Imaging Flashcards
What should be ordered for almost all patients presenting with chest pain or dyspnea?
Chest x-ray
CXR has low sensitivity for the detection of _____ heart disease, but some findings have fairly high specificity (e.g. for ____ enlargement).
CXR has low sensitivity for the detection of structural heart disease, but some findings have fairly high specificity (e.g. for chamber enlargement).
CXR is sensitive for the detection of _____ processes that result from cardiac disease.
CXR is sensitive for the detection of pulmonary processes that result from cardiac disease.
e.g. pulmonary edema, pleural effusion
What is echocardiography?
Basically a cardiac ultrasound
High frequency (ultrasonic) waves generated by a piezoelectric element travel through the body
These waves are reflected at interfaces where there are differences in the acoustic impedance of adjacent tissues.
The reflected waves return to the transducer and are recorded, then processed into an image.
What is M Mode echocardiography?
A form of echocardiography based on one-dimensional (“ice-pick”) analysis of the heart in motion.
Provides both high spatial and temporal resolution, and it is used to measure the thickness of the ventricle walls and the volumes of cardiac chambers.
Not really used much anymore.
What is 2D echocardiography?
Have 2 primary probe positions, with multiple angulations (multiple ultrasonic beams are transmitted from transducer through a wide arc). The returning signals are integrated to produce 2D images of the heart on a video monitor.
Most used method today.
Identify the chambers shown in this image:
Identify the chambers shown in this image:
Identify the chambers shown in this image:
What is color flow doppler imaging?
Depicts blood flow direction and velocity
Identifies regions of turbulent (i.e. high velocity) flow
Particularly useful for assessing valvular abnormalities (regurgitation and stenosis)
Transesophageal echocardiography:
Patient is mildly sedated for outpatient procedure. Echo probe is passed down the esophagus (and into the stomach).
Gold standard for exclusion of intracardiac (especially left atrial appendage) thrombus. Optimal imaging for left-sided (mitral and aortic) valves.
Also used in cardiac surgery cases
An echo should be ordered for all patients who present with ____ or ____.
An echo should be ordered for all patients who present with new heart failure or dyspnea of unclear etiology.
A(n) ____ is the ideal diagnostic study to evaluate the structure and function of the heart.
A(n) echo is the ideal diagnostic study to evaluate the structure and function of the heart.
_____ is the gold standard for evaluation of valvular structure and function.
Echocardiography is the gold standard for evaluation of valvular structure and function.
Risk of toxicity with echo?
No inherent risk or toxicity
Low-intermediate expense
What does this image show?
Note the uniform uptake of tracer at rest, with areas of poor uptake after stress.
The images are processed and presented in multiple orthogonal views.
In this case, the ischemia is in the lateral wall and apex.
Right heart vs. left heart catheterization:
Right Heart Catheterization (RHC or Swan Ganz): performed via the venous route to measure pressures on the right side of the heart and out into the pulmonary artery (lungs)
Left Heart Catheterization (LHC): Performed via the arterial route to perform an angiogram (shoot dye) into the coronary arteries, but can also look at pressures on the left side of the heart
Cardiac MRI creates both ____ and ____ pictures of your heart and major blood vessels
Cardiac MRI creates both still and moving pictures of your heart and major blood vessels
