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ECOS II Final > Cardio Imaging > Flashcards

Cardio Imaging Flashcards

1
Q

What are the indications for an echocardiogram?

A

Evaluative congenital heart defects, changes in heart size, pumping strength (ejection fraction and CO), damage to heart muscle, valvular dysfunction, presence of pericardial effusion, guidance of pericardiocentesis

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2
Q

What are the three types of an echocardiogram?

A

Transthoracic echocardiogram (TTE)
Doppler echo
Stress echo

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3
Q

What are the pros for TTE?

A

Usually first line cardiac imaging modality bc its widely available, noninvasive and no radiation risk

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4
Q

What are the risks for echocardiogram?

A

During stress echo, exercise (not the echo) may cause temporary dysrhthymia and rarely heart attacks

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5
Q

What are the pros for a Doppler echo?

A

Finds blood flow abnormalities in cardiac arteries missed by traditional ultrasound

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6
Q

What are the indications for the a continuous wave Doppler?

A

Measures high velocities

Pulmonary HTN or aortic stenosis

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7
Q

What are the indications for pulsed Doppler?

A

Assess low velocities

Mitral/tricuspid inflow, atrial appendage flow, ventricular outflows

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8
Q

What are the indications for a color flow Doppler?

A

Assess regurgitation, intracardiac shunts (ASD, VSD), and pulmonary vein flow

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9
Q

What are the risks for a Doppler echo?

A

None

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10
Q

What are transducer positions?

A

Usually performed with patient left lateral decubitus

Left handed scanning is more ergonomic and lower risk of sonographer othropedic injuries

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11
Q

An apical view US is best for viewing what?

A

Heart chambers

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12
Q

What is the MC congenital cardiac anomaly?

A

Ventricular septal defect

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13
Q

What are the sx for a septal defect?

A

Small lesions may be asymptomatic with harsh pansystolic murmur
Large lesions may cause signs of heart failure

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14
Q

What is the modality of choice for septal defects?

A

An echo allows direct visualization of the septal defect with no radiation exposure

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15
Q

CTA with EKG-gating allows for direct visualization of the defect but with risk of what?

A

Radiation exposure

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16
Q

What is coarctation of the aorta?

A

Aortic narrowing near insertion of the ductus arteriosus

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17
Q

What are the sx for coarctation of the aorta?

A

HTN in UE, weak pulses in LE (brachial-femoral delay)

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18
Q

What is the imaging of choice for coarctation of the aorta?

A

Echo establishes sx and severity in most pts

CTA can be a complimentary imaging tool important prior to intervention

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19
Q

What are the indications for a multiple gated acquisition (MUGA) scan?

A

Detect for causes of reduced ejection fraction (ie. Heart failure, damaged myocardium from MI or cardiomyopathy)
Can help answer why a pt has angina, dizziness, dyspnea or fatigue

20
Q

What are the pros for a MUGA scan?

A

Accurate, reproductive, non-invasive
Measured EF is more precise vs other cardiac tests
Can localize abnormally functioning myocardium to find blocked coronary arteries

21
Q

What are the risks for a MUGA scan?

A

Low level of radioactivity unions to cause any short/long term damage, allergic reaction to tracer

22
Q

When is a MUGA scan contraindicated?

A

Renal disease, pregnant women or breastfeeding

23
Q

What is the gold standard for CAD?

A

Coronary angiography

24
Q

Wha are the indications for a coronary angiography?

A

CAD, angina, acute MI, valvular disease, CHF

25
Q

What are the contraindications for coronary angiography?

A

Renal failure, contrast medium allergy, coagulopathy, uncontrolled HTN, decompensated HF, GI hemorrhage, pregnancy, active infection

26
Q

What are the cons for coronary angiography?

A

Expensive, procedural risks

27
Q

What are the indications for CT?

A

Locate aneurysm, blockages, blood clots, vascular malformations, stenosis, injury, vessel rupture/dissection, pulmonary embolism

28
Q

What are the risks for CT?

A

Minimal radiation exposure, allergic reaction to contrast, tissue damage via contrast leakage

29
Q

What are the pros for CT?

A

Quick, non-invasive, may eliminate need for surgery, allows surgeries to be performed more accurately, cheaper than catheter angiography

30
Q

What are the contraindications for CT?

A

Severe kidney disease

31
Q

What is the most posterior most of the heart on CT?

A

LA

32
Q

What is the most anterior part of the heart on a CT?

A

RV

33
Q

What is aortic dissection?

A

Longitudinal intimal tear forming a false lumen

Associated with chronic HTN and Marfan’s

34
Q

What are the sx of aortic dissection?

A

Sudden onset tearing chest pain radiating to the back, unequal BP in arms, diminished or unequal peripheral pulses, new diastolic murmur from aortic regurgitation

35
Q

What is the imaging of choice for aortic dissection?

A

CXR shows mediastinal widening

CTA is choice of imaging bc it can diagnose/classify the dissection and evaluate for distal complications

36
Q

What is thoracic aortic aneurysm?

A

Associated with cystic medial degeneration seen in Marfan’s

Aortic root dilation can lead to aortic regurgitation and associated sx

37
Q

What are the sx for thoracic aortic aneurysm?

A

Mass effect on airway and esophagus

38
Q

What is the imaging of choice for choice aortic aneurysm?

A

CTA

39
Q

What is a posterioanterior (PA) film?

A

Pt facing film plate with X-ray tube behind them

Most commonly used

40
Q

What is an anterioposterior (AP) film?

A

Pts back a giants film plate with X-ray machine in front

41
Q

What is the importance of the PA/AP CXR views?

A

In AP view the mediastinum appears widened due to AP magnification
Don’t consider the heart to be enlarged if viewing in AP

42
Q

What are some DDx for cardiomegaly?

A

CHF, HTN with left ventricular hypertrophy, valvular disease, cardiomyopathies, pulmonary dz with RV hypertrophy, myocarditis, normal athletic heart

43
Q

What is the imaging of choice for cardiomegaly?

A

CXR is sufficient to dx cardiomegaly

Other imaging modalities can be used to narrow down the differential

44
Q

What are some DDx for widened mediastinum?

A

Anthrax, aortic dissection, thoracic aortic aneurysm, pneumomediastinum, mediastinal mass

45
Q

What is the imaging of choice for widened mediastinum?

A

CXR is sufficient to dx

Other imaging modalities can be used to narrow down the differential

ECOS II Final (10 decks)

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