to evaluate ischemia as ischemic muscle moves differently

Question 10

Arteriography

Answer 10

XRAY

Evaluates occlusive disease of adrenal glands, kidneys, mesentery, brain, and lower extremity
Renal angiograph evaluates blood flow dynamics, demonstration of abnormal blood vessels
Often can be ordered in uncontrolled HTN, hypertensive crisis
Lower extremity angiograph evaluates PVD
Emergent arteriogram ordered in patient with sudden arterial occlusion

Question 11

Cardiac Catheterization

Answer 11

XRAY

Visualizes heart, great blood vessels, and coronary arteries
Used to identify severity of atherosclerotic, occlusive CAD; valvular or septal defects; evaluate cardiac muscle function; treat acute MI
Performed by cardiologist

Question 12

Venography

Answer 12

XRAY

Contrast enhanced xray of venous system to identify obstruction or thrombus
More specific than venous doppler
Performed by radiologist