cardiovascular diagnostics Flashcards
during a 12 lead, pt has to lie down to decrease…?
artifact -> false electrical activity
2 PRE-stress test recommendations
- no bb or caffeine for 24 hours before
- no smoking or strenuous exercise for 3 hours before
two methods for stress test
exercise on treadmill or bike
pharmacological: adenosine, dipyridamole , or dobutamine, lexiscan
what is the major tool for cardiac diagnostic
echocardiogram
what does echo evaluate
structures and function; ejection fraction
what is a normal ejection fraction
greater than or equal to 55-60%
- less than that is HF
anesthesia used for transesophageal echocardiogram
IV sedation and local anesthesia
NPO for TEE
6 hours NPO before procedure
which side does pt lay on for TEE
left side
what to check specifically after TEE
gag reflex
what is TEE good for
looking for clots
what is CT scan good for measuring
calcifications
what may use contrast dye that contains iodine
CT scan
coronary CT angiogram is used for what
clogged arteries
MRI looks at?
soft and hard tissue
does MRI use radiation?
no
important to remember about MRI and the room it is in
magnet is always on– all metal must be removed before entering the room
what contrast is used for MRA
IV gadolinium
what does PET scan stand for
positron emission tomography
pre-test for PET scan
- NPO
- no caffeine or tobacco for 4 hours
- IV glucose and radioactive fluorine 40 mins prior
MUGA scan stands for?
multigated acquisition scan
what is MUGA scan AKA
- cardiac blood pool
- nuclear ventriculography
what is taken and injected prior to PET scan
blood sample taken and radioactive isotope injected
what is PET scan used for
to see if blood is making its way through the heart
what is used for imaging in a PET scan
ECG and gamma camera
how long does a PET scan take
3 hours
cardiac catheterization uses contrast dye?
yes, radioactive contrast dye
what does left sided cardiac cath do
- arterial access
- evaluates coronary arteries, mitral/aortic valves, left ventricle
what does right sided cardiac cath do?
- venous access
- tricuspid and pulmonic valves
contraindications for a heart cath
- severe HTN
- ventric. arrhythmias
- acute stroke
- severe anemia/bleeding
- unexplained fever
how long to be NPO before heart cath
6-8 hours
how could AKI, CKD, and DM affect a heart cath?
the dye is nephrotoxic, could damage the kidneys. more fluid may be given to these pts
risks of heart cath
- stroke
- cardiac tamponade
- MI
what kind of anesthesia for heart cath
moderate to deep sedation
possible interventions in a heart cath
angioplasty
atherectomy
what is an angioplasty
balloon inflates artery to push back plaque; could be placed as well
atherectomy
- scrape plaque off walls
- common in carotid arteries
- not common for coronary arteries
3 things to assess post cath
stable
skin
site
how often to take VS post op
q15x4, q30x2, q1hx2, q4hx24h
where does blood commonly collect if artery bursts
in the back
retroperitoneal bleed
collection of blood in the peritoneal cavity
manual pressure
1” above site
at least 5 mins of firm pressure
perclose device
nonabsorbable suture
- bedrest: 30-60 minutes
mynx
extravascular sealant
- polythylene glycol swells 3-4x and absorbs blood
angioseal
collagen plug
- dissolves within 60-90 days
- risk of embolism
- careful when palpating site
- bedrest 2-4 hours
syvek patch
round patch increasing platelet aggregation
- occlusive dressing
- bedrest for 1 hour
manual closure devices
C-clamp and fem stop (femo stop)
c-clamp
applied 1 inch above site
- monitor VS/pulses q15 minutes
- only use for 30-45 mins
- bedrest 4hrs
- last resort
fem stop
- inflated dome with manometer
- systematically decrease pressure
- used for 10 or less hours post op
- HOB flat
- last resort
TR band
radial compression device
- less complications
- important not to lose syringe bc it cannot be replaced
non invasive cardiac cath
CCTA
- cardiac computed tomography angiography
