Week 4- Other Cardiac Diagnostic Tests

Question 1

PART 1

Answer 1

PART 1

Question 2

Holter Monitor:

• What is it?
• Is it used in inpatient or outpatient setting?

Answer 2

• Continuous 24hr EKG monitoring ordered for detecting and assessing arrhythmias and for evaluating effectiveness of antiarrhythmic therapy.
• Used in both inpatient and outpatient. (patient carries around)

Question 3

What is the gold standard for assessing cardiac structure and function?

Answer 3

Echocardiogram

Question 4

What are some things an echocardiogram can look at? (8)

Answer 4

• Size of the ventricular cavities
• Thickness and integrity of interatrial and intraventricular septa
• Function of the valves
• Motions of individual segments of ventricular wall
• Volumes of the L ventricle***
• Assessment of performance of the heart muscle itself
• Estimates stroke volume and EF***
• Allows the analyze motion of valves and heart muscle ***

Question 5

Echocardiogram:

• Provides _____ ______ images of the beating heart.
• Can provide information about ______ ______.

Answer 5

• real time

- blood flow

Question 6

What are (3) main types of echocardiography? Describe each.

Answer 6

Surface/Transthoracic Echocardiography
-The echo transducer is moved on the skin over the heart.

Transesophageal Echocardiography
-The echo transducer is swallowed. Provides clear images of structures.

Stress Echocardiography
-Imaging is done while the patient is exercising or immediately after.

Question 7

Transesophageal Echo (TEE):

• When would we use TEE?
• When is it contraindicated?

Answer 7

• Used when image quality is confounded by obesity, chest deformities, pulmonary disease. Imaging modality of choice for evaluation of known/suspected cardioembolic stroke.
• Contraindicated for those with dysphagia.

Question 8

List (2) additional types of echocardiography.

Answer 8

• 3-Dimensional Echocardiography

- Contrast Echcardiography

Question 9

What is considered the gold standard for blood flow measurement and metabolic assessment of the heart?

Answer 9

Positron Emission Tomography (PET)

Question 10

Positron Emission Tomography (PET):

• DETECTS TISSUE _________ and __________.
• Measures cardiac _________ and __________ of the heart.
• Requires specialized equipment, highly trained personnel, and is very expensive.

Answer 10

• VIABILITY and FUNCTION

- cardiac metabolism and blood flow

Question 11

Radionuclide Perfusion Imaging:

• Evaluated cardiac _______/_________ at rest and during dynamic exercise.
• Commonly used agents (Thallium-201, Technetum-99m) move into cardiac tissue and are taken up based on coronary blood flow.

Answer 11

-perfusion/function

Question 12

Thallium Stress Test:

• ______ or ______ stress test.
• Nuclear stress test shows how well blood flows in the heart while exercising or at rest.
• When are they usually done?

Answer 12

• cardiac or nuclear

- Usually done with patients whho c/o CP with activity, SOB, etc. with a cardiac history.

Question 13

What uses the movement of water molecules in a magnetic field to create an image?

Answer 13

Magnetic Resonance Imaging (MRI)

Question 14

Magnetic Resonance Imaging (MRI):

• What was it originally used for?
• What is it currently used for?
• What are some barriers to MRI?

Answer 14

• Originally used for assessing cardiac anatomy and congenital malformations and to identify masses/thrombi.
• Currently evaluates valvular disease, cardiac shunts, cardiac flow, and coronary artery anatomy.
• If patient has a pacemaker, artificial joint, or other metallic devices.

Question 15

What is an X-ray examination of the blood vessels or chambers of the heart that have been perfused with a special dye?

Answer 15

Coronary Angiography

Question 16

Coronary Angiography:

• Small tube inserted into vessel in upper thigh or arm.
• Tube positioned in the heart or beginning of the arteries supplying the heart.
• Dye is injected, which is visible by X-ray.
• Able to interpret presence and severity of ______.
• Presence of LV, atrial, pulmonary vein, CA dysfunctions.
• Presence of _______ heart disease.

Answer 16

• CAD

- valvular heart disease

Question 17

What are (4) major complications of coronary angiographs?

Answer 17

• Serious bleeding
• Heart attack
• Stroke
• Kidney failure

Question 18

Cardiac Catheterization PT Implications:
Left Heart Catheterization:
-Due to femoral artery incision, bed rest for __-__ hours with involved LE ________.
-Knee immobilizer to minimize hip ________.
-Monitor for groin hematomas and pain.

Right Heart Catheterization

• Used to diagnose right ______/______ and __________ artery impairments.
• The incision site is generally via the external ________ vein.
• Are the activity restrictions?

Answer 18

Left Heart Catheterization:

• 6-8 hours, straight
• hip flexion

Right Heart Catheterization:

• ventricular/atrial and pulmonary artery
• jugular vein
• No

Question 19

Computer Tomography (CT):

• What is it? How does it work?
• Provide more detailed information than plain X-rays and are the same as _________.

Answer 19

• Series of X-ray images to create “slices: of the bones/vessels/tissues and creates detailed images from 2D pictures.
• CAT scan

Question 20

CAT Angiography:

• What is it?
• Used to diagnose and treat ___________ diseases and conditions.
• Involves the use of contrast material.

Answer 20

• Imaging test that looks at the arteries that supply blood to the heart.
• blood vessel condition

Question 21

Cardiac Calcium Scan:

• What is it? How does it work?
• _______ Ca+ = higher blockage

Answer 21

• CT for Calcium Scoring uses special x-ray to produce pictures of coronary arteries to determine if they are blocked/narrowed due to plaque buildup.
• higher

Question 22

Doppler US:

• What is it?
• What can it show?

Answer 22

• Noninvasive test used to estimate blood flow through vessels. Turns sound waves into images.
• Can show DVT, blockage in arteries, check blood flow in veins/arteries/heart, and locate aneurysms.