non-invasive cardiac disease

Question 1

how to classify chest pain

Answer 1

1. location
2. with exertion?
3. relived with rest or NTG

Question 2

which type of stress test is the gold standard?

Answer 2

exercise stress test

Question 3

what is the goal HR in exercise stress test?

Answer 3

85% of Target HR (220 – age)

Question 4

patients with INTERMEDIATE PRE-TEST PROBABILITY of stable ischemic heart disease;INTERPRETABLE EKG AND AT LEAST MODERATE PHSYICAL FUNCTIONING OR NO DISABLING COMORBIDITY

Answer 4

class I of 2012 ACC/AHA recommendations

Question 5

low pre-test probability; interpretable EKG and at least moderate physical functioning or no disabling comorbidity

Answer 5

class IIa of 2012 ACC/AHA recommendations

Question 6

what is a positive rsponse on exercise stress test?

Answer 6

horizontal or Downsloping ST depression >1mm

Question 7

what type of test to use when patients can exercise but ekg is non interpretable?

Answer 7

exercise echo

Question 8

which test is specific for triple vessel disease?

Answer 8

exercise echo

Question 9

what to use when patient can’t walk, can’t exercise

Answer 9

dobutamine stress test

Question 10

contraindications for dobutamine stress test

Answer 10

unstable angina, recent MI, SBP 200, Hx of ventricular tachyarrhythmias, severe AS, HOCM, large aortic aneurysm or dissection

Question 11

what is the most sensitive and specific stress test?

Answer 11

dobutamine stress echo

Question 12

contraindications for vasodilator stress test (adenosine)

Answer 12

severe asthma, COPD, SBP

Question 13

whe to use radioactive tracer?

Answer 13

high risk patients–see how much myocardium is involved

Question 14

what is the gold standard test for those who are at very high risk?

Answer 14

PET scan