Other Cardiac Diagnostic Tests Flashcards
What is Holter Monitoring?
- Continuous 24 hr EKG monitoring
- Ordered for detecting and assessing arrhythmias and for evaluating effectiveness of antiarrhythmic therapy
- used in both inpatient and outpatient
PT implications for Holter Monitoring
- know the pt is using one
- know the results and change treatment plan accordingly
What is an echocardiogram?
provides ultrasound images of the heart
allows visualization of abnormal cardiac anatomy and determination of abnormal cardiac function/physiology
List things that an echocardiogram will provide images for
- ventricle cavity size
- L ventricle volumes
- motions of individual segments of ventricular wall
- valve function
- motion of valves and heart muscle analysis
- interartial and intraventricular septa thickness/integrity
- heart muscle performance assessment
- estimated SV and EF
T/F: echocardiograms provide a real time image of a beating heart?
TRUE
can also provide info about blood flow
List and briefly describe the types of echocardiography
- Surface or transthoracic
- echo transducer is moved on the skin over the heart
- Transesophageal
- echo transducer is swallowed
- provides a very clear image of those heart structures and valves
- Stress
- imaging done while the pt is exercising or immediately afterwards (or both)
when is a transesophageal echo used?
who is it contraindicated for?
aka TEE
- used when image quality is confounded by obesity, chest deformities, pulmonary disease
- invasive, contraindicated for those with dysphagia.
- may cause breathing problems or bleeds
list additional types of echocardiographs (2)
what does the first one display?
What does the second one provide an assessment of?
- 3D echocardiography
- newest form
- displays intracardiac anatomy
- Contrast echocardiograph
- provides an assessment of aortic stenosis, pulmonary vein flow analysis
- improved diagnostic accuracy in assessing myocardial perfusion and ventricular chambers
echo report abbreviations
- IVS
- PW
- LVID
- RWT
- FS
- IVS → interventricular septum thickness
- PW → posterior wall thickness
- LVID → LV inside diameter
- RWT → Relative wall thickness
- FS → fractional shortening
- relationship between LV dimensions and EF
Describe what PET is
what are the main 2 things it measures?
what does it detect? (2)
Positron Emission Tomography
- measures cardiac metabolism (glucose, FFA) and blood flow of heart
- requires specialized equipment, highly trained personnel, very expensive
- uses a radioactive labeled glucose
- imaging allows for quantification and qualification of regional myocardial tracer distribution
- blood flow/areas of underperfusion
- detects tissue viability, and function
what is the gold standard assessment for blood flow measurement and metabolic assessment of the heart?
PET
List types of imaging of the heart
- PET
- Radionuclide perfusion imaging
- Thallium stress test
- MRI
- Coronary angiography
- CT
- CAT angiography
- Cardiac calcium scan
- Doppler ultrasound
- MUGA scan
what is radionuclide perfusion imaging?
What does it evaluate?
- evaluates cardiac perfusion and function at rest and during dynamic exercise and global and regional L ventricular systolic function
- commonly used Thallium-201
- follow radioactive labels as they move into cardiac tissue
- taken up by cardiac tissue based on coronary blood flow
- assesses blood flow and cell membrane intregity
- cells must be perfused and metabolic to be “hot”
describe a thallium stress test
- cardiac or nuclear stress test
- nuclear imaging stress test shows how well blood flows in the heart while exercises or at rest
what is an MRI?
Magnetic Resonance Imaging
- uses the movement of water molecules in a magnetic field to create an image
- originally used for assessing cardiac anatomy and congenital malformations and to ID masses/thrombi
what can an MRI currently be used for pertaining to cardiac disease?
- Currently evaluates:
- valvular disease
- cardiac shunts
- cardiac flow
- coronary artery anatomy
- evaluates morphology, blood flow, and contractility
what is a coronary angiogram?
- an X-ray examination of the blood vessels or chambers of the heart that have been perfused with a special dye (cardiac cath.)
- this fluid is visible via X-ray and the pictures obtained are called angiograms
what can a coronary angiogram help detect? (3)
- Presence and severity of:
- CAD
- LV, atrial, pulmonary vein, CA dysfunctions
- valvular heart disease
PT implications of left heart cathererization
- due to the arterial incision site (femoral artery), bed rest is recommended for 6-8 hours with involved LE straight
- knee immobilizer to minimize hip flexion
- monitor for groin hematomas and pain
PT implications of right heart catheterization
- used to dx right ventricular, atrial, and pulmonary artery impairments
- the incision site is generally via the external jugular vein and there are no activity restrictions
what is a CT scan?
Computer Tomography
- combine series of X-ray images taken from different angles around your body and uses computer processing to create cross-sectional images (slices) of the bones, blood vessels, and soft tissues inside your body
- provides more detail than plan X-rays do
- same as CAT scan
what is a CAT angiogram?
- A CT coronary angiogram is an imaging test that looks at the arteries that supply blood to your heart
- used to dx and treat blood vessel diseases and conditions
- invovles the use of contrast material
a CAT angiogram can be used to dx what conditions?
- aneurysms
- blockages
- blood clots
- congenital (birth-related) abnormalities of the cardiovascular system, including the heart
- disorganized blood vessels, such as vascular malformations
- vessel rupture or tears
what are cardiac calcium scans?
- uses special X-ray equipment to produce pictures of the coronary arteries to determine if they are blocked or narrowed by the buildup of plaque
- x-ray beam is sensitive to different intracellular Ca2+ content
- when calcium is present, the higher the score, the higher one’s risk of heart disease
interpretation of cardiac calcium scans
- zero = no plaque
- 1-10 = small amount of plaque
- 11-100 = some plaque
- 101-400 = moderate amount of plaque
what is a doppler ultrasound?
a noninvasive test that can be used to estimate the blood flow through your blood vessels by bouncing high-frequency soundwaves (ultrasound) off circulating RBCs. It turns sound waves into images
what can a doppler ultrasound show
- DVT
- blockage in arteries
- check blood flow in your veins, arteries, and heart
- locate aneurysms
what are MUGA scans?
- Creates video images of the lower chambers of the heart to check whether they are pumping blood properly
- it shows any abnormalities in the size of the chambers and in the movement of blood through the heart
- involves the use of a radioactive tracer
