Diagnostic Test: Cardiac & Pulm Flashcards
This test has continuous 24 hour ECG monitoring
Holter monitor
The holter monitor provides info for the diagnosis and management of episodes of ________
Arrhythmias
Indications for a holter monitor include
IDing symptoms possibly caused by dysrhythmias
Describing the dysrhythmias noted with activating
Evaluating anti-arrhythmia therapy and pacemaker functioning
All symptoms and activity are DOCUMENTED during the 24 hour period for what test?
Holter monitoring
When is it common to perform holter monitoring prior to discharge?
After an MI
Patients on a holter monitor may be referred for:
EPS
Ablation procedure
ICD
An ICD is usually placed in _________ and it is used to detect ______
In the right ventricle
Used to detect arrhythmia
What does EPS stand for?
Electrophysiology study
What does ICD stand for?
implantable cardioverter defibrillator
This test is often associated with ablation
EPS
An EPS is indicated to…. (3 things)
Investigate the cause
Location of origin
Best treatment for various abnormal heart rhythms
Ablation is common in patients that have…
A-fib
What is an echocardiography?
Noninvasive procedure that Evals the functioning heart
Gives real time images of beating heart
What is an echo used to assess?
The performance of the heart muscle and valves
Quantifies volume of left ventricle
Estimates SV and EF
What does SV stand for?
Stroke volume
What does EF stand for?
Ejection fraction
Problems that are evaluated with an echo (14)
Aortic dissection
Aortic regulation
Aortic stenosis
Aneurysm
Cardiac tamponade
Idiopathic cardiomyopathy
Hypertrophic cardiomyopathy
Ischemic heart muscle
Pericardial effusion
Mitral valve regurgitation
Mitral valve prolapse
Thrombi
Vegetation of valves
Masses
What is a cardiac tamponade?
Acute, uncontrolled pericardial effusion
Transesophageal Echo (TEE) allows for what?
Improve visualization of cardiac structures and function
Valuable in the intraoperative and perioperative monitoring of LEFT VENTRICLE performance
What is the mode of choice for the eval of cardioembolic stroke?
Transesophageal Echo (TEE)
Where is the TEE probe placed?
Into the mouth and down the esophagus (can also be placed in the stomach)
What does a stress echo evaluate?
Ischemia-induced wall motion abnormalities
Stress echos are useful for the eval of what?
Atypical symptoms (dyspnea and fatigue) as well as for patients with no diagnostic ECGs with exercise
Or who have atypical chest pain syndromes
Are stress echos better for women or men?
Women
What is a contrast echo?
IV injected contrast agent with the echo
Improved diagnostic accuracy to assess myocardial perfusion and ventricular chambers
SPECT
Single photon emission computed tomography
Is SPECT invasive or noninvasive?
Noninvasive
SPEC detects and quantifies…
Myocardial perfusion defects and contractility defects
SPECT is used in conjunction with
Radioactive isotopes
In a SPECT, radioactive tracer is injected into bloodstream then..
Gamma camera picks up emissions creating picture of heart
PET
Positron emission tomography
PET provides visualization and direct measurement of
Metabolic functioning, including glucose and fatty acid metabolism and blood flow of the heart
What imaging is the gold standard for blood flow measurement and metabolic assessment of the heart?
PET
CT is used predominantly to ID…
Masses in the cardiovascular system
CT detects what?
Aortic aneurysms or pericardial thickening
Benefit of CT?
Noninvasive
Harmless
CTA stands for..
Computed tomography angiography
What does a CTA highlight?
Coronary arteries to eval for CHD
What does a spiral CT evaluate?
The presence of PE
How does a spiral CT work?
Scanner rotates around the body in a spiral to create 3D images
Detects abnormalities in the arteries in the lungs with greater precision
Spiral CTs are (faster or slower?) that conventional CT scans?
Faster
Spiral CT can be done with or without contrast?
True
If your patient is getting a spiral CT when you see them, should you treat?
NOOOOOOOO
Spiral CT are 2D or 3D?
3D
What does EBCT stand for
Electron Beam Computerized Tomography
EBCT is what kind of method?
And what does it detect?
Noninvasive
Detects and quantifies coronary atherosclerosis (detects coronary calcification)
Detects presence of calcium in coronary arteries as well as the location, extent, and density of the deposits
Provides a calcium scoring system
MUGA does what?
Noninvasive technique to calculate LEFT VENTRICULAR ejection fraction
What is the purpose of an MRI?
Evaluates morphology, cardiac blood flow, myocardial contractility
Assess valvular disease, cardiac shunts, quantification of cardiac flow, coronary artery anatomy
Radioactive nuclide perfusion imaging is the assessment of
Coronary perfusion
Commonly used agents in radioactive nuclide perfusion imaging include
Thallium 201 and technetium 99m
When are the agents injected for radioactive nuclide perfusion imaging?
After exercise of after pharmacologic stress test
What do nonperfused or dead myocardium look like on a radioactive nuclide perfusion image?
Cold spots
If you have a cold spot immediately after exercise or 4 hours afterward, it is considered….
IRREVERSIBLY DAMAGED (scarred)
If a cold spot reperfused after 4 hours, it is…
Ischemic
What agent is more stable in radioactive nuclide perfusion imaging?
Sestamibi
Sestamibi can detect infarcts that are…
A few hours old
A pharmacologic stress test is…
A physiologic stress test while the pt remains in RESTING state
What are the most common agents used for a pharmacologic stress test?
Dupyridamole
Dobutamine
Adenosine
Are cardiac catheterizations invasive or non?
Invasive
What does a cardiac catheterization establish?
A DX of cardiac dysfunction or heart disease
Demonstrates severity of CAD or valvular dysfunction
Specific determination that are made with cardiac catherization (4)
Presence of and severity of CAD
Presence of left vent dysfunction or aneurysm
Presence of valvular heart disease and severity
Presence of pericardial disease
Where is a cardiac catheterization usually performed?
Femoral artery
Caths as treatment are usually called…
PCI - percutaneous coronary intervention
For a cath, a single vessel involvement can usually be treated….
NON INVASIVELY
PT implications for cardiac cath…
Since femoral ARTERY is accessed, pressure needs to be placed on area how many hours after procedure?
4-8 hours
Post cath, patients are typically on bed rest with LE in what position?
In knee immobilizer
Ergonovine stimulation is an important diagnosis test for what?
Coronary spasm
Where are ergonovine stimulation tests performed?
In the cath lab or in CCU
Bronchography is needs for the eval and management of what?
Some congenital pulmonary anomalies as well as some acquired diseases
A bronchography is looking at gross pathological changes in the ….
Bronchial wall and lumen
In a bronchography is contrast needed?
Yes to study the airways
What is performed more, bronchography or bronchoscopy?
Bronchoscopies and CT scans are performed more
What does a bronchoscopy assess for?
Infection that cannot be evaluated from a sample
Assesses malignancy
What tool is occasionally used to clear viscous secretion or to retrieve a foregn object
Bronchoscopy
