123 Main St NY, New York ph: (202) fax: (202)

Save this PDF as:
 WORD  PNG  TXT  JPG

Size: px
Start display at page:

Download "123 Main St NY, New York 12345 ph: (202) 555 5555 fax: (202) 555 5555"

Transcription

1 Patient Name: DOE, JOHN D. Gender: M Date of Study: 4/2/2013 Date of birth: 6/28/1962 Age: 50 Medical Record #: Ordering Physician: JANE INTERNIST, MD History: Atypical Angina, Abn ECG, High Cholesterol, Hypertension, Positive Treadmill Test Indications: Assessment of chest pain, Positive ETT 5.8 mci of Tc-99m sestamibi was administered via IV injection at rest. Approximately 45 minutes afterwards, cardiac SPECT imaging was performed. A stress test was then performed and at peak exercise, 17.9 mci of Tc-99m sestamibi was injected IV; approximately 45 minutes post injection, cardiac gated SPECT and prone cardiac gated SPECT imaging was performed. Attenuation correction was not used. STRESS PROTOCOL: Exercise Stress Test The patient exercised on a treadmill utilizing the Bruce protocol; they completed 11 minutes & 10 seconds, achieving approximately 12.9 METS. Baseline heart rate was measured at 62 bpm, and increased to 185 bpm at peak exercise; which is 108% of the maximum predicted heart rate. The heart rate response was normal. Baseline blood pressure was 142/78 mmhg and increased to 168/92 mmhg at peak exercise, which is a normal response to exercise. Resting ECG demonstrated normal sinus rhythm with diffuse non-specific ST-T wave abnormalities. During exercise, the ECG showed non-sustained V-tach. At peak stress, the ECG revealed downsloping ST-T depression of mm. During exercise, the patient developed dyspnea, chest pain level 4 of 10, fatigue. The reason for exercise termination was chest pain, fatigue, dyspnea, patient's request. Symptomatology resolved during standard recovery period. EXERCISE TEST SUMMARY: min on Bruce protocol Chest pain level 4 of 10 Dyspnea Exercise ST-T changes noted Stopped for chest pain, fatigue, dyspnea, patient's request. EXERCISE TEST IMPRESSION: Positive Study quality: suboptimal due to artifact Left Ventricle: Normal Artifacts: sub-diaphragmatic activity SPECT imaging demonstrated transient ischemic dilation of the left ventricle on the post-stress images, along with a medium size, mostly reversible perfusion abnormality of moderate severity located in the apical anterior, apical septal, mid anterior segment(s) of the left ventricle. The stress perfusion defect extent was 20%, the rest perfusion defect extent was 6%, and the stress ischemia extent was 14%. Gated SPECT imaging revealed normal left ventricular wall motion, thickening, and overall LV systolic function. The estimated post-stress ejection fraction was 52%. Abnormal myocardial perfusion: There was transient ischemic dilation of the left ventricle on the post-stress images. This is associated with severe CAD. Also, there was a medium size mostly reversible perfusion abnormality of moderate severity located in the apical anterior, apical septal, mid anterior segment(s) of the left ventricle. Stress defect extent = 20%; Rest defect extent = 6%; Stress ischemia extent = 14%. Normal left ventricular systolic function: All segments of left ventricle demonstrated normal wall motion and thickening. Ejection fraction = 52%. Results indicate that myocardial ischemia is possibly the cause of patient chest pain. Recommend cardiac catheterization, PCI if indicated. Joe Cardiologist, MD FACC Date of Final Report: 4/2/2013 cc: SALLY SPECIALIST,MD 123 Main St NY, New York ph: (202) fax: (202)

