Cardiovascular Diagnostics Flashcards
Worn externally, monitors a continuous EKG for 24 to 48 hours and allows patients to “mark” events of symptoms.
Holter monitor
Who is a holter monitor useful for?
A patient who is having frequent episodes of symptoms that could be cardiac related
Who is an event/loop monitor useful for?
A patient who is having sporadic episodes of symptoms that could be cardiac related; monitors continuous EKG for WEEKS!
On a chest X-ray, how much of the heart should be on each side of the thoracic cavity?
2/3 on the left, 1/3 on the right. Should not take up more than 1/2 of thoracic cavity
What is the normal cardiothoracic ratio?
0.5:1
What will you see on CXR in a patient with pulmonary edema or CHF?
Interstitial edema Kerley B lines Perihilar infiltrates Peribronchial cuffing Cephalization of vessels
Short, parallel lines at lung periphery that are distended into interlobular septa
Kerley B lines
Redistribution of blood to upper lobe vessels
Cephalization of vessels
With full inspiration, what is visible? How many ribs should you be able to see?
Right heart border is visible
8-10 ribs
What are some x-ray limitations?
Heart may appear falsely enlarged or small (COPD) with X-ray
The image may be obscured from effusions or pneumonia
The AP view shows _____ of the heart and _____ of the mediastinum
Magnification
Widening
Who should the AP view be reserved for?
Patients who cannot stand
What are some things that echocardiography can detect?
- Defects between chambers
- Pericardial effusions
What are the benefits of echocardiography?
- Minimally invasive
- Can view in real time
- Can evaluate chamber size, wall motion, and valve abnormalities
When is a stress echo useful?
To look for functional abnormalities under the stress of exercise
Standardized stress testing is designed to take patients to ___% or higher of their predicted max HR
85
Women have ___X more false positive on standardized stress testing than men
5
What does standard stress testing reveal?
- Exercise induced ischemia = coronary artery disease
- Stress induced arrhythmias
- BP response to exercise
- Patient’s functional capacity
What are the three orientations of perfusion imaging?
Short axis
Vertical long axis
Horizontal long axis
What type of nuclear stress testing is most common?
Technetium (myoview)
The technetium is attracted to the functional _____ of the heart and accumulates in viable heart muscle
Mitochondria
What is nuclear imaging useful for with resting heart tissue?
Shows which tissue is viable vs non-viable
What is nuclear imaging useful for with exercised heart tissue?
Ischemic vs non ischemic
When you compare rest and stress images with nuclear perfusion, a filling defect after rest indicates ____ and filling defect after exercise indicates _____
After rest = old MI
After exercise = Ischemia
