Ch. 5 - Coronary Artery Disease Pt. 2

Question 1

A non-invasive, tracing of the electrical activity of the heart, inexpensive, and painless test that is frequently obtained in clinical and insurance medicine

Answer 1

Electrocardiogram (EKG)

Question 2

For this test, individuals are asked to exercise, usually by walking on a treadmill, through various workloads as determined by a standardized protocol while their EKG and blood pressure are monitored

Answer 2

Exercise Electrocardiogram

Question 3

In this test a radioisotope, typically either thallium or technetium, is injected into the individual undergoing exercise or pharmacologic stress testing, and the images are collected using single photon computed tomography (SPECT)

Answer 3

Myocardial Perfusion Imaging (MPI)

Question 4

What tests allow assessment of the cardiac chambers?

Answer 4

The echocardiogram, the radionuclide angiogram - also known as a multi-gated acquisition scan (MUGA) - and the gated SPECT. Myocardial ischemic is detected as a decrease in left ventricular ejection fraction (LVEF), a measure of the pumping ability of the heart, or the development of a regional wall motion abnormality with exercise

Question 5

Exercise testing, while important in the function assessment of CAD, does not define the coronary anatomy. How is this accomplished?

Answer 5

Through coronary angiography, an invasive, radiographic test where dye is injected directly into the coronary arteries to determine the site, extent, and the percentage of the coronary obstruction

Question 6

What is considered the “gold standard” in the diagnosis of CAD?

Answer 6

The angiogram (with cardiac catheterization). However, obstructions can be underestimated or missed because the geometry seen on angiograms may not accurately correlate with the true intravascular geometry

Question 7

These tests are increasingly being used to assess the degree of coronary artery disease because they are less invasive and can visualize significant CAD without subjecting a person to a cardiac catheterization procedure

Answer 7

Computed tomography (CT) or magnetic resonance (MR) angiography. Coronary CTA is highly accurate at detecting significant (50% or greater) stenosis in the major coronary arteries

Question 8

Can image atheroma within the vessel wall directly, allowing measurement of atheroma size and distribution and is becoming more frequently used in situation where a “normal” angiogram does not seem to fit with the known facts of the case

Answer 8

Intravascular Ultrasound (IVUS)

Question 9

Used to detect deposits of calcium in the arterial walls

Answer 9

Electron beam computed tomography scans and ultrafast CT scans