Cardio and Vascular for Radio (myocardial ischemia, acute chest pain, vascular, and general) Flashcards
What is the 1st level investigation for suspected ischemia of the heart ?
Echocardiogram (by Holter monitor 24/72h) and stress test
In a pharmacological stress test, if a patient has bronchospasm/COPD, what do we give ?
Dobutamine
In a pharmacological stress test, if a patient has no bronchospasm/COPD, what do we give ?
Dipyridamole
what is the 2nd level diagnostic tool for cardiac suspected ischemia ?
Myocardial scintigraphy (location and extent)
this is done with gated SPECT
First line imaging for acute chest pain ?
CXR
why do we measure troponin and perform ECG in acute chest pain ?
to exclude MI
Why do we measure D-dimer in acute chest pain ?
to exclude PE
What is the gold standard imaging for acute chest pain ?
CT with contrast
What is the first line imaging for Abdominal aortic aneurysm ?
Echo (to see size and the plaque)
what is the 2nd line imaging for the Abdominal aortic aneurysm ?
CT
what is the gold standard for ischemic heart disease ?
Coronary CT angiography
what are the two types of coronary CT angiography ?
Direct and angiographic
In coronary CT angiography, what type is with contrast media and what type is without ?
Direct- w/o contrast media
Angiographic- W/ contrast media (iodinated)
In order to perform Angiographic (with contrast) coronary CT, what criteria must be fulfilled ?
HR must be <60 bpm
What is the use of Direct-coronary CT angiography ?
Evaluation of Calcium content of plaques and risk stratification
What is the scoring system we use for the stratification of ischemic heart disease in Coronary CT angiograpy ?
Agatston score
what is the contrast media in Coronary CT angiography ?
Iodine
What is the use of Angiographic coronary CT with contrast ?
Coronary anatomy study with the study of coronary lumen plaque/stenosis status
What imaging is used for patient with with intermediate risk for CAD ?
coronaro-CT angiography
What are the main indication for Myocardial scintigraphy ?
Ischemia and Dilated cardiomyopathies, HF
What is the indication of PET in CAD ?
Evaluation of flow/ metabolism coupling
whether it’s ; stunned/hibernating/ necrotic myocardiums
what are the 3rd line tools for CAD ?
MRI
CT
what is the imaging tool we use for gaining information about coronary flow (perfusion) ?
SPECT
What are the tracers we use with SPECT when imaging the coronary flow ?
Sestamibi and Thalium
What is the use of SPECT in CAD ?
Risk stratification, therapeutic strategy, and px management.
How invasive is cCTA (Coronary CT Angiography) ?
Minimally invasive
what are the indication of MRI as 3rd level tool ?
cardiac / paracardiac masses and intracardiac thrombi
what are the indication of MRI as 1st level tool in cardiac pathologies ?
Hypertrophic cardiomyopathy, myocarditis
How do we define ectasia of the aorta ?
increase in the diameter of the aorta that is up to 3cm
How do we define Aneurysm of the Abdominal Aorta ? (AAA)
dilatation of the vessel that is 3cm and larger
what are the layers involved in Pseudoaneurysm ?
Muscularis and the Adventitia tunica
what layers are involved in True aneurysm ?
All three layers
What tool do we use in order to perform screening for AAA ?
Abdominal Echo —> CT
