Term
| what are cardiac diagnostic tools |
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Definition
| lab tests, chest xray, EKG, EP studies, holter and loop monitoring, echocardiogram, cardiac catheterization, nuclear studies, MRI, CT scan |
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Term
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Definition
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Term
| what does EP studies stand for |
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Definition
| electrophysiologic studies |
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Term
| what are goals of cardiac diagnostic studies |
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Definition
| identify type, size, and location of pathology, determine disease progression with serial testing, formulate best treatment, determine effectiveness of treatment |
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Term
| how to choose type of cardiac diagnostic test |
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Definition
| minimally invasive, risk to benefit ratio, specificity and sensitivity, timeliness of results, cost |
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Term
| what are 2 types of lab tests for cardiac diagnostics |
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Definition
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Term
| what do serum studies show in cardiac diagnostics |
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Definition
| cardiac enzymes, lipids, complete blood count, coagulation, electrolytes, glucose |
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Term
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Definition
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Term
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Definition
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Term
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Definition
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Term
| what to look for in coagulation studies |
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Definition
| how well does the blood clot |
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Term
| how do we know that cardiac muscle is damaged vs. skeletal muscle |
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Definition
| damaged cardiac muscle myocytes release specific isomers of enzymes LDH, CKP, and tropnonin T and I |
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Term
| as cell injury continues, how does the number of isoenzymes in the blood change |
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Definition
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Term
| how long does the release of isoenzymes into the blood continue |
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Definition
| until the infarct is completed |
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Term
| when are the various cardiac isoenzymes released |
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Definition
| at different times during cellular destruction. Each isoenzyme peaks at a different time. |
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Term
| by what time after MI have all cardiac isoenzymes peaked |
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Definition
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Term
| what does serial monitoring of isoenzymes show |
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Definition
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Term
| what is the total serum concentration of isoenzymes proportional to |
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Definition
| extent of myocardial injury |
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Term
| for how long does an MI evolve |
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Definition
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Term
| how quickly do cardiac enzymes become present in the blood following MI |
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Definition
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Term
| why is it relevant that cardiac enzyme testing can be done within 30 minutes following MI |
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Definition
| thrombolytic treatment must occur within 6 hours after MI and is best within 3h |
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Term
| is cardiac enzyme testing expensive |
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Definition
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Term
| what is the risk of cardiac enzyme testing |
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Definition
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Term
| if a patient presents to ED with possible MI, what tests will be done first |
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Definition
| vital signs, EKG, bloodwork including cardiac enzyme panel |
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Term
| how often is bloodwork taken with suspected MI |
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Definition
| every 3 hours, total of 4 times to see if there is atrend of myocardial damage. |
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Term
| do you want the ratio of total cholestrol:HDL to be high or low to have a lower risk of heart disease |
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Definition
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Term
| what are the components of the complete blood count |
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Definition
| WBC, RBC, Hg, Hct, platelets |
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Term
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Definition
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Term
|
Definition
| immune status: presence of infection, immune suppression |
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Term
| which patients experience immune suppression |
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Definition
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Term
| what do platelets reflect |
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Definition
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Term
| what are some other lab values besides CBC |
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Definition
| coagulants, glucose, electrolytes |
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Term
| what do coagulants represent |
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Definition
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Term
| why would coagulants be manipulated |
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Definition
| to dissolve/prevent clot formulation |
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Term
| wh ywould glucose be abnormally elevated |
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Definition
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Term
| what electrolytes are measured in lab values |
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Definition
| sodium, potassium, chloride, carbon dioxide, BUN, creatine, Anion gap, BUN/Cr |
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Term
| what can happen if there are abnormalities in sodium, potassium, calcium |
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Definition
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Term
| what can BUN, Cr give you information about |
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Definition
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Term
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Definition
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Term
| what lab changes occur with chronic diagnosis |
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Definition
| BUN elevated with CHF and renal insufficiency; sodium elevated with CHF; loop diuretics can deplete K |
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Term
| what are benefits of chest xray |
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Definition
| noninvasive, can betaken serially, verifies line/lead placement of a chest tube |
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Term
| what are common cardiac related findings |
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Definition
| cardiomegaly, pulmonary edema, pleural effusion, widened mediastinum |
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Term
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Definition
| fluid around pericardial sac. |
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Term
| how is cardiomegaly detected by chest xray |
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Definition
| borders of heart are unusually enlarged |
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Term
| can chest xray show early cancer |
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Definition
| no. by the time cancer appears o chest xray, it's advanced. |
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Term
| what is the dark part on a chest xray |
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Definition
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Term
| what is the purpose of electrophysiological studies |
