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WDclass11

The document provides an overview of cardiac testing and diagnostics, including the use of ECGs, echocardiograms, and various stress tests to evaluate heart function and detect ischemia. It outlines the indications for ordering these tests, such as chest pain and risk factors for heart disease, and discusses the role of coronary angiograms and blood tests in assessing cardiac health. Additionally, it includes links to educational videos for further understanding of these diagnostic procedures.

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Logan Hutchinson
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© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PPTX, PDF, TXT or read online on Scribd
5 views25 pages

WDclass11

The document provides an overview of cardiac testing and diagnostics, including the use of ECGs, echocardiograms, and various stress tests to evaluate heart function and detect ischemia. It outlines the indications for ordering these tests, such as chest pain and risk factors for heart disease, and discusses the role of coronary angiograms and blood tests in assessing cardiac health. Additionally, it includes links to educational videos for further understanding of these diagnostic procedures.

Uploaded by

Logan Hutchinson
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PPTX, PDF, TXT or read online on Scribd
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Western Diagnostics

Class 11, Cardiac testing and diagnostics


a little quiet
Electrocardiogram
s

ECGs measure the


electrical activity in the
heart
Video on ECG

• https://www.youtube.com/watch?v=xIZQRjkwV9Q
Standard 12 lead ECG
Lead placement
Flow through various
leads
Some typical reasons for ordering an
ECG

• Report of chest pain or discomfort


• Report of palpitations
• Report of shortness of breath
• Report of nausea
• Or any of the standard symptoms of angina with
exertion
• We would have a lower threshold for getting an
ECG if a patient has multiple risk factors for heart
disease
Echocardiograms

• Echocardiograms can be used to evaluate the


anatomy and function of the heart
• When do you think a doctor might want to order an
echocardiogram?
Types of Echocardiograms

• To evaluate anatomy only, wall thickness, valves


• To evaluate flow through the chambers and valves
• To evaluate ejection fraction
• Stress echos are used to assess for ischemia
Three types of stress tests, all are
screens to show ischemia

• Stress echo- shows wall motion abnormality with


ischemia
• Stress ECG- shows ST segment depression with
ischemia if the ischemia involves the full wall
thickness of the ventricle
• Nuclear stress test- demonstrates perfusion
abnormality in ischemia
Echo video

• https://www.youtube.com/watch?v=DZ3G8P0L_sM

• Stress echo video


• https://www.youtube.com/watch?v=ioRHjagbEX4
Stress ECG

• In this test a patient is hooked up to an ECG


machine and resting ECG is recorded.
• Then they are put on a treadmill (if they can
tolerate this) and the ECG is recorded during
exercise
• A positive test shows ST segment depression
• A potential problem is that this will only show up if
the ischemia is encompassing the full thickness of
the ventricular wall.
Nuclear stress test

• In this test a nuclear tracer is administered at rest


and the way it distributes in the heart is recorded.
• Then the patient is exercised, and a second tracer
is administered. If there is ischemia there will be a
perfusion abnormality in the area of ischemia that
will show up on the follow up scan.
See the perfusion defect in the stress
portion
Coronary angiogram

• When do you think this would be ordered?


Angiogram with stent placement

• https://www.youtube.com/watch?v=JeH4zPzQgRc
CT angiogram, for low or intermediate
risk patients
Coronary calcium score, low risk patients
In conclusion

• If positive stress test direct angiogram


• If low to moderate risk CT angiogram
• If low risk Calcium score
Deep Vein Thrombosis

• Venous ultrasound with doppler


Peripheral arterial blockages

• Ankle Brachial index


• Arterial ultrasound
• Arterial angiography
• Angiograms can be used to visualize any part of
the cardiovascular system
Blood tests for Cardiac health

• Myoglobin
• CPK
• Troponin
• CRP
• BNP
• Homocysteine
• Fibrinogen
• Lipids
Questions?

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