Common Diagnostic Procedures

Question 1

What is the purpose of ambulatory ECG (Holter monitoring)?

Answer 1

used for 24-48 hours to evaluate cardiac rhythm, efficacy of medications, and pacemaker function and then correlated with a diary of the patient’s symptoms and activities

Question 2

What is an angiography and what is it used for?

Answer 2

a radiological examination where a patient is injected with a contrast medium into their blood vessels to show the location of plaques in the coronary arteries and the extent of occlusion

Question 3

What is a bronchoscopy and what is it used for?

Answer 3

a procedure where a camera attached to wiring is placed down a patient’s bronchial tree to visualize the area for tumors, bronchitis, foreign bodies, and bleeding, it can also be used to remove tissue specimens by biopsy or lavage

Question 4

What is a cardiac catheterization and what is it used for?

Answer 4

a thin catheter injected into an artery and maneuvered tot he coronary arteries where a dye is injected to measure BP in the heart, oxygen in the blood and evaluate narrowing or occlusion of coronary arteries

Question 5

What is a carotid ultrasound and what is it used for?

Answer 5

a procedure where airwaves are used to examine and visualize the carotid arteries to screen for blockages, evaluate placement of a stent, and screen the function of the arteries after carotid endarterectomy

Question 6

What is a chest radiograph and what is it used for?

Answer 6

medical imaging of the chest to visualize the anatomy of the chest and also reveal fluid in the lungs or pleural space, pneumonia, emphysema, cancer, etc.

Question 7

What is an echocardiograph and what is it used for?

What are the two most common types?

Answer 7

procedure that uses high frequency sounds waves non-invasively to evaluate the function of the heart in real time

Transthoracic Echocardiogram (TTE) uses a transducer on a patient’s chest

Transesophageal Echocardiogram (TEE) uses a transducer that is passed into the esophagus and provides a more detailed image of the heart due to esophagus’ close proximity to the heart

Question 8

What is electrophysiologic testing and what is it used for?

Answer 8

used to evaluate the rhythm or electrical conduction abnormalities in the heart using 3-5 catheters inserted into blood vessels and threaded to the heart to help locate abnormal tissue that causes cardiac arrythmias

Question 9

What is fluoroscopy and what is it used for?

Answer 9

a continuous x-ray procedure that shows the heart and lungs but due to high radiation exposure has been mostly replaced by echocardiograms

Question 10

Which kind of catheter measures pulmonary artery wedge pressure and left atrial pressure?

Answer 10

a balloon catheter a.k.a Swan-Ganz catheter which is placed in the pulmonary artery

Question 11

What kind of catheter can be used to measure cardiac output?

Answer 11

thermodilution catheter

Question 12

What kind of catheter can measure pressure in the vena cava and right atrium?

Answer 12

central venous pressure line

Question 13

What is Myocardial Perfusion Imaging (nuclear stress test or radionuclide stress test) and what is it used for?

Answer 13

a test that shows how well the heart muscle is perfused at rest and under exercise stress by injecting a radionuclide agent into the blood at rest and at a max level of exercise to reveal areas that have reduced blood supply due to narrowing of one or more coronary arteries

Question 14

What is a Pharmacological Stress Test and what is it used for?

What drugs are typically used?

Answer 14

• a diagnostic procedure in which cardiac stress is induced by drugs when contraindications to routine exercise exist or when patient is unable to exercise due to various reasons
• it is used with imaging modalities such as radionuclide imaging and echocardiograms

Common drugs used include adenosine, dipyridamole, and dobutamine

Question 15

What is phonocardiography and what is it used for?

Answer 15

a test which creates an image of the sound procuded by the heart and great vessels to supplement auscultation and improves the detection of S3 and S4 sounds in the diagnosis of heart failure

Question 16

What is Positron Emission Tomography (PET) and what is it used for?

Answer 16

a PET scan is an imaging technique where radioactive material is injected, inhaled or swallowed. Because radioactive material tends to accumulate in area of increased chemical activity the material is tracked to where it accumulates which can typically represent an area of disease which is useful for evaluating heart disease and cancer

Question 17

What is thoracentesis and what is it used for?

Answer 17

a procedure that includes removal of fluid fro the pleural space with a needle for microbiologic and cytologic studies

Question 18

What is venography and what is it used for?

Answer 18

procedure where dye is injected into veins and then imaging is done to look for clots or blockages

Question 19

What is a Ventilation-Perfusion Scan (V:Q Scan) and what is it used for?

Answer 19

a study that used small amounts of radioactive material to study airflow and blood flow within the lungs. It is used most commonly in the diagnosis of pulmonary embolism.

Question 20

How does pulse oximetry work?

Answer 20

by measuring the differential absorption of light by oxygenated and nonoxygenated hemoglobin

Question 21

What factors can limit the accuracy of pulse oximetry?

Answer 21

• motion artifact
• abnormal hemoglobin
• intravascular dyes
• exposure of probe to ambient light during measurement
• skin pigmentation
• nail polish

Question 22

When should you stop an activity on the basis of concern over pulse oximetry readings?

Answer 22

if SpO2 is below 90% in patients who are acutely ill or if it is below 85% in patients with a chronic lung disease