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Cardiac Diagnostics
Downstate > MS2 CV Block > Cardiac Diagnostics
17
Medical
Graduate
01/22/2011

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Cards

Term
what are the events of the ischemic cascade, in order? which events are least reliable in diagnosis?
Definition
diastolic dysfunction, systolic dysfunction, EKG changes, chest pain; EKG and chest pain are least reliable
Term
define flow limited CAD
Definition
at least 70% stenosis
Term
what do you look for in a stress test?
Definition
ABCDE, backwards = EKG, Diagnostics, Chest pain, Blood pressure, Arrhythmias = ST depressions, pt achieves 85% of maximum HR, chest pain, hypotension, PVCs
Term
what are 3 ways to improve specificity and sensitivity of ST depression in diagnosing flow limited CAD?
Definition
ABCDE, imaging, Bayes Theorem
Term
what information is given by an echocardiogram?
Definition
systolic function (ejection fraction, sites of hypokinesis), pericardial information, valvular function
Term
A patient is given a nuclear imaging study with technetium. A cold spot appears at rest but goes away with exercise. What is this defect called and what does it indicate?
Definition
Reverse defect; ischemia
Term
A patient is given a nuclear imaging study with technetium. A cold spot appears at rest and remains cold with exercise. What is this defect called and what does it indicate?
Definition
Fixed defect; infarction
Term
A 25yo female presents with chest pain. What diagnostic test do you use?
Definition
stress echo
Term
A 50yo male with hx of MI presents with chest pain. What diagnostic test do you use?
Definition
nuclear imaging
Term
A 25yo male with COPD presents with chest pain. What test do you order?
Definition
stress echo with dobutamine
Term
A 50yo male with diabetes and an amputated foot presents with chest pain. What test do you order?
Definition
nuclear imaging with dipyridamole/persantine
Term
A 50yo male with emphysema and wheezing presents with chest pain. What test do you order?
Definition
nuclear imaging with dobutamine
Term
what drugs are used for chemical stress test and with what tests?
Definition
dobutamine for echo; persantine for nuclear imaging
Term
plaque rupture directly correlates with ___, indirectly correlates with ___, and does not correlate at all with ___.
Definition
directly: size of lipid core in plaque; indirectly: Ca++ in plaque; no correlation: degree of stenosis
Term
what non invasive procedure is used to assess atherosclerosis and what does it measure?
Definition
CT angiogram; measures Ca++ levels
Term
Pt presents with CHF. What test do you order?
Definition
echo to measure EF
Term
at what point does risk of mortality drastically increase with decreasing EFs?
Definition
EF<40%
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