Cardiac Testing

Question 1

What is an ambulatory event monitor?

Answer 1

Monitor longer than a holter monitor
Can be taped events or monitored from a distance
Can be patient triggered or automatic recording with abnormalities
Loop recorder - can be implanted for up to 2 years

Question 2

Serum testing for acute MI

Answer 2

Troponin (only need 1 elevated troponin for diagnosis)

CK-MB (rises 2-4 hours after onset of s/s, peaks at 24 hours)

Question 3

how long does it take for a troponin to elevate

Answer 3

2-3 hours

Question 4

what are the contraindications for a stress test

Answer 4

CHF, uncontrolled arrhythmia, aortic stenosis, angina,

MI, PE, Severe pulmonary HTN, Aortic dissection

Question 5

What do you need for a stress test

Answer 5

ACLS equiptment
12 lead ECG
NPO 4 hours prior
IV access for chemical stress test

Question 6

L sided heart cath can look at what and used for what

Answer 6

Looks at vessels, mitral valve, aortic valve, L ventricular ejection fraction
Used to insert stents, balloons, ect

Question 7

R sided heart cath is for what

Answer 7

Looks at pressures in heart, blood flow problems, valve disease, pulmonary HTN

Question 8

what is an echocardiogram used for

Answer 8

Looks at the inside of the heart - valves, walls, septum, pericardium, tamponades, rupture of wall after MI, decreased or dead wall function
determines systolic and diastolic functions

Question 9

An echocardiogram does not diagnose ______

Answer 9

Cardiovascular disease

Question 10

An echocardiogram is recommended for patients with long standing _____

Answer 10

HTN

Question 11

What is a transesophageal echocardiogram used for

Answer 11

Closer to the back of the heart 
Can visualize better
Shows vegetation (infection) better
Looks for embolic source (afib)
Acute dissection

Question 12

what is a stress echocardiogram used for

Answer 12

can show problems with blood flow that isnt visible when resting

Question 13

What is confirmed with a bubble or contrast echocardiogram

Answer 13

Atrial-septal defect

Question 14

what is a normal ejection fraction

Answer 14

50-80%

Question 15

A decreased ejection fraction can indicate

Answer 15

LV systolic dysfunction - needs interventions such as medication, pacemaker, ICD.

Question 16

If EF is normal but a pt has a clinical s/s of heart failure look for______

Answer 16

R sided heart failure or diastolic dysfunction

Question 17

Wall motion abnormality on echocardiogram indicates

Answer 17

Ischemia or muscle damage

can indicate a AMI or post MI

Question 18

preferred method to look at valvular abnormalities

Answer 18

echocardiogram

Question 19

If a pt has a new murmur, what do you order?

Answer 19

echocardiogram

Question 20

What are some causes of Aortic stenosis?

Answer 20

congenital, calcification, abnormal formation of valves, should have 3 parts

Question 21

What happens to heart and lungs in aortic stenosis

Answer 21

causes back up of flood into LV - rest of heart and lungs. LV size increases (LA increases - can cause afib

Question 22

symptoms of aortic stenosis

Answer 22

syncope, dyspnea, angina, low pulse pressure (instead of 120/80 you have 110/90), sudden death

Question 23

electrophysiology study is what?

Answer 23

done by specialist
catheters are inserted into veins and threaded to the heart so that they can sense the electrical activity
Electrical impulses are sent through one of the catheters and the response is watched on another

You might see this in afib

Question 24

CT scan of the heart looks at what

Answer 24

can look at calcium plaques on the vessels

Dye used to look at patency of coronary arteries

Question 25

other scans used on heart

Answer 25

PET scans - MUGA Scans

MRI/MRA