TEE and Stress Flashcards
What does TEE stand for?
Transesophageal echocardiography
What is the definition of TEE?
A diagnostic test using an ultrasound device that is passed into the esophagus of the patient to create a clear image of the heart.
What is an endoscope?
An instrument used to examine the inside of a body cavity or organ
What is a gag reflex?
A normal reflex consisting of elevation of the palate, retraction of the tongue, and contraction of the throat muscles
Regurgitation
Backward flow of blood through a partially closed valve
What is a transducer?
A device that converts electrical signals into ultrasound waves and ultrasound waves back into electrical impulses
What is ultrasound?
Sound waves at a frequency of 20,000 Hz, often used for diagnostic imaging
TEE is often superior to transthoracic echo when evaluating ____ and ____
Valves and regurgitation
What is the test of choice for assessing endocarditis, aortic dissection, PFO/ASD’s, prosthetic valves, left atrial blood clots?
TEE
Patients should not eat or drink ____ hours prior to procedure
4-6
How long does a TEE last?
30-60 minutes
What is the job of the sonographer during a TEE?
- Second set of eyes for the physician to help when looking for pathology.
- Run the machine and take measurements as needed.
- Assist in keeping the physician on task and make sure nothing is forgotten during the exam
What are the four things Dobutamine stress echo is used for?
- Determine how well the heart tolerates stress or exertion
- Evaluate the function of the heart & valves
- Evaluate the effectiveness of the cardiac treatment plan
- Determine the likelihood of having coronary artery disease & the need for further testing
What images are taken during a stress echo?
Rest and post exercise:
- PLAX
- PSAX, mid-ventricular level
- 4 chamber
- 2 chamber
During a stress echo, patients with ____ ____ ____ may have minimal or no symptoms during rest
Coronary artery blockages
During exercise, healthy coronary arteries ____ more than an artery with a blockage
Dilate
Narrowed arteries supply ____ flow to it’s area of distribution
Reduced
This reduced flow, caused from narrowed arteries, causes the involved muscle to ____ during exercise
“starve”
What are the indications for stress echo?
- Chest pain of unknown origin
- Shortness of breath
- Abnormal EKG
What does it mean to have exercise related dysrhythmias?
A person may have a dysrhythmia during exercise but show no wall motion abnormality
During the Bruce protocol, the speed of the treadmill and it’s slope or inclination is increased every ____ minutes.
3
During the Bruce protocol, the treadmill is abruptly stopped when the patient exceeds ____% of the target rate
85%
During a stress echo, EKG recordings are made during every ____ of exercise and then again after exercise is stopped
Minute
During a stress echo, the blood pressure is recorded at ____ minute intervals during exercise and then again at rest
Three
During a stress test, the Echo images must be acquired within ____ seconds
60
What are the advantages of a treadmill stress echo?
- Gives useful clinical info (ex. B.P. response, exercise capacity, arrhythmias)
- Used commonly
- Simple protocol
What are the disadvantages of a treadmill stress echo?
- Unable to acquire adequate images during exercise
- Rapid recovery
