ICL 5.4: Cardiac Imaging Flashcards

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1
Q

which tests are used to evaluate the heart electrical system?

A
  1. EKG
  2. holter.event recorder/ILR
  3. electrophysiology study/ablation
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2
Q

which tests are used to evaluate chest orientation/size?

A

CXR

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3
Q

which tests are used to evaluate the coronary arteries?

A
  1. stress testing
  2. CT coronary anatomy
  3. MRI
  4. cardiac catheter
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4
Q

which tests are used to evaluate the heart valves and muscles?

A
  1. echo
  2. TEE
  3. CT
  4. MRI
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5
Q

which tests are used to evaluate the heart vasculature?

A
  1. ultrasound
  2. MRA
  3. angiography
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6
Q

what are the indications to get an EKG?

A
  1. chest pain/possible myocardial Ischemia
  2. palpitations/Arrhythmias
  3. unexplained syncope/preSyncope
  4. MI
  5. CHF (systolic and diastolic)
  6. antiarhythmic drug evaluation
  7. permanent paceMaker (PPM) or internal cardiac defibrillator (ICD) evaluation
  8. cardiomyopathy
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7
Q

what are Holter monitors?

A

ambulatory motors that check heart rhythm 24/7 for 1-3 days –> if you need to measure for longer use an event recorder which works for up to 30 days

you’re not recording a 12 lead EKG but you still will see a P,T and QRS

it’s the snow above grass, fire above coal, chocolate in the middle – white on right

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8
Q

what is an ILR?

A

ILR = internal loop recorder that’s a subcutaneous implant over the heart tissue that monitors heart rhythm 24/7 and sends info to a website

this is used when symptoms occur less than monthly

also use them in people who have had a cryptogenic stroke aka we don’t know why it happened so you put them in to see if Afib might have bee the reason

can use up to 3 years

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9
Q

what is an electrophysiology study?

A

we want to check the conduction system in the heart which sits in the endomyocardium

we can put catheters in the high RA kind of mimicking the SA nodes

then we put a second catheter right where the AV node is to find where the His bundle depolarization is

then the third catheter goes into the coronary sinus

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10
Q

what will you see on a CXR of a HF patient?

A
  1. wide mediastinum
  2. fluid in alveoli
  3. curly B lines coming off the ribs
  4. pulmonary edema = fluff
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11
Q

what are the indications to get an echocardiography?

A
  1. chest pain
  2. symptoms of HF: DOE or SOB at rest
  3. palpitations/Arrhythmias
  4. syncope
  5. murmur
  6. abnormal ECG
  7. suspect LV structural changes/damage

helps you evaluate LV and RV function

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12
Q

what are the special indications for the use of an echo?

A
  1. masses, tumors, myxoomas
  2. embolic source for stroke or TIA
  3. endocarditis
  4. congenital heart disease
  5. cardiac device evaluation
  6. screen 1st degree relative of cardiomyopathy
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13
Q

what is the continuity equate in a closed flow system?

A

A1 x V1 = A2 x V2

done with a doppler echo

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14
Q

what are the indications for the use of a TEE?

A
  1. further valve assessment
  2. embolic source for cause of stroke or TI because great view of left atrial appendage
  3. further asses PFO, ASD, VSD
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15
Q

if someone has palpitations or syncope what test do you do?

A

ECG and 30 day event recorder before ILR

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16
Q

if someone has edema what test do you do?

A

evaluate veins before echo

17
Q

if someone has HTN what test do you do?

A

EKG and if abnormal then do echo

18
Q

if someone has chest pain what test do you do?

A

EKG because ordering echo or stress test

19
Q

what high risk conditions do you need to refer to a cardiologist?

A
  1. chronotropic incompetence
  2. exercise induced arrhythmias or syncope
  3. prior to anti arrhythmic drugs
  4. positive CTA with high burden Ca+2
  5. new cardiomyopathy with LV above 40%
  6. non cardiac transplant evaluation
20
Q

what is the ankle brachial index?

A

the BP in the upper vs. lower extremities to see if there’s blockages in the lower extremities

.99-1.30 is normal

  1. 91-0.99 is borderline PAD
  2. 41-0.9is significant PAD

0-0.4 is severe PAD

be careful with DM because their arteries can calcify and that means the vessels can’t be compressed so you can’t get an accurate ABI since the BP cuff won’t work since it can’t compress