2 Patient Name: DOE, JOHN A. Gender: M Date of Study: 4/2/2013 Date of birth: 8/24/1955 Age: 57 Medical Record #: History: Fatigue, DOE, Dyslipidemia, A-Fib Indications: Assessment of anginal equivalents (Fatigue) (DOE) 5.7 mci of Tc-99m tetrofosmin was administered via IV injection at rest. Approximately 30 minutes afterwards, cardiac SPECT imaging was performed. A stress test was then performed and at peak stress, 20.3 mci of Tc-99m tetrofosmin was injected IV; approximately 30 minutes post injection, cardiac gated SPECT imaging was performed. Prone images were also acquired to mitigate attenuation artifact(s). STRESS PROTOCOL: Regadenoson Stress Test Reason for Pharmacologic Stress: V-paced, reactive airway disease The patient was intravenously infused with 5ml of regadenoson over 10 seconds for a total dose of.4 mg, followed by a 5ml saline flush over 10 seconds, followed by stress radiotracer administration seconds later. Adjunctive exercise was not used during pharmacologic stress infusion. Heart rate was 64 bpm at baseline, and changed to 89 bpm at peak stress. The heart rate response was normal. Baseline blood pressure was 120/80 mmhg and changed to 80/52 mmhg at peak stress, which is a hypotensive response to regadenoson. Resting ECG demonstrated normal sinus rhythm w/ PVCs, PACs with IVCD, LAHB. During stress the ECG revealed no additional arrythmia. At peak stress, the ECG revealed no diagnostic ST-T changes. During exercise, the patient developed a "funny" feeling, abdominal discomfort, dyspnea. The reason for infusion termination was end of protocol. 100 mgs of aminophylline was infused IV during recovery to reverse vasodilator stress agent. Symptomatology resolved approximately 3 minutes after standard recovery period. REGADENOSON STRESS IMPRESSION: Equivocal Study quality: adequate Left Ventricle: Normal Artifacts: diaphragmatic attenuation, frequent PVCs; gated study suboptimal SPECT imaging demonstrated homogeneous perfusion on the rest and stress images, with transient ischemic dilation of the left ventricle on the post-stress images. Gated SPECT imaging of the left ventricle was abnormal, demonstrating mild global hypokinesis of the left ventricle. Overall left ventricular systolic function was mildly impaired. The estimated resting ejection fraction was 55%, and the calculated post-stress ejection fraction was 43%. Abnormal myocardial perfusion: there was transient ischemic dilation of the left ventricle on the post-stress images. This is associated with severe CAD. Abnormal left ventricular systolic function: Mild global hypokinesis of the left ventricle. Ejection fraction = 43%. John Hancock, MD FACC Date of Final Report: 4/2/2013

3 Patient Name: DOE, JOHN Gender: M Date of Study: 4/2/2013 Date of birth: 3/15/1945 Age: 68 Medical Record #: History: Chest Pain, DOE, Sleep Apnea, Diabetic, Palpitations, Fam Hx of CAD Indications: Assessment of chest pain, Ischemic Equivalent (DOE) 5.6 mci of Tc-99m sestamibi was administered via IV injection at rest. Approximately 45 minutes afterwards, cardiac SPECT imaging was performed. A stress test was then performed and at mid-point of vasodilator infusion, 18.5 mci of Tc-99m sestamibi was injected IV; approximately 45 minutes post injection, cardiac gated SPECT imaging was performed. STRESS PROTOCOL: Adenosine Stress Test Reason for Pharmacologic Stress: Rate-related LBBB A dose of 140ug/kg/min of adenosine infused IV over 4 minutes for a total dose of 58.7 mg. Adjunctive exercise was used during pharmacologic stress infusion. The radiopharmaceutical was injected at 2 minutes into the infusion. Heart rate was 68 bpm at baseline, and changed to 89 bpm at midpoint of vasodilator infusion. The heart rate response was normal. Baseline blood pressure was 126/76 mmhg and changed to 112/72 mmhg at midpoint of vasodilator infusion, which is a physiologic response to adenosine. Resting ECG demonstrated normal sinus rhythm w/ PACs with rightward axis, early r-wave progression. During infusion the ECG revealed no additional arrythmia. At peak infusion, the ECG revealed no diagnostic ST-T changes. During infusion, the patient developed a "wierd" feeling, shortness of breath, flushing. The reason for infusion termination was end of protocol. 100 mgs of aminophylline was infused IV during recovery to reverse vasodilator stress agent. Symptomatology resolved during standard recovery period. ADENOSINE STRESS IMPRESSION: Nondiagnostic Study quality: suboptimal due to artifact Left Ventricle: Normal Artifacts: diaphragmatic attenuation SPECT imaging demonstrated uniform (normal) tracer distribution throughout the myocardium at rest and at peak stress. Gated SPECT images revealed normal thickening, wall motion, and overall left ventricular systolic function. The calculated post-stress ejection fraction was 57%. IMPRESSION: Normal Normal myocardial perfusion. Normal left ventricular systolic function: All segments of left ventricle demonstrated normal wall motion and thickening. Ejection fraction = 57%. John Hancock, MD FACC Date of Final Report: 4/3/2013

