Clin Lab: Cardiovascular Imaging Flashcards

1
Q

Types of Imaging imaging of the heart

A
  • CXR
  • CT chest
  • US
  • Radionuclide imaging & Stress testing
  • Coronary angiography
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2
Q

CXR: Heart tells use

A
  • heart size
  • Dextrocardia
  • Pericardial effusions
  • Pleural effusions from HF
  • Pulm vascular edema from HF
  • Aortic dissections/aneurysms
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3
Q

CT chest: Heart tells use

A
  • pericardial effusions
  • coronary artery calcifications
  • aortic dissections/aneurysms
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4
Q

US: Heart tells use

A

Echo
- TTE or TEE
- Tells us of structure & mechanic (valves/EF)

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4
Q

Radionuclide imaging & stress testing: Heart tells use

A

evidence of coronary artery dz before we have to do anyting invasive

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5
Q

Coronary angiography: Heart tells use

A

can be used as therapeutic and diagnostics about things going on in the vascular of the heart

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6
Q

Angiography: Vascular tells use

A

looks at BVs
- traditional angiography
- CTA
- MRA

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7
Q

US: vascular tells use

A

External
- mostly done
Internal
- probe used into BVs

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8
Q

Plethysmography: vascular tells use

A

uses BP measurements and looks at wave forms associated to blood flow w/ different pressures

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9
Q

What is dextrocardia?

A

transposition of the heart
- may be isolated or other organs in additional
- >asymptomatic, found in some genetic syndromes

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10
Q

What is cardiomegaly CXR?

A

In PA view, the hearts max width should be < 1/2 the total thoracic cavity width.
With cardiomegaly it is larger

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11
Q

Describe Pericardial effusions CXR

A

“water bottle” sign
large if seen on CXR
b/t the fibrous sac of the heart

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11
Q

Describe CHF: CXR

A

may see:
Pleural effusions–> transudative
–> bilateral costophrenic angles
–> fissures b/t lung lobes
–> interlobular septa (Kerley B lines)

Incr vascular markings
–> diffuse incr in vascular markings
–> Cephalization of pulm vessels in upper lobes

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11
Q

Describe aortic dissection CXR.

A
  • widened mediastium
  • “Ca++ sign”
    –> Ca++ area >1cm from outside curse of aortic knob
  • weakened the wall of BVs allows for leakage of blood
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12
Q
A
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12
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12
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13
Q

When do we do a CT for pleural effusion?

A

done if quantification of effusion needed or if Echo is inconclusive

13
Q

What are calcifications associated with?

A

atherosclerotic plaques

13
Q

Do we used contrast w/ coronary artery coalification CT?

A

NO

14
Q

When do we order a coronary artery calcification?

A

asymp pts w/ intermediate 10 yr risk

14
Q

What does a Coronary artery calcification tell us?

A

a coronary calcium score
- the amount of calcification can be quantified

prognostic for ASCVD and adverse events (MI/Stroke)

15
Q

What is a normal EF?

A

50 - 55%

15
Q

What is severely bad EF?

A

< 25%

15
Q

Where is the ejection fraction measure on an echo?

A

LV ventricle

16
Q

How is diastolic dysfunction graded?

A

Grades I, II, III
Grade 1 - little problem stretching
Grade 2 - a lot of stretching

16
Q

What is akinesis?

A

no movement

16
Q

What is dyskinesis?

A

no moving as much as it should
due to stenosis or plaque

16
Q

What can we tell about valves on an Echo?

A
  • # of leaflets- prolapse
  • Stenosis
  • regurg
  • calcifications
  • vegetations
16
Q

What is a normal for IVC collapse?

A

~ 50% w/ inspiration

16
Q

What does no IVC collapse mean?

A

possible volume overload
- collapse >50% is abnormal

17
Q

Indications for TEE?

A
  • NonDx TTE
  • Assessment of:
    –> cardiac tumors
    –> valves
    –> aortic dissections
    –> native & prosthetic valves
    –> intracardiac thrombus w/ repeated strokes
  • intraoperative monitoring
17
Q

Absolute Contraindications of TEE

A
  • recent esophageal/gastric surg
  • esophageal stricture/obstruction
  • active upper GI bleed
  • Known/suspected perf GI organ
17
Q

Relative Contradictions for TEE

A
  • known coagulopathy or thrombocytopenia
  • malformation of nose/throat/esophagus/cervical etc
  • Hx of GI surg or GI bleed
  • Hiatal hernia
  • Esophageal varices
17
Q

What are EKG finding would suggest an exercise stress test to assess for CAD?

A
  • LBBB
  • Digoxin
  • Pacemaker
  • Baseline ST segment changes
  • Accessory pathway
17
Q

Possible meds used for a pharmacological stress test?

A

Vasodilators
- Adenosine
- Regadenoson (Lexiscan) - adenosine deriv
- Dipyridamole

Sympathomimetic
- Dobutamine