Cardiac Imaging

Question 1

when should a Chest CT (vascular protocol with IV contrast) be ordered

Answer 1

• for diseases of the THORACIC aorta (e.g. aortic dissection)

Question 2

uptake of tracer at rest

Answer 2

• uniform uptake

Question 3

for a boundary to show between structures on CXR

Answer 3

• they must differ in density

Question 4

CXR of myocardium, valves, and other intracardiac structures

Answer 4

• have densities similar to blood
• CXR won’t image internal cardiac structure

Question 5

left border of CXR on frontal projection formed by

Answer 5

• left ventricle
• left atrial appendage

Question 6

how do you calculate cardiothoracic ratio

Answer 6

• compare width of heart to width of thoracic cavity

>50% is enlargerd heart

Question 7

normal ejection fraction

Answer 7

• 55-60%

Question 8

posterior border of CXR on lateral projection

Answer 8

• left atrium (superiorly)
• left ventricle (inferiorly)

Question 9

color flow doppler imaging useful for

Answer 9

• assessing valvular abnormalities (e.g. regurgitation and stenosis)

Question 10

cardiac silhouette

Answer 10

• radiographs can depict dilatation of individual cardiac chambers
• dilation takes time, not seen in acute processes

Question 11

anterior border of CXR on lateral projection

Answer 11

• right ventricle

Question 12

An echo should be ordered for patients who present with

Answer 12

• new heart failure
• dyspnea of unclear etiology

Question 13

an echo is the initial diagnostic study to evalulate

Answer 13

• structure and function of heart

Question 14

M mode cardiography based on

Answer 14

• one-dimension analysis of the heart in motion

Question 15

CT coronary angiography can define

Answer 15

• coronary anatomy
• identify severe coronary artery disease

Question 16

CXR has high specificity for detection of

Answer 16

• chamber enlargement

Question 17

MRI should be ordered for

Answer 17

• characterization of structures and function that is unclear by echocardiography

Question 18

left sided pressures

Answer 18

• aorta
• left ventricle

Question 19

what is used to measure pressures on the right side of the heart out into the pulmonary lungs?

Answer 19

• right heart cardiac Catherization (swan-Ganz)

Question 20

color flow doppler imaging identifies

Answer 20

• regions of turbulent flow

Question 21

uptake of tracer at stress

Answer 21

• poor uptake after stress

Question 22

the extend of penetration of X rays through the body is inversely proportional to

Answer 22

• tissue density

Question 23

which is the gold standard for exclusion of intracardiac thrombus (esp. left atrial appendage)

Answer 23

• TEE

Question 24

CXR has low sensitivity for detection of

Answer 24

• structural heart disease

Question 25

cardiac catheterization involves exposure to

Answer 25

- radiation - constrast dye

Question 26

CXR should be ordered for patients presenting with

Answer 26

- chest pain - dyspnea

Question 27

MRI is gold standard for

Answer 27

- assessing cardiac structure and function - offer some characterization of myocardial tissue

Question 28

dense materials like bone on CXR

Answer 28

- absorb more X rays - appear white (or radio-opaque)

Question 29

CXR is sensitive for detection of

Answer 29

- pulmonary processes that result from cardiac disease

Question 30

right heart catheterization performed via to measure

Answer 30

- Swan Ganz - venous route - to measure pressures on right side of the heart and into pulmonary artery (lungs)

Question 31

elevated PCWP indicates

Answer 31

- left sided heart failure

Question 32

what is the gold standard test for evaluation of valvular structure and function?

Answer 32

- echocardiography

Question 33

color flow doppler imaging depicts

Answer 33

- blood flow direction and velocity

Question 34

pressures between RA and PCW (pulmonary capillary wedge)

Answer 34

- are similar

Question 35

M mode cardiograph can measure

Answer 35

- thickness of ventricular walls - volumes of cardiac chambers

Question 36

which access is lower risk

Answer 36

- venous access lower risk than arterial access

Question 37

pulmonary artery (capillary) wedge pressure used to estimate

Answer 37

- left ventricular diastolic pressure

Question 38

left heart catheterization performed via - to perform - but can also

Answer 38

- performed via arterial route - to perform angiogram (shoot dye) into the coronary arteries - but can also look at pressure on left side of heart

Question 39

right sided pressures

Answer 39

- right atrium - right ventricle - pulmonary artery

Question 40

what must the cardiothoracic ratio be for it to be considered an enlarged heart

Answer 40

- greater than 50%

Question 41

what its the gold standard test for defining coronary anatomy and detecting clinically significant coronary stenosis

Answer 41

- coronary angiography

Question 42

what does nuclear imaging increase the sensitivity and specificity of

Answer 42

- stress tests for detection of ischemia

Question 43

right border of CXR on frontal projection formed by

Answer 43

- right atrium

Question 44

During the Apical 4 chamber view, where do you place the probe?

Answer 44

- probe at PMI over apex of heart

Question 45

air filled tissues on CXR

Answer 45

- absorb few X rays - appear black

Question 46

TEE how it works

Answer 46

- patient is mildly sedated for outpatient procedure - echo probe is passed down esophagus and into stomach