Cardiovascular Imaging

Question 1

what is the treatment for a stable angina or NSTEMI

Answer 1

coronary angiogram with PCI

Question 2

What is the procedure for a conventional coronary angiogram

Answer 2

A catheter is inserted into the arm or groin the guided up to to the heart through a blood vessel to the narrowed coronary arteries using xray and contrast for visualisation and guidance. A ballon stent is insterted at the tip of the catheter and inflated in the narrowed arteries to open them up and enable more blood flow. The ballon is removed and the stent is left in place to reduce the risk of re-narrowing.

Question 3

what are the advantages and disadvantages of a conventional coronary angiogram

Answer 3

Advantages
the the gold star imaging for a CAD because it has the highest resolution out of all
angiogram imagaing

it shows the site and degree of stenosis whilst allowing treatment

its more time and cost effective than surgery

Disadvantages
Has a higher radiation dose

its invasise so there are risk to the patient such as bledding

the patient could react to contrast

patient may experience some discomfort but sedation is avalaible

Question 4

What are the patient risks and benefits of a coronary angiogram

Answer 4

benefits
its quick procedure , fast recovery time with reduced time in the hospital

risks
high radiation dose , chance of contrast reaction and bleeding

Question 5

What is the imaging pathway for a stable angina

Answer 5

first line - CT Coronary Angiography to visualise stenosis

second line - non invasive functional testing to determine the significance of stenosis

third line - conventional angiogram with PCI to treat stenosis

Question 6

What are the 4 non invasive functional tests

Answer 6

MPS with SPCECT , stress echocardiography , contrast enchanced MR perfusion and a MRI

Question 7

What is is MPS with SPECT

Answer 7

a gamma scan to visualise perfusion of the heart at rest and stress

Question 8

What is a stress echocardiography

Answer 8

a ultrasound to show heart wall motion at stress and rest. its non invasive and provides real time imaging

Question 9

What is a contrast enhanced MR perfusion

Answer 9

a MRI scan where the patient is injected with galdolinum that highlights the heart tissue so we can see perfusion at stress and rest. poorly perfused heart highlights slowly and a a adequately one quickly

Question 10

What is the MRI functional test for

Answer 10

use of gradient echo sequence to show wall motion and ventricular function