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Definition
| attempts to induce arrhythmias to localize area of pathology |
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Term
| once electrical physiologic stimulation has localized pathology that causes arrhythmias, what can be done |
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Definition
| can ablate area/kill it off so that it can't set off arrhythmia. Can recommend pacemaker or deplantable defibrillator |
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Term
| what is the normal impulse direction of the heart |
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Definition
| normal impluse in the heart goes from SA to AV to bundle of HIS to bundle branches. |
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Term
| what happens with Wolf Parkinson white syndrome |
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Definition
| a patch forms in the AV node that can cause arrhythmias |
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Term
| how can wolf parkinson syndrome be treated |
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Definition
| surgeons can go in and laser out the abnormal pathway so that the arrhythmias aren't as fatal or chronic |
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Term
| what do implantable defibrillators do |
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Definition
| deliver a shock to the patient's heart when it detects an abnormal rhythm |
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Term
| what are holter and loop monitors |
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Definition
| portable EKG monitors that patients wear during normal activities/ADLs |
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Term
| how long does a patient typically wear a holter monitor |
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Definition
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|
Term
| when to use holter monitor |
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Definition
| for patients with symptoms that aren't effectively documented by an EKG. Patient also keeps a diary so they can see if activity relates to arrhythmia |
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|
Term
| what is an echocardiogram |
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Definition
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|
Term
| is an echocardiogram invasive |
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Definition
|
|
Term
| what are the 2 approaches of echocardiograms |
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Definition
| parasternal, transesophogeal |
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|
Term
| what is the standard of the 2 echocardiogram approaches |
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Definition
|
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Term
| what are limitations of the parasternal approach of the echocardiogram |
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Definition
| pulmonary problems, obesity, chest wall defects |
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Term
| what diagnoses/findings come from the echocardiogram |
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Definition
| ventricular size and ejection fraction; wall motion; valves; septal defects; pericardial effusion; thrombus; neoplasm; anuerysm; areas of ischemia |
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Term
| what is ejection fraction |
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Definition
| heart's ability to pump strongly |
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|
Term
| what can you correlate with an echocardiogram |
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Definition
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|
Term
| is cardiac catheterization invasive |
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Definition
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|
Term
| how is cardiac catheterization done |
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Definition
| peripheral line radiographically guided to heart |
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|
Term
| is cardiac catheterization expensive |
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Definition
|
|
Term
| can you assess both sides of the heart with cardiac catheterization |
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Definition
| no, only right or left, not both |
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|
Term
| how to get to right side of heart with catheter |
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Definition
|
|
Term
| how to get to left side of heart with catheter |
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Definition
|
|
Term
| what are the two possible entry points for a left heart cath |
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Definition
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|
Term
| what are the protocols following left heart cath with radial or femoral artery entry point |
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Definition
| at least 6h strict bedrest after procedure. Hematoma risk |
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Term
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Definition
| dye injected into coronary arteries for mapping |
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|
Term
| along with coronary angiography, what else is measured in left heart cath |
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Definition
|
|
Term
| what are risks of left heart cath |
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Definition
| bleeding, arrhythmias, allergic reactions |
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|
Term
| what interventions can be performed with left heart cath |
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Definition
| percutaneous transluminal coronary angioplasty; stent placement |
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|
Term
| what do we call the catheter line that goes to the right heart cath |
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Definition
|
|
Term
| does a right heart cath use venous or artery entrance point |
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Definition
|
|
Term
| which veins are used for right heart cath entry |
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Definition
|
|
Term
| what is the path of a swan ganz catheter |
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Definition
| femoral or jugular vein to vena cava to R atria to R ventricle to pulmonary artery |
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|
Term
| how long can a person have a swan ganz catheter |
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Definition
| can remain in for hours or days or weeks |
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|
Term
| is ambulation allowed for patients with swan ganz |
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Definition
| usually - check with MD first |
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|
Term
| what is measured by a swan ganz/right heart cath |
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Definition
| heart pressure, temperature, blood pressure, wedge pressure, |
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Term
|
Definition
| radionucleotide ventriculogram |
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Term
|
Definition
| estimates left ventricular ejection fraction |
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|
Term
| what type of study is an RNV |
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Definition
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|
Term
| what is a pharmacologic stress/perfusion test |
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Definition
| distress patient with adenosine and dobutamine to increase HR and heart contraction. Stimulates exercise stress test |
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Term
| what do adenosine and dobutamine do |
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Definition
| increase HR and strength of contraction |
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|
Term
| what is positive chronotrope |
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Definition
|
|
Term
| what is positive ionotrope |
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Definition
| increase strength of contraction |
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|
Term
| why is thallium given with adenosene or dobutamine in physiologic stress test |
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Definition
|
|
Term
| what kinds of patients are nuclear studies such as physiologic stress tests good for |
|
Definition
| amputees, paraplegics, SCI patients, transplants with poor physical activity, grossly obese, significant leg pain |
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Term
| what are other cardiac diagnostic tests that are expensive |
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Definition
|
|
Term
| what are PET scans good for |
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Definition
| detecting tumors in the heart or lungs |
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