TEE and Stress

Question 1

What does TEE stand for?

Answer 1

Transesophageal echocardiography

Question 2

What is the definition of TEE?

Answer 2

A diagnostic test using an ultrasound device that is passed into the esophagus of the patient to create a clear image of the heart.

Question 3

What is an endoscope?

Answer 3

An instrument used to examine the inside of a body cavity or organ

Question 4

What is a gag reflex?

Answer 4

A normal reflex consisting of elevation of the palate, retraction of the tongue, and contraction of the throat muscles

Question 5

Regurgitation

Answer 5

Backward flow of blood through a partially closed valve

Question 6

What is a transducer?

Answer 6

A device that converts electrical signals into ultrasound waves and ultrasound waves back into electrical impulses

Question 7

What is ultrasound?

Answer 7

Sound waves at a frequency of 20,000 Hz, often used for diagnostic imaging

Question 8

TEE is often superior to transthoracic echo when evaluating ____ and ____

Answer 8

Valves and regurgitation

Question 9

What is the test of choice for assessing endocarditis, aortic dissection, PFO/ASD’s, prosthetic valves, left atrial blood clots?

Answer 9

TEE

Question 10

Patients should not eat or drink ____ hours prior to procedure

Answer 10

4-6

Question 11

How long does a TEE last?

Answer 11

30-60 minutes

Question 12

What is the job of the sonographer during a TEE?

Answer 12

• 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

Question 13

What are the four things Dobutamine stress echo is used for?

Answer 13

• 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

Question 14

What images are taken during a stress echo?

Answer 14

Rest and post exercise:
- PLAX
- PSAX, mid-ventricular level
- 4 chamber
- 2 chamber

Question 15

During a stress echo, patients with ____ ____ ____ may have minimal or no symptoms during rest

Answer 15

Coronary artery blockages

Question 16

During exercise, healthy coronary arteries ____ more than an artery with a blockage

Answer 16

Dilate

Question 17

Narrowed arteries supply ____ flow to it’s area of distribution

Answer 17

Reduced

Question 18

This reduced flow, caused from narrowed arteries, causes the involved muscle to ____ during exercise

Answer 18

“starve”

Question 19

What are the indications for stress echo?

Answer 19

• Chest pain of unknown origin
• Shortness of breath
• Abnormal EKG

Question 20

What does it mean to have exercise related dysrhythmias?

Answer 20

A person may have a dysrhythmia during exercise but show no wall motion abnormality

Question 21

During the Bruce protocol, the speed of the treadmill and it’s slope or inclination is increased every ____ minutes.

Answer 21

3

Question 22

During the Bruce protocol, the treadmill is abruptly stopped when the patient exceeds ____% of the target rate

Answer 22

85%

Question 23

During a stress echo, EKG recordings are made during every ____ of exercise and then again after exercise is stopped

Answer 23

Minute

Question 24

During a stress echo, the blood pressure is recorded at ____ minute intervals during exercise and then again at rest

Answer 24

Three

Question 25

During a stress test, the Echo images must be acquired within ____ seconds

Answer 25

60

Question 26

What are the advantages of a treadmill stress echo?

Answer 26

• Gives useful clinical info (ex. B.P. response, exercise capacity, arrhythmias)
• Used commonly
• Simple protocol

Question 27

What are the disadvantages of a treadmill stress echo?

Answer 27

• Unable to acquire adequate images during exercise
• Rapid recovery