Diagnostic tests for coronary artery diseases resident survival guide: Difference between revisions
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!Disadvantages | !Disadvantages | ||
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|'''Dobutamine echocardiography''' || | |'''Dobutamine echocardiography''' ||Done in patients who can't exercise || Information regarding functional capacity, <br> and hemodynamic changes to exercise || Contraindicated with baseline EKG abnormalities i.e. [[LVH]] , <br> [[LBBB]], > 1mm ST depression, [[WPW]], [[paced rhythm]] | ||
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|'''Dobutamine nuclear perfusion''' ||a) | |'''Dobutamine nuclear perfusion''' ||a) Done in patients who can't exercise <br> b) Information on an area of myocardium at risk is needed|| a) Information regarding exercise data, <br> wall motion abnormality, valvular defects, and pulmonary pressures <br> b) portable, cheap, fast|| Image quality, and interpretation difficult <br> with baseline wall motion abnormality, <br> decreased accuracy in single vessel disease, <br> or delayed images | ||
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|'''Vasodilator nuclear perfusion''' ||a) With baseline EKG abnormality <br> b) Information on an area of myocardium at risk is needed|| a) Technetium has superior images compared <br> to thallium but has longer half life. For superior images technetium is used|| Artifacts caused by diaphragm, or breast tissue <br> Radiation exposure | |'''Vasodilator nuclear perfusion''' ||a) With baseline EKG abnormality <br> b) Information on an area of myocardium at risk is needed|| a) Technetium has superior images compared <br> to thallium but has longer half life. For superior images technetium is used|| Artifacts caused by diaphragm, or breast tissue <br> Radiation exposure | ||
Revision as of 00:30, 3 December 2013
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-In-Chief:; Priyamvada Singh, M.D. [2]
Definition
Causes
Life Threatening Causes
Common Causes
Management
Exercise stress testing
| Test | Indications | Advantages | Disadvantages |
|---|---|---|---|
| Exercise EKG | Initial test for suspected CAD | Information regarding functional capacity, and hemodynamic changes to exercise |
Contraindicated with baseline EKG abnormalities i.e. LVH , LBBB, > 1mm ST depression, WPW, paced rhythm |
| Stress ECHO | a) With baseline EKG abnormality b) Information on an area of myocardium at risk is needed |
a) Information regarding exercise data, wall motion abnormality, valvular defects, and pulmonary pressures b) portable, cheap, fast |
Image quality, and interpretation difficult with baseline wall motion abnormality, decreased accuracy in single vessel disease, or delayed images |
| Nuclear SPECT perfusion | a) With baseline EKG abnormality b) Information on an area of myocardium at risk is needed |
a) Technetium has superior images compared to thallium but has longer half life. For superior images technetium is used |
Artifacts caused by diaphragm, or breast tissue Radiation exposure |
Pharmacological stress testing
| Test | Indications | Advantages | Disadvantages |
|---|---|---|---|
| Dobutamine echocardiography | Done in patients who can't exercise | Information regarding functional capacity, and hemodynamic changes to exercise |
Contraindicated with baseline EKG abnormalities i.e. LVH , LBBB, > 1mm ST depression, WPW, paced rhythm |
| Dobutamine nuclear perfusion | a) Done in patients who can't exercise b) Information on an area of myocardium at risk is needed |
a) Information regarding exercise data, wall motion abnormality, valvular defects, and pulmonary pressures b) portable, cheap, fast |
Image quality, and interpretation difficult with baseline wall motion abnormality, decreased accuracy in single vessel disease, or delayed images |
| Vasodilator nuclear perfusion | a) With baseline EKG abnormality b) Information on an area of myocardium at risk is needed |
a) Technetium has superior images compared to thallium but has longer half life. For superior images technetium is used |
Artifacts caused by diaphragm, or breast tissue Radiation exposure |