MUGA

Question 1

what quantitative data do we get from a MUGA?

Answer 1

• global and regional EF
• phase and amplitude (Fourier Analysis)
• stroke volume and paradox image
• peak filling/emptying rates

Question 2

word to describe “less or diminished contraction” of wall motion

Answer 2

hypokinesis

Question 3

word to describe “late contraction” of wall motion

Answer 3

tardokinesis

Question 4

word to describe “out of phase with the rest” wall motion

Answer 4

dyskinesis

Question 5

word to describe no wall motion

Answer 5

akinesis

Question 6

how is stroke volume calculated?

Answer 6

SV = (ED volume - bkg) - (ES volume - bkg)

Question 7

normal SV

Answer 7

~80-100 ml/beat

Question 8

how is ejection fraction calculated?

Answer 8

((EDvol - bkg) - (ESvol - bkg)/(EDvol - bkg)) * 100

Question 9

how is cardiac output calculated?

Answer 9

SV * HR

Question 10

normal cardiac output

Answer 10

5-6L/min

Question 11

normal EF

Answer 11

~50-80%

Question 12

peak filling/emptying rates

Answer 12

reflection of early rapid filling phase of DIASTOLE and measures LV compliance (elasticity)

Question 13

normal emptying/peak filling rate

Answer 13

> 2.5 EDV/sec

Question 14

of frames needed to obtain reliable peak filling rate

Answer 14

> 32 frames

Question 15

what is seen in an acquired MUGA image

Answer 15

liver/spleen
lungs
aorta and pulmonary arteries

Question 16

what does pericardial effusions look like?

Answer 16

thicker lines between heart and liver (cold line)

Question 17

best view for right atrium

Answer 17

ANT
LAO during vent systole

Question 18

normal variant for right atrium

Answer 18

enlargement

Question 19

best view for left atrium

Answer 19

LAO or LLAT

Question 20

best view for right ventricle

Answer 20

LAO or ANT

Question 21

if a patient has LBBB, what occurs in the ventricles?

Answer 21

out of sync contractions between R and L ventricles

Question 22

enlargement of the right ventricle could mean…

Answer 22

pulmonary hypertension or cardiomyopathy

Question 23

best view for L ventricle

Answer 23

LAO

Question 24

normal LVEF

Answer 24

50-80% (at rest)

Question 25

normal RVEF

Answer 25

40-60%

Question 26

stress LVEF

Answer 26

+ 5-10%

Question 27

SV = ?

Answer 27

EDV - ESV

Question 28

phase

Answer 28

ex. LV and RV contracting at the same time, and oppo of artia contraction

Question 29

amplitude

Answer 29

amount of contraction

Question 30

stroke volume image

Answer 30

subtracting ES frame from the ED frame giving result to ring that represents stroke volume ED-ES = SV

Question 31

paradox image

Answer 31

subtracting ED from ES, being left with nothing unless paradoxical motion occurring ES-ED

Question 32

what are possible pathologies for an abnormal MUGA

Answer 32

- cardiotoxicity - CAD/MI - CHF (congestive heart failure) - cardiomyopathy

Question 33

what chemotherapy agents are linked to cardiotoxicity?

Answer 33

- anthracyclines (doxurubicin/adriamycin) - trastuzumab (herceptin)

Question 34

what baseline EF indicates high risk for cardiotoxicity?

Answer 34

<30%

Question 35

mild cardiotoxicity

Answer 35

drop in EF <10%, EF >45%

Question 36

moderate toxicity

Answer 36

drop in EF = 15%, EF <45%

Question 37

severe toxicity

Answer 37

drop in EF = 20%, EF <30%

Question 38

how will wall motion be effected by CAD?

Answer 38

area of ischemia or infarct in the area of wall motion abnormality with hypokinesis or akinesis on STRESS study REST = no wall motion abnormality (unles infarct or very sig. ischemia)

Question 39

CAD: rest images

Answer 39

amp and phase normal unless severe CAD (>75%)

Question 40

CAD: stress images

Answer 40

phase - areas of hypokinesis or akinesis amplitude - loss of contractility from ischemia SV - void in ring in areas of hypo or akinesis

Question 41

LV dysfunction (low EF or abnormal wall motion) + normal RV = ?

Answer 41

ischemia

Question 42

bilateral ventricular enlargement and dysfunction = ?

Answer 42

inflammation

Question 43

what can be an early sensitive indicator of CHF?

Answer 43

decrease in PFR

Question 44

dilated cardiomyopathy

Answer 44

chambers of heart are enlarged

Question 45

hypertrophic cardiomyopathy

Answer 45

myocardium thicken, so chambers are smaller

Question 46

restrictive cardiomyopathy

Answer 46

change in compliance, resistance to filling, less stretchy

Question 47

what can cause dilated cardiomyopathy?

Answer 47

CAD, viral/bacterial infection, chronic hormone disorders, alcohol, drugs, chemo, pregnancy, RA

Question 48

what are the effects of dilated cardiomyopathy?

Answer 48

- valvular regurgitation - decreased LVEF - increased risk of clot formation (stagnation)

Question 49

causes of hypertrophic cardiomyopathy

Answer 49

- unknown... possibly genetic

Question 50

what are the effects of hypertrophic cardiomyopathy?

Answer 50

- fibrosed tissue - LV dysfunction, decreased perf. - eventual decrease SV, EF - A Fib, mitral valve reguritation

Question 51

appearance of dilated cardiomyopathy

Answer 51

dilation in all 4 chambers decrease LVEF. RVEF. LV wall thickness

Question 52

appearance of hypertrophic cardiomyopathy

Answer 52

normal or small LV cavity, normal or slightly elevated LVEF

Question 53

appearance of restrictive cardiomyopathy

Answer 53

normal LV cavity, normal or decreased LVEF, normal or enlarged RV cavity and normal or decreased RVEF

Question 54

true aneurysm

Answer 54

3 layers of heart wall ant or anteroapical wall usually

Question 55

aneurysm

Answer 55

weakening of wall

Question 56

false/pseudo aneurysm

Answer 56

doesn't involve endocardium

Question 57

mitral or aortic regugitation

Answer 57

no increase in EF on stress MUGA

Question 58

aortic stenosis

Answer 58

normal or elevated LVEF at rest, decline in EF during stress (due to increased afterload pressures of stenosed valve)

Question 59

tricuspid regurgitation

Answer 59

dilated RV and decreased RVEF

Question 60

choice for assessment of valvular heart disease

Answer 60

doppler echocardiography

Question 61

false positives

Answer 61

underestimates LVEF

Question 62

including LA or aorta in ROI increase/decrease LVEF?

Answer 62

decreases LVEF

Question 63

subtracting too little background increase/decrease LVEF?

Answer 63

decreases LVEF

Question 64

subtracting too much background increase/decrease LVEF?

Answer 64

increases LVEF

Question 65

excluding part of LV in ROI increase/decrease LVEF?

Answer 65

increases LVEF