How does ultrasound work?
ultrasound wave echoes onto structures and back into transducer. The time it takes for it to reflect determines the distance
What are the 3 possible views of the heart
paratersnal long-axis = 2 chamber
parasternal short axis = 3 chamber
subcostal = 4 chamber
What is echo Doppler? Color Doppler?
using sounds, gives information about the speed and direction of blood flow
Color Doppler is a variant that depicts the different speeds with colors
Why would we use Bernoulli Equation in Echo?
to change the Doppler speed into a measure of pressure
What is bernoulli’s equation?
DeltaP = 4V^2
What is the continuity equation and why is it used in doppler?
to estimatie the effective area of a region of interest ( like a stenotic valve)
A1V1 = A2V2
What is a transesophageal echo and why is it prefered?
it’s a probe that goes into the esophagous and ends up closer to the heart for a more precise echo
How does nuclear perfusion imagig work?
Radionuclides are injected (techntium, sestamibi or thallim) and the uptake in hte myocardium is proportional to the blood flow and thus reflects the coronary artery patency
A SPECT is used to image this
How can nuclear perfusion imaging identify an occluded coronary artery?
during exercise, on side will not receive the necessary blood flow and we will be able to detect this˜
in nuclear perfusion imaging, what is a fixed vs reversible defect?
a reversible defect is when blood flow returns to normal at rest
How does a PET scan work?
we inject isotrope of glucose which will go where there is the most metabolic activity, so can be towards infloammation (endocardits)
How do we perform a catherization?
insert sheath into femoral artery or jugular vein depending on what we want to look at. Then go to the coronary vessels and inject iodinated contrast to see the vessel
What is PCI?
percutaneous coronary intervention = insertion of a stent
What is TAVR?
transcatheter aortic valve replacement
Is ccatherization dangerous?
not really, 1 in 1000 chances of serious complications
so we do these now in more scenarios
What is the coronary flow reserve (CFR)? What is the average CFR?
flow or perfusiono of vessel after vasodilation/ flow or perfusion in vessel at rest
normal is 4-5
What are advantages of MRI?
high spatial and contrast resolution
Accurate measrements
tissue characterization
no radiation
What are limitations of MRI?
time consumming
not always feasible
susceptible to artifacts
rare risk of gadolinium-induced nephrogenic systemic fibrosis
What are the 3 main MRI sequences?
T1 = fat and contrast appear white
T2 = FLuid and edematous tissue appear white
Late gadolinium enhancement (LGE) = detect hyperenhancement that reflects abnormal accumulation and poor clearance of gadolinium in areas of tissu fibrosis
What are 3 things that cardiac MR can do that echo cannot?
detecct fibrosis, edema and perfusion
Why does gadolinium accumulate in infarct or scar tissue
stays in extracellular content with less perfusion, so mostly in scars and in empty and dead infarct cells
When do we want to time our CT pictures when taking a CT of the heart?
in the calmest moments so holding breath and before systole
What causes a stair step artifact ?
irregular HR
What causes a blooming artifact?
calcium in artery outer wall that blocks view inside
-
Histology66
-
Anatomy74
-
Hemodynamics56
-
The heart pump52
-
Blood pressure30
-
Orthostasis25
-
ECG34
-
Electrophysiology106
-
Embryology32
-
Epidemiology35
-
Pharmacology21
-
Valves36
-
Heart sounds39
-
Pericardium disease30
-
physiology 260
-
Atherosclerosis21
-
CAD14
-
Pharmacology122
-
Ischemic heart disease38
-
acute coronary syndromes19
-
systemic and pulmonary vascular pathobiology9
-
imaging25
-
Vascular disease50
-
Dyslipidemia34