4 Patient Name: DOE, JANE B. Gender: F Date of Study: 4/3/2013 Date of birth: 2/9/1937 Age: 76 Medical Record #: Ordering Physician: JANE INTERNIST, MD History: Atypical Chest Pain, Depression, PVD, Positive Treadmill Test Indications: Assessment of chest pain, + ETT 5.3 mci of Tc-99m tetrofosmin was administered via IV injection at rest. Approximately 45 minutes afterwards, cardiac SPECT imaging was performed. A stress test was then performed and at ~ 3 minutes after infusion, 18.4 mci of Tc-99m tetrofosmin was injected IV; approximately 30 minutes post injection, anterior cardiac planar & cardiac gated SPECT imaging was performed. CT based attenuation correction was used. STRESS PROTOCOL: Dipyridamole Stress Test Reason for Pharmacologic Stress: V-paced The patient was intravenously infused with dipyridamole at 142ug/kg/min over 4 minutes for a total dose of 51.3 mg. Adjunctive exercise was used after the pharmocologic stress infusion; the stress dose of radiotracer injected then. The radiopharmaceutical was injected 3 minutes after the infusion. Heart rate was 69 bpm at baseline, and increased to 110 bpm at time of radiopharmaceutical injection. The heart rate response was normal. Baseline blood pressure was 138/84 mmhg and increased to 142/86 mmhg at time of radiopharmaceutical injection, which is a physiologic response to dipyridamole. Resting ECG demonstrated normal sinus rhythm w/ PVCs, PACs with lateral Q-waves. During dipyridamole infusion the ECG revealed PACs, PVCs. At peak infusion, the ECG revealed horizontal ST-T depression of mm. During infusion, the patient developed diaphoresis, nausea. The reason for infusion termination was end of protocol. Symptomatology resolved during standard recovery period. DIPYRIDAMOLE STRESS IMPRESSION: Positive by ECG criteria Study quality: adequate Left Ventricle: Normal Artifacts: none SPECT imaging demonstrated a medium size, fixed perfusion abnormality of moderate severity located in the mid inferolateral, basal inferolateral, mid anterolateral segment(s) of the left ventricle. Gated SPECT imaging of the left ventricle was abnormal, demonstrating moderate hypokinesis of the lateral segment(s) of the left ventricle (this abnormality matches a fixed perfusion defect, suggesting myocardial scarring from previous myocardial infarction). Overall left ventricular systolic function was mildly impaired. The estimated post-stress ejection fraction was 44%. Abnormal myocardial perfusion: Medium to large size fixed perfusion abnormality of moderate severity located in the mid inferolateral, basal inferolateral, mid anterolateral segment(s) of the left ventricle. Abnormal left ventricular systolic function: Moderate hypokinesis of the lateral segment(s) of the left ventricle. Ejection fraction = 44%. Compared to previous study on 1/18/2009, perfusion shows new infarction. There is new LV function abnormality. John Hancock, MD FACC Date of Final Report: 4/1/2013 cc: SALLY SPECIALIST,MD

