stress echo

Question 1

which LV segments are seen in this view?

Answer 1

inferoseptum and anterolateral

Question 2

which LV segments are seen in this view?

Answer 2

inferior and anterior

Question 3

which LV segments are seen in this view?

Answer 3

anteroseptum and inferolateral walls

Question 4

which of the following endocardial excursion methods has the optimal Sn and Sp?

Answer 4

floating EPICARDIAL centroid

Question 5

is the “wall thickening method” on strss testing (used on most labs) affected by translational or rotational motion?

Answer 5

no

Question 6

during stress testing, does BP increase more with treadmill or supine bike?

Answer 6

supine bike

Question 7

contraindications to atropine during DST

Answer 7

narrow angle glaucoma, severe urinary retention

Question 8

contraindications to adenosine/lexiscan or dipyridamole stress test

Answer 8

2nd or 3rd degree heart block, severe bronchospasm, theophylline

Question 9

eq’n for Sn and Sp

Answer 9

Sn = tp/(tp + FN), Sp = tn/(tn +FP)

Question 10

what view can you do a stress echo in if patient has LBBB and you want to see LAD

Answer 10

apical 2 chamber view

Question 11

what is the % cardiac event rate per yr if you ahd a normal stress echo?

Answer 11

< 1%/yr

Question 12

eq’n for ischemic threshold (%), which determines preop risk

Answer 12

HR at which ischemia/(220-age) x 100

Question 13

if a wall measures < ?mm, it is specific for non-viable myocardium

Answer 13

6

Question 14

describe the meaning and significance of the dobutamine biphasic response on stress

Answer 14

hypokinetic LV segment improves to normal at low dose dobutamine, then becomes hypokinetic again at high dose. signifies hibernating myocardium. Biphasic reponse is BEST PREDICTOR of LV fxn RECOVERY

Question 15

in an asymptomatic pt < 5y post CABG or < 2 y post PCI, is it appropriate to do stress echo?

Answer 15

rarely