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Year 3: CardioPulm Rehab > Lecture 6: CV Outcome Measures and Diagnostics > Flashcards

Lecture 6: CV Outcome Measures and Diagnostics Flashcards

1
Q

validity

A

does test measure what It intends to

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2
Q

reliability

A

how repeatable is test

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3
Q

sensitivity to change

A

ability to statistically detect change over a period of time

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4
Q

responsiveness to change

A

detection of clinically relevant change

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5
Q

minimal detectible change

A

amount of change that exceeds measurement error

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6
Q

minimal clinically important difference

A

amount of change needed to determine if clinical change can be achieved

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7
Q

purpose/benefits of gait speed with CV patients

A

almost perfect measure for CV pts

pts with chronic HF
- < 0.65m/s = increase risk of all cause mortality

  • <0.8 m/s = increase risk of all cause hospital admission

MCID = 0.05-0.12 m/s

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8
Q

6 minute walk test relevance with CV patients and average values for HF pts

A

submax

can easily convert to METs and VO2 max

average distance for pt with chronic HF = 310-427m
- less that 300m indicates poor prognosis
- less than 200m predicts hospital/mortality

30-50m improvement = positive effect on mortality

80m = QOL benefit

MCID = 54m

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9
Q

TUG normal values/interpretation

A

stand in chair, walk 3 m, turn and return to sit

normal = 8.2s

> 13.5 sec = increased fall risk

reliable and valid with HF

slower speeds associated with increased mortality and CVD risk

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10
Q

5x STS or 30 sec STS values for further assessment of fall risk

A

> 12 seconds for 5xSTS = need further fall risk assessment

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11
Q

what is short physical performance battery test and important values

A

combines balance, STS, and gait speed

better for lower functioning pts

MCID = 1 point

<10/12 predicts increased mortality

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12
Q

what is Activity Measure for Post Acute Care (AMPAC “6 clicks”)

A

widely used in acute care settings to predict discharge destinations and functional impairment levels

medicare uses for approval/denial

<17/24 = might need post acute rehab

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13
Q

health related quality of life measures

A

medial outcomes study short form (SF-36)

Minnesota Living with Heart Failure Questionnaire (LHFQ)

Seattle Angina Questionnaire (SAQ)

Kansas City Cardiomyopathy Questionnaire (KCCQ)

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14
Q

indications for ECG

A

cardiac arrhythmias
ischemia
structural damage
heart failure
pre-op clearance
medication adjustments/interactions
following device placement/procedures

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15
Q

what is a Holter monitor

A

continuous ambulatory 24 hr monitor of heart activity

can be work for up to 30 days

various options for recording in correlation with S&S

event recording button

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16
Q

indications for Holter Monitor

A

arrhythmia
palpations
unexplained dizziness/syncope
assessment of ICD function

17
Q

purpose of chest X-ray

A

cannot see internal structures

good way to view fluid accumulation

18
Q

indications for chest X-ray

A

heart failure
pulmonary edema
cardiomegaly
post-op CT sx
device placement
post extubation

19
Q

what is an echocardiogram

A

US of heart to assess structure and function

can detect atrial and ventricular size, cardiac mm function, valve function, heart chamber thickness, and movement

real time images of beating heart

estimates EF, SV, and flow rates

20
Q

indications for echocardiogram

A

valve conditions, congenital heart disease, thrombus, ischemia, cardiac mm dysfunction, cardiomyopathy, aortic dissection

21
Q

transthoracic echo (TTE) vs transesophageal echo (TEE)

A

TTE
- noninvasive
- anterior superior view of heart

TEE
- invasive
- requires anesthesia
- posterior and inferior view of heart
- used for more accurate and closer view of cardiac structures

22
Q

contrast echo

A

injected contrast allows for improved resolution and more accurate cardiac blood flow

helps detect cardiac effects

can look closely at coronary blood flow without more invasive diagnostics

23
Q

MRI

A

evaluates cardiac form and structure, cardiac blood flow and myocardial contractility

similar diagnostic accuracy as PET imaging but less expensive and more available

higher chance of contraindications

24
Q

MRA

A

magnetic resonance angiogram

MRI imaging with IV contrast to evaluate vasculature

25
Q

CT

A

used to identify structural defects of heart, aorta, and other large vessels

can be performed with or without IV contrast depending on indication and comorbidities

26
Q

PET scan

A

positron emission tomography

nuclear imaging that can detect glucose uptakes, blood flow, and cardiac metabolism

noninvasive, can assess jeopardized but viable myocardium without exercise

not as accessible, expensive, requires equipment

27
Q

cardiac catheterization

A

invasive

diagnosis or management of cardiac disease

femoral or radial arterial access

he’s identify further medical management interventions needed

typically performed pre CT sx

28
Q

indications for cardiac Cath

A

CAD
heart failure
cardiac arrest
valve disease
angina
worsening of exercise tolerance
pending organ donation

29
Q

how does a cardiac Cath work

A

IV contrast injected into heart chambers and coronary arteries

fluoroscopy used to view and measure pressures, blood flow, chambers, vessels, and valves

stents can be placed during same procedure

30
Q

information that can be obtained from cardiac Cath

A

presence of/severity of CAD, % stenosis or block

valvular heart disease and severity of dysfunction

pericardial disease

cardiac output, ejection fraction

shunts, structural heart defects

chamber pressures

pulmonary artery pressures

31
Q

what does cardiac Cath predict well

A

greater predictive accuracy in assessment of CAD than exercise testing

Riley to be on bedrest for 4-6 hours after procedure

32
Q

what is an endocardial biopsy

A

samples of endocardium can be obtained at time of cardiac Cath

usually taken from ventricle or at intraventricular septum

determines myocardial rejection in pts with heart transplant

33
Q

indications for endocardial biopsy

A

cardiac transplant
sarcoidosis
amyloidosis
myocarditis
cardiomyopathy
tumors
genetic conditions

34
Q

ankle brachial index

A

compares BP in posterior tibialis or dorsalis pedis to brachial artery

represents % of blood reaching feet

used to diagnose degree of PAD, determine likelihood of tissue healing

35
Q

doppler ultrasound

A

sound waves used to determine degree of blood flow

especially useful in small or diseased vessels

various variations of device

indications = DVT, endothelial injury, arterial occlusion, aneurysm, venous insufficiency

36
Q

carotid ultrasound

A

used to detect ischemia or measure blood flow to brain

indications: new CVA, PAD, cardiac arrest, syncope

Year 3: CardioPulm Rehab (20 decks)

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