Diagnostics In Cardiology Flashcards
With a Holter monitor, patients keep a symptom diary and it is compared to their data. How often do these match up?
Very rare. Patients are mostly asymptomatic during recording peroid.
Which test is described as subcutaneous monitoring device
Implantable loop recorder
I want to evaluate my patient for septal defect or a patent foramen ovale. What test should I order?
Transesophageal Echocardiogram TEE
My patient might have myocarditis. What test should I order?
YOU shouldn’t order anything. The cardiologist will order an MRI
What are the cardiac enzymes that can be tested. which one is used the most often
CK (creatine kinase)
CK-MB
Troponin (used most often)
Which diagnostic exam is continuous ECG monitoring on a video screen
Telemetry
Why is a CT scan not that useful in cardiac diagnostic
Motion of the heart
What test should be done post-resuscitation from a cardiac arrest
Catheterization/angioplasty
You want to give your patient Dobutamine for a stress test, but they have ___________ so you cannot.
AFib
LBBB
My patient has unstable angina, what test should I order
Catheterization/Angioplasty
What are the risks associated with catheterization/angioplasty
Bleeding
Arrhythmia
Vessel injury
Post-procedure bleeding
I want to determine the chamber size of my patient. What test should I order?
Transthoracic Echocardiogram TTE
I want to evaluate my patient for ascending aortic atherosclerosis. What test should I order?
Transesophageal Echocardiogram TEE
Which test is an ultrasound directed AT the heart
Transthoracic Echocardiogram
What device is used to detect the tracer in a nuclear medicine imaging stress test
Gamma ray detection camera
Which diagnostic test is the gold standard for CAD
Cardiac catheterization/ angiogram
Which test should I order to monitor ST segment abnormalities
Holter Monitor
With an event recorder, the patient must activate themselves when they are symptomatic. What time frame does the recorder capture
Previous 2-5 min + next few min
Does my patient have endocarditis? Not sure, so I’ll order this test:
Transesophageal echocardiogram TEE
I want to evaluate my patient for myocardial motion. What test should I order?
Transesophageal Echocardiogram TEE
When is the peak of cardiac enzymes
18-24 hours
What type of patient would get an implantable loop recorder
Infrequent symptoms
Syspected arrhythmia + non-invasive tests were negative
In catherterization/Angiogram, dye is injected into the groin arm or neck, and patetncy is viewed via
Fluoroscopy
What is the difference in deteching ischemia between an exercise ECG stress test and nuclear medicine imaging stress test
Nuclear medicine imaging can detect the specific areas of ischemia, location/size of the injured muscle, and narrowing arteries whereas exercise ECG cannot
I suspect valvular pathologies on my patient. Which tests could confirm this
Transesophageal Echocardiogram TEE
Transthoracic Echocardiogram TTE
What type of ischemia would you be testing for if you ordered an echocardiogram stress test
Ischemia related to development of wall motion abnormality with stress
I had my patient do a stress test, and they experienced angina. What do I do now?
Catheterization/Angioplasty
Which diagnostic test is described as ambulatory ECG
Holter monitor
I’m thinking my patient has an aortic dissection. What tests could confirm this?
Transesophageal Echocardiogram TEE
CT scan
MRI
How does a stress test work
Increase myocardial oxygen demand to reveal hypoperfusion in diseased coronary arteries.
Compare to resting
What is a CT scan useful for
Thoracic aorta
Pericardium
Aortic dissection
Coronary artery calcium deposits
What is the difference between a Holter monitor and Event Recorder
Holter monitor = continuous 24-48 hours
Event recorder = needs activation from patient, 30-60 days
What can be used for pharmacologic stress if exercise is not possible
Adenosine
Dipyridamole
Dobutamine
An MRI can evaluate myocardial perfusion with a __________ contrast during ___________ stress
Gadolinium
Adenosine
What test should be done before valve surgery if they have chest pain or ECG changes
Catheterization/Angioplasty
I want to evaluate the valve function and structure of my patient. What test should I order?
Transthoracic Echocardiogram TTE
Which is the least expensive cardiac diagnostic test
ECG
My patient has a history of MI and current ECG changes. What do I do now?
Catheterization/Angioplasty
Holter monitor is best at detecting:
Syncope
Palpatations
Heart rate variability
ST segment
I want to calculate my patients ejection fraction. What test should I order?
Transthoracic Echocardiogram TTE
I want to evaluate the diastolic function of my patient. What test should I order?
Transthoracic Echocardiogram TTE
How long can creatine kinase (CK) and CK=-MB be detectable in the blood after a cardiac event
36-48 hours
I want to evaluate my patients wall motion after they had an MI. What test should I order?
Transthoracic Echocardiogram TTE
Which diagnostic test is a smaller ultrasound probe down the esophagus behind the heart
Transesophageal echocardiogram
How long can troponin be detected in the blood after a cardiac event
Up to 10 days
Which test is usually done FIRST
ECG
High sensitivity troponin can detect levels as low as
5 ng/dL
What is injected for a nuclear medicine imaging stress test
Thalium 201 or Technetium-99m
When performing an exercise stress test, what are you looking for?
ECG changes
Increased heart rate
Symptom development
When is ECG done as a solitary assessment
Almost NEVER
When is the onset of cardiac enzymes
3-12 hours
