cvm

Question 1

JVD, muffled heart sounds and hypotension

what is it and what’s the tx

Answer 1

beck’s triad: pericardial effusion (cardiac tamponade)

1. EKG: low voltage, electrical alternans
2. Dx: Pt Hx, presentation, CXR, EKG, and echo findings
3. Tx: pericardiocentesis , surgical drainage, thoracotomy

Question 2

Transthoracic Echocardiogram

Answer 2

Cardiac tamponade!

Use of US to evaluate cardiac anatomy and function

▪ **Initial test of choice!**

▪ Indications:

▪ Evaluate pericardium

▪ Evaluate ventricles/atria/septa

▪ Evaluate cardiac valves

▪ Ejection fraction!!!

▪ WHEN WOULD

Question 3

Abdominal aortic angiography

Answer 3

dissection, lots of radiation.

Question 4

Process of identifying an AAA

Answer 4

US to identify, CTA to confirm if aneursym is 5 cm

Question 5

ACUTE CORONARY SYNDROME

Answer 5

Portable CXR, place on cardiac monitor, review CXR, send to cath lab

Question 7

Cardiac Cath Lab

Answer 7

Physician places catheter into either femoral artery or radial artery

2. Guides the catheter into aorta to reach coronary vasculature
3. Uses FLUOROSCOPY to visualize coronary arteries

▪ It’s like a “movie xray”
▪ CONTRAST IS USED!!!

4. Depending on what is found on imaging and intervention may/may not be performed

Question 8

Risks and Benefits of Coronary Angiography

Answer 8

Risks:
▪ 1. Bruising/Bleeding
▪ 2. MI
▪ 3. Infection
▪ 4. CVA
▪ 5. Arterial damage
▪ 6. Arrhythmias
▪ 7. KIDNEY DAMAGE – WHY!?

▪ 8. Allergic Rxn

Benefits:
▪ 1. Diagnostic with benefit of

immediate intervention ▪ 2. Life saving

Question 9

Transesophageal echocardiogram (TEE)

Answer 9

visualize all chambers of the heart to assess for thrombus formation.

Question 10

TEE uses

Answer 10

▪ Use of US via esophagus to evaluate structural integrity of heart

▪ **Invasive procedure!!**

▪ Uses:

▪ LA thrombus in atrial fibrillation

▪ Infective endocarditis

▪ Prosthetic valve evaluation

▪ Acute aortic pathology (dissection, etc)

▪ If TTE in unrevealing