Notes in 05 Cardiac Diagnostics and Non-Invasive Imaging

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Published	10/13/2023	751dc2501b824290b0aede79bc8e5873-oa-1
Published	10/13/2023	{{c1::Transesophageal}} echocardiogram (TEE) is where you insert a camera into the esophagus and then look at the heart through the esophagus
Published	10/13/2023	Benefits of TEE over traditional echocardiography:Better imaging for {{c1::large}} patients (ex. obese patients)High resolution image due to {{c1::dec…
Published	10/16/2023	Contraindications to TEE (Transesophageal Echocardiography):{{c1::Esophageal::what part?}} diseases (ex. tumor, perforation, bleed, structure){{c1::Ne…
Published	10/13/2023	Logistics of TEE:Requires {{c1::sedation/anesthesia}}{{c1::Resource}} allocation (outpatient/inpatient center dedicated to same-day testing, PACU)
Published	10/13/2023	A {{c1::CT scan::what imaging technique?}} is an array of Xrays that are put together and stacked, created a 3D data set. They are best for looking at…
Published	10/13/2023	Indications of cardiac CT:Assessment of {{c1::vascular anatomy}} like the coronary arteries (main)Assessment of congenital {{c1::arterial}} and {{c1::…
Published	10/13/2023	Pros of cardiac CT:{{c1::Quick::Speed}}{{c1::Widely}} available{{c1::High}} resolution images (best for coronaries){{c1::Low}} training for technician…
Published	10/13/2023	Cons of cardiac CT:{{c1::Radiation}} exposure{{c1::Contrast dye}} allergies (limited in renal impairment){{c1::Fixed}} imaging No {{c1::flow}} in…
Published	10/13/2023	A CT scan has {{c1::higher::higher vs. lower}} radiation exposure than X ray, and they are both higher than things like your annual UV exposure
Published	10/13/2023	To look at a CT scan, focus on {{c1::1}} thing at a time and move through the slices by looking at that same structure
Published	10/13/2023	{{c1::Calcium scoring}} shows the calcium deposition on the coronary arterioes and the degree of atherosclerosisThe {{c1::higher::higher vs. lower}} t…
Published	10/13/2023	{{c1::MRI}} machines have a constant magnetic field, causing the {{c2::protons::what molecules?}} in our bodies to align with them.Then, a frequency p…
Published	10/13/2023	Indications of cardiac MRI:Assessment of cardiac {{c1::anatomy}}, {{c1::function}}, {{c1::blood flow}}Assessment of congenital {{c1::arterial}} and {{…
Published	10/16/2023	Pros of Cardiac MRI:Soft tissue contrast (can differentiate {{c1::masses}}){{c1::3}}D or {{c1::4}}D imagingNo {{c1::radiation exposure}}Less {{c1::ren…
Published	10/13/2023	Cons of Cardiac MRI:{{c1::Longer}} duration (45 mins - 2 hours){{c1::Contrast dye}} allergies{{c1::Claustrophobia}}, bad cooperation, breath holdingNo…
Published	10/13/2023	Having {{c1::MRI unsafe implants}} are an absolute contraindication to doing a cardiac MRI
Published	10/13/2023	{{c2::Late gadolinum enhancement}} is a powerful tool used for cardiomyopathies, post-infarction myocardial assessment (viable vs. non-viable), infilt…
Published	10/13/2023	{{c1::Late gadolinium enhancement}} works by giving contrast to the myocardium and then seeing how quickly it washes outFrom viable myocardium: {{c2::…
Published	10/13/2023	The main options of monitoring rhythm are {{c1::holter}}, {{c1::event monitor}}, and {{c1::loop recorders}} which each differ in the {{c2::duration}} …
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Published	10/13/2023	Loop recorders are placed {{c1::subcutaneously}} and are not usually used in {{c1::kids::what demographic?}}
Published	10/13/2023	Tropomyosin usually {{c1::inhibit::activate vs. inhibit}} muscle contraction by {{c1::blocking::activating vs. blocking}} the interaction between acti…
Published	10/13/2023	{{c1::Troponin C}} binds {{c2::Ca 2+}} ions which causes a conformational change in {{c1::troponin I}}, exposing the actin filament to myosin and allo…
Published	10/13/2023	Troponin {{c1::T}} anchors the troponin complex to the tropomyosin structure
Published	10/13/2023	Smooth muscle {{c1::does not::does vs. does not}} contain troponin
