Cardiology overview imaging

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Cardiology Overview

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Acute Coronary Syndromes

Antiplatelets and antithrombins

Cardiomyopathy

Congenital heart disease

Electrophysiology

Heart failure

Hypertension

Imaging

Invasive cardiology

Pericardial disease

Peripheral arterial disease

Pharmacology

Pregnancy

Preoperative evaluation

Prevention

Pulmonary hypertension

Stable angina

Valvular heart disease

Venous thromboembolism

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Angiography

  • Assess coronary lumen, not wall of artery
  • Inaccurate and variable in the assessment of short, diffusely diseased left main lesions
  • Provides less functional information than fractional flow reserve
  • Should be combined with fractional flow reserve in intermediate lesions. PCI should be performed if FFR is < 0.80. It is safe to hold off on PCI in intermediate lesions with an FFR > 0.80 as shown in the FAME study.

CT Scanning

Echocardiography

  • The E/E* ratio is a new criteria to assess diastolic dysfunction.
  • Echocardiography tends to overestimate that gradient in aortic stenosis

MRI

Distinguishing Stunning from Hibernation and Chronic Myocardial Infarction

Stunning

  • In the patient with stunning there is preservation of augmentation of contractility with an inotrope, glucose metabolism, and perfusion.

Chronic MI

  • In the patient with a chronic MI and scar there is no augmentation with an inotrope, glucose metabolism (FDG uptake) is reduced, and there is reduced perfusion (reduced N labeled amonia).

Hibernating Myocardium

  • In the patient with hibernating myocardium there is preserved augmentation of contractility within inotrope, there is preserved glucose metabolism, but there is reduced perfusion. This is often what is seen prior to coronary artery bypass grafting.

References

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