Cardiology and Cardiac Catheterization Overview

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Questions and Answers

What defines myocardial injury in the context of acute coronary syndrome?

Presence of ischemic ECG changes without elevated troponin levels

Acute coronary thrombus on angio without elevated troponin levels

Troponin level above the 99th percentile without evidence of myocardial ischemia (correct)

New wall-motion abnormalities without elevated troponin levels

What characterizes Type 2 myocardial infarction?

Spontaneous plaque rupture leading to intraluminal thrombus

Ischemic ECG changes with clear precipitating factor

Presence of new wall-motion abnormalities with elevated troponin levels

Supply-demand mismatch that is not atherothrombosis (correct)

What is the most common cause of Type 2 myocardial infarction?

Sepsis/infection (correct)

Vasospasm

Aortic dissection

Spontaneous plaque rupture

What is the purpose of rotating the probe 90° in the 5-chamber view?

To visualize the inferior vena cava (IVC) and assess volume status and right atrial (RA) pressure Signup and view all the answers

What does the LV internal diameter in diastole (LVIDd) measure?

LV internal diameter at rest Signup and view all the answers

What does an abnormal septal motion indicate?

Constrictive pericarditis Signup and view all the answers

What does the diameter and respiratory variation of the IVC provide an estimate of?

Volume status and right atrial (RA) pressure Signup and view all the answers

What is the preferred treatment approach for STEMI without cardiogenic shock?

Complete revascularization strategy Signup and view all the answers

Which condition warrants culprit-lesion only PCI for STEMI?

STEMI with cardiogenic shock Signup and view all the answers

What is the preferred treatment for 3VD, L main disease, 2VD with prox LAD stenosis or EF<40%?

CABG Signup and view all the answers

What is assessed during Left Heart Catheterization?

Coronary anatomy/lesions and performs PCI Signup and view all the answers

What does Right Heart Catheterization assess?

Hemodynamics, cardiac biopsies, and CO Signup and view all the answers

What should be the approach for intermediate risk patients in terms of invasive procedures?

Delayed invasive approach within 72h Signup and view all the answers

Which modality is preferred over pharmacologic testing if the patient can reach goal exertion?

Exercise Tolerance Test (ETT) Signup and view all the answers

What diagnostic criteria are used for exercise stress testing?

Reaching >85% max-predict HR, peak double product >20k, and HR recovery >12 Signup and view all the answers

Which imaging modality is used to determine the viability of ischemic myocardial tissue?

SPECT Signup and view all the answers

What is the indicated use of Coronary CTA?

To evaluate the presence and extent of CAD Signup and view all the answers

What do Cardiac MRI assess primarily?

The functional and tissue properties of the heart Signup and view all the answers

What are the stress testing modalities mentioned in the text?

Exercise, vasodilator, inotropy Signup and view all the answers

Which diagnostic criteria are used for exercise stress testing?

>85% max-predict HR, peak double product >20k, HR recovery >12 Signup and view all the answers

What is the preferred stress testing modality if the patient can reach goal exertion?

Exercise Tolerance Test (ETT) Signup and view all the answers

Which modality is used for viability testing to determine the viability of ischemic myocardial tissue?

SPECT Signup and view all the answers

What does rest imaging include for evaluating the presence and extent of CAD?

Coronary CTA Signup and view all the answers

What is indicated for low to moderate risk patients to evaluate the presence and extent of CAD?

Coronary CTA Signup and view all the answers

Study Notes

Non-Invasive Cardiac Testing Overview

Stress testing modalities include exercise (treadmill), vasodilator (adenosine, regadenoson), and inotropy (dobutamine).
Imaging modalities for stress testing include ECG, TTE, SPECT, PET, and MRI.
Exercise Tolerance Test (ETT) is preferred over pharmacologic testing if the patient can reach goal exertion.
Diagnostic criteria for exercise stress testing include reaching >85% max-predict HR, peak double product >20k, and HR recovery >12.
Pharmacologic stress tests are used for imaging only and involve choosing agents like adenosine/regadenoson or dobutamine.
Viability testing is used to determine the viability of ischemic myocardial tissue and involves SPECT, PET, TTE, or MRI.
Rest imaging includes the use of coronary CTA to evaluate the presence and extent of CAD.
Coronary CTA should not be used to screen asymptomatic patients and is indicated for low to moderate risk patients.
Coronary Artery Calcium (CAC) scans provide risk assessment scores for CAD and ASCVD risk stratification.
Cardiac MRI is the modality of choice for assessing the functional and tissue properties of the heart.
Different echocardiography views, such as parasternal long axis, apical 4 chamber, and parasternal short axis, are used to assess various aspects of cardiac function and anatomy.
Echocardiography helps in assessing LV size, function, wall thickness, MV/AoV function/flow, RV/LV size, function, thrombus, septal size/motion, and pericardial effusion.

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Description

Test your knowledge of cardiology and cardiac catheterization with this summary quiz covering topics such as chest pain evaluation, cardiac catheterization procedures, and non-invasive cardiac testing modalities.