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Cardio Dx Med


Initial dx test to screen for & follow known AAA = Abdominal US
Abdominal US: advantages 100% sensitivity, no contrast, low cost
AAA: CT scan pre-op or if US indeterminate; better defines shape & location/ extent of AAA
AAA: Catheter aortography may: underestimate diameter
TAA Evaluation CXR; Echo (TTE vs TEE); CT/ MRI
TAA: CXR for dx: CXR NOT dx alone (need CT or MRI to r/out if CXR neg)
Aortic Dissection Eval: CXR = wide aortic silhouette & mediastinum, poss L sided pleural effusion
Aortic Dissection Eval: Echo = 98% sensitive, 99% specific, +/- pericardial effusion, done bedside
Aortic Dissection Eval: CT helpful in: acute presentation
Aortic Dissection Eval: MRA/MRI useful for: serial follow up
Aortic Dissection Eval: EKG = LVH, nonspecific or inferior abnormalities (dissections preferentially extend into Right coronary ostium)
DVT Evaluation D-dimer; LE Doppler/ US; if PE suspected, VQ scan versus spiral CT; hypercoaguable w/u if no identifiable predisposing event
a break down product of a thrombus d-dimer
characteristic of d-dimer sensitive, but not specific
d-dimer is best for _______ DVT, or PE ruling out
gold standard for suspected DVT, however it is rarely done contrast venography
most common and practical means of detecting DVT ultrasound
most common test for PE spiral CT
gold standard for PE but rarely done pulmonary arteriogram
CHF on CXR Fluffy bilateral edema, Kerley B Lines, pleural effusions
cardiac biomarkers for stable/unstable angina always negative
CHF: Cardiac Cath consists of: Left ventriculogram; Arch shot; Coronary angiography to assess for blockages
Cardiac Cath: Indicated in: MI, USA
Kerley B lines = sharp, linear densities of interlobular interstitial edema
CHF: Echo provides: structural, anatomic & physiologic info about the heart
BNP: relationship to CHF: BNP secreted from ventricles under stress in CHF
BNP may be falsely elevated in: renal failure
HTN eval labs UA; serum Cr, glu, K+, Na+ ; Lipids (TC, trigs, HDL, LDL); 12-Lead EKG (LVH)
Venous Thromboembolism: Screen with: duplex Doppler venous ultrasound
Echo: TTE vs TEE TTE only good to visualize aortic root (good for Marfan); TEE to visualize entire aorta, but is semi invasive (CT/ MRI better)
Hx angina but no acute sx; EKG no acute changes; next step: Do exercise stress test
Diagnostic features of systolic CHF Echo reduced EF; CXR Cardiomegaly; CXR Pulm edema
Diagnostic features of diastolic CHF Echo LVH; EKG LVH; CXR Pulm edema
Echo features present in systolic HF & absent in diastolic HF Reduced EF; LV dilation
In a pt with HTN, CAD, A-fib, and multiple TIA episodes in last 2 weeks (currently asymptomatic), what test is next step in mgmt? TEE
Patient with hx of HTN and CAD presenting with substernal CP is given SL NTG and then has syncope. What is next diagnostic step in mgmt? TTE
Created by: Abarnard