Procedures (Investigations and Treatments) Flashcards
Echocardiogram
What are the different types?
1) Measures the structure and function of the heart, image built up from ultrasound waves reflecting off of the muscle/bones creating the picture.
2) 2-D –> valve structure and function, LV contractility, chamber size
3) Doppler –> Speed and direction of blood flow using Doppler effect - shows different colours on the image - looks for any chamber septal defects and valve regurgitation
Angiography
“Shows sites and severity of a blockage”
Catheter inserted into femoral/wrist artery
Dye infused to outline the blood vessels and show occlusion sites
X-Ray pictures used for analysis and diagnosis
Myocardial Perfusion Scan
Thallium is injected to detect for any ischaemic areas and determine if it is reversible from exercise to rest
Exercise/Stress test (Adenosine) then 45 min break to remove thallium, then at rest
X-Ray taken of the infusion areas to see where any ischaemic changes may lie
CT Scan
Calcium Score, CT Coronary Angiogram
“3D X-Ray image of the Heart”
2) Increased calcium in the heart = increased event likelihood
3) Way to diagnose for CAD, however HR needs to be well controlled by using Beta-Blockers - diagnosis cause of chest pain
MRI
What cannot be used when doing an MRI?
“Magnetic Resonance Imaging”
Gold standard non-invasive procedure
See the structure and function of the heart - mass
Can be completed at rest/exercise (stress)
Cannot use with pacemakers or ICD’s
Coronary Angiography
1) Catheter placed through and dye infused to locate area of occlusion
2) Balloon slowly inflated and squishes the fatty deposits against the arterial wall
3) STENT left in to widen the vessel and keep blood flow moving more smoothly
4) Must take aspirin and blood thinning agents for 6 months post to a year
5) STENT gives reduced risk of re-stenosis
CABG
“Coronary Artery Bypass Graft”
1) Artery or vein grafted onto the coronary artery to bypass any narrowed areas
2) Single/Double/Triple bypass dependent on how many narrowed areas towards the heart
3) Open sternotomy, plugged into bypass machine
4) 6-8 week recovery time
ECG
Electrocardiogram
Gives 360 degree view of the hearts electrical activity, can be done at rest or exercise and commonly used procedure, 12-leads
Inform us on rhythm, HR and activity
PQRST - shows atrial and ventricular de and repolarisation
Normal rhythms are sinus - but can be tachy or brachy
Common abnormalities = MI, Ischaemia, Fibrillation, Heart blocks, bundle branch blocks
Exercise Tolerance Test
Used to determine if there is ischaemia present
Bruce test - full and modified
Test termination = ST elevation/depression, reach max HR, arrhythmias, SBP decreases
From this get a Duke Treadmill Score
