Diagnostic tests for coronary artery diseases resident survival guide: Difference between revisions
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|'''Dobutamine echocardiography''' ||(a) Done in patients who can't exercise <br> b) Information on an area of myocardium at risk is needed|| || [[Hypertension]] <br> [[Arrhythmia]]<br>[[Beta blocker]] should be held prior to test | |'''Dobutamine echocardiography''' ||(a) Done in patients who can't exercise <br> b) Information on an area of myocardium at risk is needed|| || [[Hypertension]] <br> [[Arrhythmia]]<br>[[Beta blocker]] should be held prior to test | ||
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|'''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|| [[Hypertension]] <br> [[Arrhythmia]]<br>[[Beta blocker]] should be held prior to test <br> Radiation | |'''Dobutamine nuclear <br> 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|| [[Hypertension]] <br> [[Arrhythmia]]<br>[[Beta blocker]] should be held prior to test <br> Radiation | ||
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|'''Vasodilator nuclear perfusion''' ||(a) Done in patients who can't exercise & have <br> contraindications to [[dobutamine]]|| 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 <br> perfusion''' ||(a) Done in patients who can't exercise & have <br> contraindications to [[dobutamine]]|| 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 | ||
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Revision as of 01:25, 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 | (a) Done in patients who can't exercise b) Information on an area of myocardium at risk is needed |
Hypertension Arrhythmia Beta blocker should be held prior to test | |
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 |
Hypertension Arrhythmia Beta blocker should be held prior to test Radiation |
Vasodilator nuclear perfusion |
(a) Done in patients who can't exercise & have contraindications to dobutamine |
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 |