Term
| The most common exercise testing involve the use of a stationary bicycle or a treadmill. Name the 2 most common protocols. |
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Definition
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Term
| Used as a noninvasive screening method for detection of coronary dz. There is a greater sensitivity and specificity in males over age 40 than in females. Females tend to demonstrate a greater % of false-negative results due to their silent symptoms. |
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Definition
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Term
| What during the early stages of max exercise testing is correlated with more severe disease? |
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Definition
| Ischemia (ST-segment depression) |
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Term
| This provides additional information regarding O2 exchange or breathlessness. It also provides info on cardiac performance, functional limitation, and exercise limitation. It assesses dyspnea via a ventilatory reserve and dyspnea index. |
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Definition
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Term
| This is where the pt undergoes additional non-invasive imaging immediately after an exercise test. It assesses myocardial O2 supply and demand relationship as well as coronary perfusion. Ex. Thallium-201 perfusion imaging and Sestamibi |
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Definition
| Radioactive Nuclide Perfusion Imaging |
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Term
| How does radioactive nuclide perfusion imaging assess myocardial O2 supply and demand relationship? |
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Definition
| Looks for a "cold spot" which shows that the heart is not getting enough O2. If it goes away within 4 hours then it is reversible. |
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Term
| This is used when a pt is unable to perform upright exercise on a treadmill or cycle. They get injected with a pharmacological agent to induce the physiological stress. |
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Definition
| Pharmacologic Stress Testing |
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Term
| Combines low-level treadmill exercise during adenosine infusion |
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Definition
| Adenosine or Dipyridamole-Walk Protocol |
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Term
| This test may be done for pts with atypical or unstable angina. It is an important test of coronary spasm. Its performed in cardiac catheterization lab. If a + response occurs, the pt is managed with meds that reduce or prevent the occurrence of the spasm. |
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Definition
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Term
| The accepted measurement of cardiac autonomic modulation. An impairment in vagal input can depress the variability of heart rate during deep breathing. HR variability <10 bpm during 6 deep respirations in 1 min. |
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Definition
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Term
| An invasive procedure that provides valuable info but predisposes the pt to infection, bleeds and could possible punch thru the vessel. |
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Definition
| Cardiac catheterization (coronary angiography and ventriculography) |
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Term
| Name 9 indications for cardiac catheterization |
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Definition
1. Cardiac arrest or ventricular fibrillation
2. Pulmonary edema
3. Intolerance of or non-compliance with medical therapy for angina
4. Job description mandate
5. Significant decrease in exercise duration
6. Progressive decline in systolic BP to less than 100 mmHg during exercise
7. Evidence of symptomatic hypoperfusion during exercise
8. Left ventricular EF of <35%
9. Ventricular tachycardia with exercise |
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Term
| Why might pulmonary edema be an indication for cardiac catheterization? |
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Definition
| Something may be going on with the heart that is backing up into the lungs |
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Term
| Name 4 S&S of hypoperfusion |
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Definition
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Term
| What the procedure for cardiac catheterization? |
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Definition
| Involves insertion of catheter into CV system to measure pressures or perform angiography. Performed in radiology. Catheter is inserted into brachial or femoral artery |
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Term
| After a cardiac catheterization, how are the test results interpreted? |
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Definition
-Cardiologist reviews the films to assess the ventricular function and severity of coronary artery stenosis
-Controversy - critics believe catheterization is overused and less invasive procedures should be done
-Cardiac catheterization has greater predictive accuracy in assessment of CAD than exercise testing |
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Term
| A technique involving introduction of small concentrations of iodinated contrast material into a vascular bed. It is analyzed by a computer to produce an angiogram without direct injection of contrast material into the artery. |
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Definition
| Digital subtraction angiography |
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Term
| Uses a specially designed catheter with a mini US probe attached to the distal end; used to visualize plaque |
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Definition
| IVUS (Intravascular Ultrasonography) |
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Term
| Diagnosis and assessment of CAD is difficult in women. You need to consider more accurate tests such as what 2? |
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Definition
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Term
| Taking samples of right or left ventricular endomyocardium. This determines myocardial rejections in pts with a cardiac transplant. May also be used to diagnose hypertrophic and congenital cardiomyopathy |
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Definition
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Term
| Adequate __ of muscles and organs is imperative for optimal functioning |
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Definition
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Term
| The most common dysfunction in the aorta include what 4 things? |
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Definition
| Aneurysms, atherosclerotic dz, aortic valve dysfunction, arteritis |
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Term
| What are the 4 most common diagnostic tests for aortic dysfunction? |
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Definition
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Term
| Presence of PAD increases with age and is highly correlated with what? |
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Definition
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Term
| A noninvasive test that compares BP obtained with Doppler probe in dorsalis pedic to BP in higher of two brachial pressures. Marker of diffuse atherosclerosis, CV risk, and overall survival. |
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Definition
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Term
| Aids in localizing stenosis or occlusion with placement of cuffs on thigh, calf, ankle, transmetatarsal region of foot. Pressure sequentially inflated in each cuff 20 to 30 mmHg above systolic. Pressure is measured at each segment as the pressure of the cuff is gradually released. |
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Definition
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Term
| Changes in volume of blood flowing through a limb can be detected by plethysmographic tracings |
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Definition
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Term
| More precise diagnostic test for defining arterial stenosis and occlusions |
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Definition
| Arterial Duplex Ultrasonography |
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Term
| Provides objective documentation of functional limitations from PAD. Determine physiological improvement following arterial stenosis intervention. Cycle ergometer may be the choice of mode for exercise testing. |
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Definition
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Term
| A test to see if there is a blood clot in the leg. Not very accurate. Squeeze the calf while pt is in prone. If there is a clot this will cause extreme pain. |
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Definition
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Term
| __ __ __ disease increases risk for transient and permanent ischemic attacks to the neurological system. |
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Definition
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Term
| CAD increases the risk for what 2 things? |
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Definition
| Coronary atherosclerosis and infarction |
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Term
| what type of evaluation is most commonly used for CAD? |
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Definition
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Term
| What 2 tests have increased sensitivity and specificity to neurovascular diagnosis? |
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Definition
3-D digital angiography
MR angiography |
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