5 Patient Name: DOE, JANE R Gender: F Date of Study: 4/2/2013 Date of birth: 9/24/1951 Age: 61 Medical Record #: History: Abn ECG, Syncope, Diabetic, Obesity(Morbid), High triglycerides Indications: Assessment of ischemic equivalent (Syncope), Abn ECG NUCLEAR IMAGING PROTOCOL: Dual Isotope 3.1 mci of Tl-201 thallium chloride was administered via IV injection at rest. Approximately 10 minutes afterwards, anterior cardiac planar & cardiac SPECT imaging was performed. Transmission source attenuation correction was used. A stress test was then performed and at peak stress, 21.1 mci of Tc-99m Cardiolite was injected IV; approximately 45 minutes post injection, cardiac gated SPECT and prone cardiac SPECT imaging was performed. Transmission source attenuation correction was used. STRESS PROTOCOL: Dobutamine Stress Test Reason for Pharmacologic Stress: Unable to exercise, COPD Dobutamine was infused incrementally, starting at a dose of 5 mcg/kg/min, which was increased at 3-minute intervals to 20, then 30 mcg/kg/min over 10 minutes & 19 seconds for a total dose of 24.1 mg. Adjuntive atropine was infused IV for a total dose of.5 mg. Baseline heart rate was 63 bpm and increased to 147 bpm at peak stress which represents 92% of the MPHR. The heart rate response was normal. Baseline blood pressure was 124/76 mmhg and increased to 164/88 mmhg at peak stress, which is a physiologic response to dobutamine. Resting ECG demonstrated normal sinus rhythm with LAD, IVCD. During stress the ECG revealed occaisonal PVCs. At peak stress, the ECG revealed flat to upsloping ST-T depression of mm. There was T-wave inversion during stress. During stress, the patient developed shortness of breath, chest pain (level 4 of 10). The reason for infusion termination was achievement of target heart rate. Symptomatology resolved during standard recovery period. DOBUTAMINE STRESS IMPRESSION: Positive by ECG criteria Study quality: suboptimal secondary to body habitus, artifact Left Ventricle: Normal Artifacts: diaphragmatic attenuation SPECT imaging demonstrated a small to medium size, mostly reversible perfusion abnormality of severe intensity located in the anterior lateral segment(s) of the left ventricle. The 17-segment summed stress score was 8, the summed rest score was 2, and the summed difference score was 6. Gated SPECT imaging revealed normal left ventricular wall motion, thickening, and overall LV systolic function. The calculated resting ejection fraction was 52%, and the calculated post-stress ejection fraction was 55%. Abnormal myocardial perfusion: Small to medium size mostly reversible perfusion abnormality of severe intensity located in the anterior lateral segment(s) of the left ventricle. SSS= 8; SRS= 2; SDS= 6 Normal left ventricular systolic function: All segments of left ventricle demonstrated normal wall motion and thickening. Ejection fraction = 55%. John Hancock, MD FACC Date of Final Report: 4/2/2013

Abnormal, Autoquant Adenosine Myocardial Perfusion Heart Imaging

Abnormal, Autoquant Adenosine Myocardial Perfusion Heart Imaging Background: Reason: preoperative assessment of CAD, Shortness of Breath Symptom: atypical chest pain Risk factors: hypertension Under influence: a beta blocker Medications: digoxin Height: 66 in. Weight:

More information

Cardiac Stress Testing in Nuclear Cardiology

Cardiac Stress Testing in Nuclear Cardiology Cardiac Stress Testing in Nuclear Cardiology Gaiane Doubinina, RN, MSN, FNP BC Nurse Practitioner, Nuclear Medicine/Cardiac Imaging Learning Objectives: Indications for stress testing Contraindication

More information

MYOCARDIAL PERFUSION IMAGING FINAL REPORT

MYOCARDIAL PERFUSION IMAGING FINAL REPORT Guide and Checklist for ICANL Report Compliance by MYOCARDIAL PERFUSION IMAGING FINAL REPORT Patient Name: DOE, JOHN D. Gender: M Date of Study: 4/2/2013 Date of birth: 6/28/1962 Age: 50 Medical Record

More information

Part A: Structure and Organization

Part A: Structure and Organization Part A: Structure and Organization Radioactive Materials License NRC (or State) radioactive materials license present Personnel Medical Director Meets Medical Director responsibility requirements Meets

More information

Radiology Rounds A Newsletter for Referring Physicians Massachusetts General Hospital Department of Radiology

Radiology Rounds A Newsletter for Referring Physicians Massachusetts General Hospital Department of Radiology Radiology Rounds A Newsletter for Referring Physicians Massachusetts General Hospital Department of Radiology Nuclear Cardiology Stress Tests for Coronary Artery Disease Exercise ECG without imaging should

More information

September 2003 Myocardial Perfusion Imaging: a game of acronyms. Mehret Mandefro, Harvard Medical School IV. Gillian Lieberman, MD

September 2003 Myocardial Perfusion Imaging: a game of acronyms. Mehret Mandefro, Harvard Medical School IV. Gillian Lieberman, MD September 2003 Myocardial Perfusion Imaging: a game of acronyms MIBI, Thal, ETT & SPECT Mehret Mandefro, Harvard Medical School IV Objectives Review indications for when myocardial perfusion scans should

More information

Section 8: Clinical Exercise Testing. a maximal GXT?

