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DMST 367 Echo 3 > Invasive procedures ASYNC > Flashcards

Invasive procedures ASYNC Flashcards

1
Q

What is pericardiocentesis?

A

Invasive procedure in which the physician removes (aspirates) a build up of fluid from the pericardium

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2
Q

Why would we use pericardiocentesis?

A
  1. Diagnostic purpose
  2. Therapeutic purpose
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3
Q

What is the diagnostic purpose behind pericardiocentesis?

A

Identify the types of fluid for things like
1. Hemopericardium
2. Infection vs cancer

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4
Q

When would we use pericardiocentesis?

A

Can be scheduled or emergent based on purpose

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5
Q

The pericardium normally contains how much fluid?

A

20-50cc of straw colored fluid

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6
Q

Color of pericardial fluid can be what?

A
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7
Q

What is the role of echo for pericardiocentesis? 4

A
  1. Confirm location and size of pericardial fluid
  2. Identify view with largest pocket, closest to the chest wall
  3. Confirm needle placement
  4. Reassess fluid post procedure
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8
Q

In terms of pericardiocentesis, when identifying view with the largest pocket, what views are best?

A
  1. Usually apical is best
  2. May include off axis views
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9
Q

What needs to be considered when confirming needle placement with pericardiocentesis?2

A
  1. Needle may be seen in all patients on the echo
  2. agitated saline can be injected to view needle positions
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10
Q

What does this image represent?

A

Air bubbles injected to confirm needle locations

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11
Q

What does this image represent?

A

Pericardiocentesis

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12
Q

What can be associated with Pericardiocentesis?

A

Tumors

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13
Q

What does this image represent?

A

Pericarditis with constriction

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14
Q

What are risks of pericardiocentesis? 6

A
  1. Cardiac arrest
  2. Arrhythmias
  3. Air embolism
  4. Infection of the puncture site
  5. Infection of the pericardium
  6. Perforation
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15
Q

What are some arrhythmias heard with pericardiocentesis?

A

SVT, AF, VT, ventricular fibrillation

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16
Q

What is air embolism with pericardiocentesis?

A

RT heart perforation

17
Q

Where do we see perforation with pericardiocentesis?

A
  1. Lung
  2. Liver
  3. Coronary artery
  4. Heart (RV or LV)
18
Q

What does this image represent?

A

Large pericardial effusion

19
Q

What is a reliable diagnosis for heart transplant rejection?

A

Myocardial biopsy

20
Q

What is the level of risk for myocardial biopsy?

A

Low risk

21
Q

How invasive is Myocardial biopsy?

A

Invasive, May cause some patient discomfort

22
Q

Non-invasive diagnostic methods have reduced the need for biopsies, what are some? 3

A
  1. Nuclear scans
  2. RV strain
  3. Cardiac MRI
23
Q

Myocardial biopsy is performed with what?

A

Local anesthesia

24
Q

In terms of myocardial biopsy, venous sheath is placed where?

A

In the RT IJV

25
Q

In terms of myocardial biopsy, how many specimens are obtained?

A

Multiple specimens are obtained from different sites within the RV, Tissues samples are then sent to the lab for analysis of tissue

26
Q

What are pacemakers?

A

Small electronic device that regulates the heart rate by sending electrical signals to the heart

27
Q

How many leads are in pacemakers?

A

1 or 2 lead systems

28
Q

What are the two parts of a pacemaker?

A
  1. Battery unit
  2. Wire
29
Q

What is part of the battery unit of the pacemaker?

A

Small metal case that contains the power source and regulates how often signals are sent

30
Q

What is part of the wire system of the pacemaker?

A

Carries electrical message back and forth between the heart and the pacemaker

31
Q

What is the size of the pacemaker?

A

Device is about the size of 2 toonies put together and weighs a bit more than an ounce

32
Q

When is a pacemeaker required?

A
  1. Symptomatic bradycardia (Most common)
  2. Patients with serious, uncontrollable arrhythmias
33
Q

Intra cardiac defibrillators (ICD) uses what?

A

Leads (wires threaded into the heart’s chambers) to monitor every heart beat

34
Q

If a lethal rhythm appears with ICDs what happens?

A

The defibrillator shocks the heart back to a normal rhythm
1. V-tach
2. V-flutter
3. V-fib

35
Q

Who has a defibrillator?

A
  1. Heart attack survivors with low ejection fraction
  2. Patients at high risk for sudden cardiac death (SCD)
  3. Patients post MI
36
Q

Lead perforation can affect what?

A
  1. Pacemakers and defibrillators
  2. Wire migration
37
Q

What does this image demonstrate?

A

Implantable defibrillator lead perforation of the RV apex

DMST 367 Echo 3 (27 decks)

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