Exam 2: Wk 1: Surgical Tx Of Pts With CAD

Question 1

3 major purposes of GXT

Answer 1

• detect ischemic heart disease under controlled conditions
• detect exercise endured arrhythmias
• evaluate hemodynamics during exercise

Question 2

Pharmacological Stress testing (ALTERNATIVES TO GXT)

Answer 2

Dipridamole and Adenosine: dilate healthy arteries (unhealthy arteries do not dilate)

Dobutamine: increases mVO2

Question 3

Echocardiography

Answer 3

Noninvasive realtime imaging of valve function and dimensions of the heart

Ultrasonographic imaging of heart

Question 4

Transesophageal Echocardiography (TEE)

Answer 4

Goes down esophagus to get a better view without the ribs being in the way

Question 5

Rapid Computed tomography views what ?

Answer 5

Early calcification of coronary vessels

Question 6

Thallium 201

Answer 6

Injection of thallium 201 (stress test)
Shows size of heart chambers, how effective heart pumps, myocardial profusion, or scarring

• taken up by metabolically active myocarditis in proportion to blood flow

Question 7

Cold spots found in thallium 201 stress test indication

Answer 7

• indicative of ischemia if DURING exercise
• no viable myocardium if they occur AFTER exercise

Question 8

Angiogram

Answer 8

When a dye is injected into a vessel and X-rays are used to determine blood flow in coronary arteries

Question 9

Ventriculography

Answer 9

• determines a patients cardiac function by measuring how much blood is pumped out
• estimates SV, Ejection fraction, chamber pressures, and presence of stenosis or regurgitation

Question 10

Tests for ventricular size and function

Answer 10

• chest X-ray
• muga

Question 11

MUGA

Answer 11

Multi-gated acquisition scan
- used to calculate LV EF
- noninvasive
- radioactive tracer injected

Question 12

SPECT or PET

Answer 12

Myocardial perfusion imaging (GAMMA ray detection)

Question 13

CABG - coronary artery bypass graft

Answer 13

Creation of bypasses around the narrowed areas using grafts
- uses saphenous vein in leg

Question 14

Consequences of CABG Saphenous VG

Answer 14

• infection of chest and LE from length of procedure and hemotoma; patient may be unwilling to move affected LE

Question 15

What is an alternative to CABG saphenous VG ?

Answer 15

Using the radial artery or internal mammary arteries

Question 16

MIDCAB - minamilly invasive direct coronary artery bypass

Answer 16

Much smaller incision ; surgery similar to arthroscopic surgery

Question 17

PCI or PTCA

Answer 17

Balloon tipped catheter inserted into the occluded vessel and inflated to restore patency of vessel (long term affects not as good as CABG)

Question 18

STENT

Answer 18

Wire device placed with balloon tipped catheter opened within the occluded vessel to maintain patency (may be coated to reduce risk of reocclusion)

Question 19

How many hours of bed rest after CABG

Answer 19

3 hours to prevent bleeding and hematoma at the groin due to vascular access