Section 8: Clinical Exercise Testing. a maximal GXT? Section 8: Clinical Exercise Testing Maximal GXT ACSM Guidelines: Chapter 5 ACSM Manual: Chapter 8 HPHE 4450 Dr. Cheatham Outline What is the purpose of a maximal GXT? Who should have a maximal GXT (and

More information

2015 Reimbursement Guide

2015 Reimbursement Guide Reimbursement Guide - Cardiology 2015 Reimbursement Guide for Myocardial Perfusion Imaging including radiopharmaceuticals and related product information 2015 Reimbursement Guide for Myocardial Perfusion

More information

MYOCARDIAL PERFUSION COMPUTED TOMOGRAPHY PhD course in Medical Imaging. Anne Günther Department of Radiology OUS Rikshospitalet

MYOCARDIAL PERFUSION COMPUTED TOMOGRAPHY PhD course in Medical Imaging. Anne Günther Department of Radiology OUS Rikshospitalet MYOCARDIAL PERFUSION COMPUTED TOMOGRAPHY PhD course in Medical Imaging Anne Günther Department of Radiology OUS Rikshospitalet CORONARY CT ANGIOGRAPHY (CTA) Accurate method in the assessment of possible

More information

Efficient Evaluation of Chest Pain

Efficient Evaluation of Chest Pain Efficient Evaluation of Chest Pain Vikranth Gongidi, DO FACC FACOI Indian River Medical Center Vero Beach, FL No Disclosures Outline Background Chest pain pathway Indications for stress test Stress test

More information

The Role Of Early Stress Testing In Assessing Low Risk Chest Pain Patients Admitted Through The Emergency Department

The Role Of Early Stress Testing In Assessing Low Risk Chest Pain Patients Admitted Through The Emergency Department The Role Of Early Stress Testing In Assessing Low Risk Chest Pain Patients Admitted Through The Emergency Department Simbo Chiadika LAY ABSTRACT A. Study purpose Cardiac stress testing has been recommended

More information

The Use of Nuclear Cardiology in Clinical Decision Making. T. Bryson Struse, D.O., F.A.C.O.I., D.A.B.N.M. Carondelet Heart and Vascular Institute

The Use of Nuclear Cardiology in Clinical Decision Making. T. Bryson Struse, D.O., F.A.C.O.I., D.A.B.N.M. Carondelet Heart and Vascular Institute The Use of Nuclear Cardiology in Clinical Decision Making T. Bryson Struse, D.O., F.A.C.O.I., D.A.B.N.M. Carondelet Heart and Vascular Institute Cardiovascular disease remains the leading cause of death

More information

Practical Applications of Nuclear Cardiology

Practical Applications of Nuclear Cardiology Practical Applications of Nuclear Cardiology a report by Dr Robert C Hendel President, American Society of Nuclear Cardiology, and Member, Midwest Heart Specialists Background Heart disease, specifically

More information

ASNC IMAGING GUIDELINES FOR NUCLEAR CARDIOLOGY PROCEDURES. Standardized reporting of radionuclide myocardial perfusion and function

ASNC IMAGING GUIDELINES FOR NUCLEAR CARDIOLOGY PROCEDURES. Standardized reporting of radionuclide myocardial perfusion and function ASNC IMAGING GUIDELINES FOR NUCLEAR CARDIOLOGY PROCEDURES Standardized reporting of radionuclide myocardial perfusion and function Peter L. Tilkemeier, MD, a C. David Cooke, MSEE, b Gabriel B. Grossman,

More information

Contents. Nuclear Cardiology. Page

Contents. Nuclear Cardiology. Page Nuclear Cardiology Authored and approved by Alessia Gimelli, Danilo Neglia, Thomas H. Schindler, Bernard Cosyns, Patrizio Lancellotti, Anastasia Kitsiou on behalf of the Section on Nuclear Cardiology and

More information

Obtain patient height/weight for body surface area calculation.

