Lecture 5: Cardiac Diagnosis

Question 1

admitting diagnosis is a medical diagnosis not a pt diagnosis

Question 2

Question 3

Question 4

Halter monitoring - ecg or electrical impulse of heart - looks just like ecg placement

usually outpatient - in hospital, there is telemetry

24-48 hours; abnormal symptoms - so its testing abnormal symptoms (heart palpations) over 24-48 hours. typically pt has button to click if they feel like they’re having symptoms

patients can push themselves to catch abnormnalities

monitors for symptoms of arrythmias

life threating arrythmia or heart blocks (block conduction)

Question 5

in the hospital this continuous monitoring is called telemtry

if you unplug telly it sets alarms off
* so be careful when this is attached inpatient
* might be portable

Question 6

chest x-ray
* most common radiography study
* helps determine heaert size, chambers, and major blood vessels
* need full inspiration to do chest x-ray

portiable chest xrays are more common now
* however, can only perform posterioranteior chest film on full inspiration

Question 7

chest x-ray
* indications: issues w/ heart, chest, ribs, and lungs
* full inspairtion!
* however, is only a 2D image

Question 8

this is dilated cardiomyopathy

Question 9

DOE = dyspnea on exertion

differential diagnosis list
* pulmonary effusion
* pneumonia - 1 lung, sob, dyspnea on exertion

tools to examine
* deep breathing
* pleural rub
* oscultations

interventions for pneumonia
* postural drainage
* coughing techniques
* manual therapy w/ postural drainage

Question 10

what is an echocardiography

pos in different ways to do this

Answer 10

ultrasound of the heart

can go down throat to get better view of valves

gives info on cardiac function / valves

tends to be 1D

Question 11

echocardiogram:
* noninvasive
* indications: Valvular dysfunction, chamber sizes, ventricular size, EF (can you tolerate surgery)
* Mitral and aortic valves are the most common - also pericardial effusions and hypertrophic cardiomyopathy
* it is also used during stress test to see perfusion of the heart (is the heart getting enough coronary perfusion)
* M-mode - LV, dimensions, wall thickness, EDV and ESV - so this is all what M-mode on the echocardiogram tells you

stress echo = to check if you’re getting enough coronary artery perfusion

Question 12

Echocardiogram:
* two dimension echo: dynamic images of cardiac motion - LV function, EF, EDV, wall motion
* three dimension echo - useful for more complex anatomy - think congential heart malformations

Question 13

What does a Doppler Echo do?

Answer 13

Detects velocity and direction of blood flow - in motion, not just a picture of the heart
* CO, BF through valves

velocity and direction of BF shown

Question 14

Transechocardiography
* invasive or non invasive
* indications
* useful for

Answer 14

invasive - US transducer is placed at tend of endoscope
* so goes down esophagus - has a better look at your valves, especially if you have a prosthetic valve

Indications: bandages, obese, ventilator, repair of heart valves
* because you wouldnt be able to see through banages
* too much tissue if they’re obese or they wouldnt be able to lie in certain ways

Useful for assess prosthetic valve function, infective endocarditis (inner lining and can impact valves) and aortic dissections

Question 15

Transechocardiography