Stress Echo

Question 1

In multivessel disease what modality is best?

1. Stress echo
2. Nuclear stress

Answer 1

Stress echo

Question 2

A stress echo is to induce_____ with transient ___ that may result in a ____ seen on echo

Answer 2

Ischemia, exercise, RWMA

Question 3

True or false - a stress echo may be done post MMI for evaluation

Answer 3

True

Question 4

True or false a stress echo can be done post PTCA evaluation?

Answer 4

True

Question 5

What does PTCA stand for?

Answer 5

Percutaneous transluminal, coronary angioplasty

Question 6

True or false a stress echo can be done for a non-cardiac surgery preop for assessment of function

Answer 6

True

Question 7

List the six indications for a stress echo

Answer 7

-diagnosis of Angina
-Severity of CAD
-guiding post MI rehab
-Evaluating arrhythmias
-Postop heart transplant evaluation
-screening asymptomatic patient with many symptoms and risk factors

Question 8

What five things are we looking for on a stress echo analysis

Answer 8

-regional wall motion
-Systolic wall thickening
-wall motion score
-EF
-Doppler velocities

Question 9

What are four things were looking on our EKG interpretation of the stress echo

Answer 9

-duration of exercise
-exercise induced hypotension or arrhythmias-ST - ST segment elevation
-ST segment, depression, duration, and degree

Question 10

Derek, our image interpretation we should have captured a systolic frame with ——- msec intervals

Answer 10

40-80

Question 11

Image interpretation of a stress echo should have a continuous format with ___ speed playback with limited ____ inference and limited heart ____

Answer 11

Variable ; respiratory; motion

Question 12

What is a normal stress echo response/characteristics?

Answer 12

-hyperdynamic walls
-systolic, thickening in systole
-decreased systolic cavity when the LV squeezes
-Normal diastolic dimensions

Question 13

What are some reasons to stop a stress test?

Answer 13

-angina
-WMA
-Significant arrhythmias
-Hypertension
-Hypotension
-max dose reached
-max rate reached

Question 14

What are three reasons of stress echo can be a false positive

Answer 14

-cardiomyopathy
-Left bundle branch block
-A false interpretation and reading

Question 15

What are some contraindications to echo stress test

Answer 15

-A recent acute MI
-Unstable angina
-Uncontrolled arrhythmias
-Acute aortic dissection
-Severe aortic stenosis
-Acute pulmonary embolus

Question 16

What would be a contraindication to performing a stress test on an athlete with chest pain?

1. Left bundle branch block.
2. Systolic murmur.
3. Unstable angina.
4. Dyspnea on exertion.

Answer 16

3.

Question 17

What are five reasons for a false negative stress test

Answer 17

-delayed obtaining post images
-Patient reached less than 90% of target heart rate
-there is less than 25 to 50% stenosis
-Collateralls
-False interpretation

Question 18

What are some hints for image acquisition during a stress test?

Answer 18

-have a steady hand
-Be quick with your speed of acquisition
-Patient cooperation with shallow breathing, and minimizing motion
-marked windows
-EKG to allow frame capture gating

Question 19

What three medications can be used during a pharmacological stress test

Answer 19

-Donutamine
-adenosine
-dipyridamole

Question 20

What medication may be given during a peak dose at the target heart rate is not reached?

Answer 20

Atropine

Question 21

What’s a cateecholamine?

Answer 21

Hormones that are responsible for our fight or flight response

Question 22

Donutamine is a ?

Answer 22

Synthetic catecholamine

Question 23

_____ is given if at peak dose the target heart rate hasn’t been reached

Answer 23

Atropine