Cardiac Diagnostics Flashcards Preview

OS 205 > Cardiac Diagnostics > Flashcards

Flashcards in Cardiac Diagnostics Deck (88)
Loading flashcards...
1

What is the "Five-Finger" approach to cardiac diagnosis?

History
Physical Examination
ECG
X-ray
Lab Tests

2

What are examples of non-invasive cardiac diagnostic tests?

Chest X-ray
ECG
Treadmill Stress Test
Echocardiogram
Nuclear Scan

3

What is an example of an invasive cardiac diagnostic test?

Coronary Angiogram

4

What are the basic indications for cardiac diagnosis?

Document electrical abnormalities
Define structural abnormalities
Detect myocardial ischemia
Determine the myocardial function/viability
Detect coronary artery obstruction

5

What is the basic difference between PA and AP views?

Whether clavicle is present or not

6

What x-ray view should you recommend to a patient who can stand?

Postero-anterior (PA) view

7

What x-ray view should you recommend to a patient who cannot stand?

Antero-posterior (AP) view

8

What condition should NOT be read from an AP view x-ray? Why?

Cardiomegaly

The cardiac chambers and heart shadow are magnified.

9

In PA view, what structures of the heart make up the (patient's) right border?

Small portion of the IVC
SVC
RA
Ascending Aorta

10

In PA view, what structures of the heart make up the (patient's) left border?

Aortic Knob
Main Pulmonary Artery
LA
LV

11

What structure of the heart can be seen in PA Lateral view but not in PA view?

Right Ventricle

12

What is the most important information you can derive from a chest PA view?

Cardio-Thoracic Ratio (CTR)

13

What is the Cardio-Thoracic Ratio (CTR)?

(Widest diameter of heart)/(Widest internal rib cage diameter)

14

What is the normal CTR in adults? babies?

Adults: <0.5
Babies: ~0.65

15

In what cases will a CTR >0.5 still be considered normal?

Portable AP (heart more anterior)
Obesity
Pregnancy
Ascites
Straight Back Syndrome
Pectus Excavatum

16

What are the causes of abnormal CTR?

Obstruction to ventricular outflow
Left ventricle hypertrophy
Abnormalities with structures associated with contours

17

Manifestations of Left Ventricular Hypertrophy

PA VIEW

Inferolateral displacement of apex
Apex 0.5

LATERAL VIEW

Posterior displacement of postero-inferior border of heart

18

Manifestations of Right Ventricular Hypertrophy

PA VIEW

Rounding and upliftment of cardiac apex

LATERAL VIEW

Retrosternal fullness/haziness

19

Manifestations of Left Atrial Enlargement

PA VIEW

Double density
Enlargement of LA appendage
Upliftment of left mainstem bronchus
Widening of carinal angle
Cardiac waistline disappears (most common)

LATERAL VIEW

Prominent posterosuperior cardiac border
Posterior displacement and upliftment of left mainstem bronchus

20

Manifestations of Right Atrial Enlargement

Lateral bulging of right cardiac border (>2.5 cm from lateral aspect of thoracic vertebra and >5.5 cm from mid thoracic spinous process)
Elongation of right heart border

21

What do you call the condition wherein your heart is located at the right side?

Dextrocardia

22

What measurement of the aortic knob is indicative of left atrium enlargement?

Greater than 35 mm (measured from lateral border of air in trachea to edge of aortic knob)

23

What are the signs of a patient with left ventricular hypertrophy with congestive heart failure and effusion?

Enlarged aortic arch and descending aorta
Presence of white fluid
Possible aortic aneurysm

24

The normal osmotic tendency is to ______ the pulmonary interstitium and alveoli.

Dehydrate

Pulmonary Capillary Hydrostatic Pressure: 7 mmHg
Plasma Colloid Oncotic Pressure: 28 mmHg

25

What are the stages of pulmonary congestion?

1. Cephalization
2. Kerley B Lines
3. Pulmonary Intestitial Edema
4. Pulmonary Alveolar Edema

26

In cephalization, which vessels of the lung increase in size?

Upper lobe vessels increase in size relative to lower lobe

(Hint: It's called "cephalization", so the vessels near the head become more prominent)

27

What are Kerley B Lines?

They are distended interlobular septa located at the bases of the lungs characterized by:

1 - 2 cm long lines
Horizontally oriented
Perpendicular to the pleural space

28

Presence of donut rings in pulmonary congestion is a sign of which stage? What event do the donut rings signify?

1. Pulmonary Interstitial Edema
2. Peribronchial Cuffing

29

What are the three zones of the lung when assessing pulmonary congestion?

1. Central Zone
2. Middle Zone
3. Outer Zone

30

T/F: Can you diagnose cardiac chamber enlargement using ECG?

True