9) Diagnostic Testing

Question 1

Holter Monitor

Answer 1

Used for continuous 24hr ECG monitoring to provide info for dx & management of arrhythmias

Question 2

Indications for holter monitor use

Answer 2

• Dizziness
• Dysrhythmias
• SOB
• Syncope
• Eval pacemaker fxn

Question 3

What should pt be doing while wearing a holter monitor?

Answer 3

Document any abn’s

Question 4

What is electrophysiology (EPS) used for?

Answer 4

Used to investigate the cause & location of abn rhythms to determine the best tx

Question 5

What is the indication for EPS?

Answer 5

Abn heart rhythms

Question 6

Echocardiography

Answer 6

Non-invasive US of the heart to get a real-time image to assess performance of the heart, valves, quantify volumes, etc

Question 7

Indications for EKG

Answer 7

• Pericardial effusion
• Cardiac tamponade
• Diopathic cardiomyopathy
• Mitral valve regurgitation/prolapse
• Aortic regurgitation
• Aortic stenosis
• Vegetation of valves
• Masses
• Ischemia
• Aneurysm
• Thrombus
• Aortic dissection

Question 8

Describe a transesophageal echo

Answer 8

Scope is put down the throat to get a better pic of the heart

Question 9

What does a transesophageal echo allow for?

Answer 9

Improved visualization of cardiac structures & fxn

Question 10

What is a transesophageal echo good for?

Answer 10

Peri- & intraoperative monitroing of the left ventricle

Question 11

What is transesophageal echo the test of choice for?

Answer 11

Cardioembolic stroke

Question 12

What is the test of choice for cardioembolic stroke?

Answer 12

Transesophageal echo

Question 13

Stess echo

Answer 13

Used to eval atypical sx’s such as dyspnea & fatigue or pt’s w/normal ECGS but atypical chest pain syndromes

Question 14

What does the stress echo eval?

Answer 14

Ischemia-induced heart wall motion abn’s

Question 15

Describe contrast echo

Answer 15

IV contrast is injected to get improved accuracy to assess myocardial perfusion & ventricular chambers

Question 16

What are the indications for a contrast echo?

Answer 16

• Assess areas of at-risky myocardium for damage
• Absence/Presence of coronary collateral flow
• Revascularization of occluded arteries after angioplasty

Question 17

What are imaging modalities used for?

Answer 17

To eval for CAD & cardiac dysfxn

Question 18

Single-Photon Emission CT

Answer 18

Non-invasive imaging method to detect & quantify myocardial perfsion & contractility defects

Question 19

SPECT

Answer 19

Single-Photon Emission Computed Tomography

Question 20

What is SPECT used in conjunction w/?

Answer 20

Radioactive Isotopes

Question 21

PET

Answer 21

Provides visualization & direct measurement of metabolic fxning (glucose & fatty acid metabolism) of the heart

Question 22

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

Answer 22

PET

Question 23

What is PET the gold standard for?

Answer 23

Blood flow measurement & metabolic assessment of the heart

Question 24

What does the heart use for energy while at rest?

Answer 24

Fatty Acids

Question 25

CT

Answer 25

Noninvasive method used to ID CV masses, aortic aneurysms, or pericardial thickening

Question 26

CT Angiography

Answer 26

Highlights coronary arteries to eval for CHD

Question 27

Spiral CT

Answer 27

3D image used to eval presence of PE

Question 28

What is the advantage to spiral CT over regular CT?

Answer 28

It detects arterial abn's w/greater precision & is faster

Question 29

Does a spiral CT always require contrast?

Answer 29

No

Question 30

If a pt has a spiral CT, can you tx them that day?

Answer 30

NO!

Question 31

EBCT

Answer 31

Electron Beam CT

Question 32

Electron Beam CT

Answer 32

Noninvasive method of detecting & quantifying coronary atherosclerosis by measuring coronary calcification

Question 33

Multi-Gated Acquisition (MGA) Imaging

Answer 33

Noninvasive technique to calculate left ventricular ejection fraction

Question 34

MUGA

Answer 34

Multi-Gated Acquisition Imaging

Question 35

MRI

Answer 35

Evals morphology, cardiac blood flow, & myocardial contractility for valve disease & shunts

Question 36

Radioactive Nuclide Perfusion Imaging (RNPI)

Answer 36

*

Question 37

RNPI

Answer 37

Radioactive Nuclide Perfusion Imaging

Question 38

Pharmacologic Stress Test

Answer 38

Stress test while pt is resting

Question 39

Cardiac Catheterization

Answer 39

Invasive procedure that establishes/confirms a dx of cardiac dysfxn, heart disease, depicts severity of heart disease, or depicts severity of CAD or valve dysfxn

Question 40

What does cardiac catheterization specifically determine?

Answer 40

* Presence & severity of CAD * Left ventricular fxn * Valvular disease * Pericardial disease * Guidelines for optimal management of pt

Question 41

What is cardiac catherization called when it is used as a tx?

Answer 41

Percutaneous Coronary Intervention (PCI)

Question 42

When can cardiac catheterization/PCI be used as an alternative to CABG?

Answer 42

If only a single vessel is involved

Question 43

Ergonovine Stimulation

Answer 43

Diagnostic test for coronary spasm

Question 44

What is bronchoscopy used for?

Answer 44

* Evals & manages some congenital pulmonary anomalies & acquired diseases * Study normal & variant anatomy * Study pathological changes of the bronchial wall & lumen

Question 45

PT implications for pt's post-cardiac cath/PCI

Answer 45

* Place pressure on area 4-8hrs after procedure * Pt's will typically be on bedrest w/LE immobilizer * Some pt's may have groin pain * If the procedure was done through the femoral artery, no PT

Question 46

What do you need to have to do PT on a pt who has cardiac cath/PCI through the femoral artery?

Answer 46

MD note for clearance

Question 47

What are the main things to look for when interpreting a cardiac cath?

Answer 47

* EF * Blocked arteries * Blockage percentage * Valve dysfxn

Question 48

When is bronchoscopy indicated?

Answer 48

* Assess infections that can't be evaled from a sample * Clear viscous secretions * Retrieve foreign object