Published	10/13/2023	Troponin tests are best for detecting {{c1::cardiac muscle}} injury because you can isolate the cardiac troponins
Published	10/13/2023	Elevated {{c1::cTn}} levels reflect injury to myocardial cells, but do not give any information on the underlying pathophysiologica mechanisms
Published	10/13/2023	Rising or falling cTn values with at least one value above the 99th percentile and caused by myocardial ischemia is designated as an {{c1::acute MI}}
Published	10/13/2023	Myocardial injury does not mean that there is a {{c1::coronary artery}} problem
Published	10/13/2023	Rising troponin levels = acute {{c1::myocardial}} injury
Published	10/13/2023	Troponin levels {{c1::do not::do vs. do not}} differentiat acute from chronic myocardial injury, but the {{c1::trend}} does
Published	10/13/2023	{{c2::Acute}} myocardial injury should display a {{c1::RAPID}} rise in troponin over time, peaking at {{c2::12-18}} hours
Published	10/13/2023	{{c1::Decreases}} in cTn may indicate injury that occured {{c2::days ago::when?}}, may be associated with non-acute coronary syndrome conditions
Published	10/17/2023	Chronic myocardial conditions may cause {{c1::subtle fluctuations}} in cTn, but {{c1::rarely::how often?}} show an increase in 2-6 hour time intervals
Published	10/13/2023	Troponin raises to much {{c1::higher}} levels than other biomarkers, so this is why we use it
Published	10/13/2023	Reasons for troponin elevation because of myocardial injury{{c1::Acute myocardial ischemia}} (type 1){{c1::Acute myocardial ischemia secondary to O2 s…
Published	10/13/2023	{{c1::Type 1 mycoardial infarction}} criteria: An increase or decrease of cTn values with at least 1 value above the 99th percentile URL and with…
Published	10/13/2023	{{c1::Type 2 myocardial infarction}} criteria:Rise and/or fall of cTn values with 1+ value above the 99th percentile URL + an imbalance between myocar…
Published	10/13/2023	The largest concentration of BNP is found in the {{c1::heart}} and is released with {{c1::myocardial stretch}}
Published	10/13/2023	{{c1::Pro-BNP}} is metabolized into NT-pro BNP or BNP which are presnet in the blood {{c1::always}}
Published	10/13/2023	BNP < {{c1::100}} pg/mL usually {{c2::IS NOT::is vs. is not}} related to heart failure, but BNP > {{c1::500}} ph/mL usually {{c2::IS::is vs. is …
Published	10/13/2023	BNP is useful to trend over time in {{c1::chronic heart failure::what condition?}}
Published	10/13/2023	BNP is useful to rule in/out in {{c1::acute settings}}
Published	10/13/2023	BNP {{c1::relaxes::relaxes vs. constricts}} smooth muscle, causing vaso{{c1::dilation}} and {{c1::reducing::increasing vs. reducing}} afterload
Published	10/16/2023	BNP moves fluid into the interstitial space, {{c1::reducing::increasing vs. reducing}} pre-load
Published	10/13/2023	BNP causes {{c1::diuresis}} and {{c1::decreased::increased vs. decreased}} sympathetic nervous system activity
Published	10/13/2023	BNP {{c1::increases::increases vs. decreases}} GFR
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Published	10/13/2023	{{c1::Cardiac stress testing}} is where you have a 12 lead EKG attached and you monitor what is happening at rest and during stress (with increased HR…
Published	10/13/2023	If the patient is not able to exercise, then they are given drugs to {{c1::stimulate stress}}
Published	10/13/2023	{{c1::Exercise test with echo}} is when a patient performs exercise and then at peak exercise, echo images are obtained (wall motion, function), and t…
Published	10/13/2023	{{c1::Exercise testing with perfusion imaging}} is when a patient does exercise and then a radioactive tracer is injected into an IV, looking at how i…
Published	10/13/2023	Comparing images obtained during exercise testing with perfusion imaging allows you to see {{c1::what portion of the myocardium is not perfusing well:…
Published	10/13/2023	{{c1::Before::Before or after}} you go down the path of ordering imaging, make sure you know what it will give you and what to do with the results
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