Obtain patient height/weight for body surface area calculation. Title: NM- Cardiac Perfusion Scan Radiologist Protocol Procedure Applies To: UNM Sandoval Regional Medical Center Responsible Department: Nuclear Medicine New: 03/22/2012 Revised: 7/2014 Next Review by:

More information

Is There a Role for Nuclear Cardiology in the Era of Cardiac CT? E. Gordon DePuey, M.D. Select the Appropriate Test to Meet the Patient Need

Is There a Role for Nuclear Cardiology in the Era of Cardiac CT? E. Gordon DePuey, M.D. Select the Appropriate Test to Meet the Patient Need Is There a Role for Nuclear Cardiology in the Era of Cardiac CT? E. Gordon DePuey, M.D. Clinical Professor of Radiology Icahn School of Medicine at Mt. Sinai Director of Nuclear Medicine Mt. Sinai St.

More information

Provider Checklist-Outpatient Imaging. Checklist: Nuclear Stress Test, Thallium/Technetium/Sestamibi (CPT Code 78451-78454 78469)

Provider Checklist-Outpatient Imaging. Checklist: Nuclear Stress Test, Thallium/Technetium/Sestamibi (CPT Code 78451-78454 78469) Provider Checklist-Outpatient Imaging Checklist: Nuclear Stress Test, Thallium/Technetium/Sestamibi (CPT Code 78451-78454 78469) Medical Review Note: Per InterQual, if any of the following are present,

More information

2012 Medicare Reimbursement Information Lantheus Medical Imaging

2012 Medicare Reimbursement Information Lantheus Medical Imaging If you have questions regarding reimbursement for Lantheus Medical Imaging products, call Randy VanCoughnett at 978-436-7995 or email randy.vancoughnett@lantheus.com. Reimbursement consists of three elements:

More information

Providence St. Vincent Heart Clinic Cardiology

Providence St. Vincent Heart Clinic Cardiology Providence St. Vincent Heart Clinic Cardiology Tests and Procedures ASD/PFO Closures An atrial septal defect (ASD) is an opening between the upper two chambers of the heart. Patent foramen ovale (PFO)

More information

NUCLEAR CARDIOLOGY AND CARDIO SPECT

NUCLEAR CARDIOLOGY AND CARDIO SPECT NUCLEAR CARDIOLOGY AND CARDIO SPECT SestaMIBI SPECT Study can measure Perfusion and function of the left ventricle Pulmonary Uptake of the Radiotracer Ischemic Dilation of the left ventricle Each of these

More information

Nuclear Cardiology Page 1 of 28

Nuclear Cardiology Page 1 of 28 Nuclear Cardiology Page 1 of 28 Table of Contents Page BRUCE Protocol Stress Test 3 Pharmacologic Stress Protocols 6 For Dipyridamole, Adenosine and Regadenoson Dobutamine Protocol Stress Test 9 One Day

More information

Principal Educational Goals

Principal Educational Goals Rotation: Nuclear Cardiology Director: Dr. Frank Bengel Faculty: Drs. Lewis Becker and Richard Wahl Rotation Hours: Mon to Fri, 9 am to 4 pm; Fellow may cover on "as needed" basis for other rotations.

More information

Nurse practitioners: a safe and competent choice for stress testing in myocardial perfusion scintigraphy

Nurse practitioners: a safe and competent choice for stress testing in myocardial perfusion scintigraphy Nurse practitioners: a safe and competent choice for stress testing in myocardial perfusion scintigraphy K Standbridge, E Reyes, K Latus, SR Underwood, J Riley Imperial College London & Royal Brompton

More information

An Introduction to the 12 lead ECG & Acute MI changes

An Introduction to the 12 lead ECG & Acute MI changes An Introduction to the 12 lead ECG & Acute MI changes a lecture for student nurses Dr Kofi Amu-Darko MB. ChB. DRCOG. DFFP. MRCGP. PgDip. LLM Family Physician Charles Curtis Memorial Hospital October 2008

More information

Diagnostic and Therapeutic Procedures

Diagnostic and Therapeutic Procedures Diagnostic and Therapeutic Procedures Diagnostic and therapeutic cardiovascular s are central to the evaluation and management of patients with cardiovascular disease. Consistent with the other sections,

More information

Effect of Spinal Cord Stimulation on Myocardial Flow Reserve in Patients with Refractory Angina Pectoris

Effect of Spinal Cord Stimulation on Myocardial Flow Reserve in Patients with Refractory Angina Pectoris Effect of Spinal Cord Stimulation on Myocardial Flow Reserve in Patients with Refractory Angina Pectoris Antti Varis, Heikki Ukkonen, Antti Saraste, Tuija Vasankari, Satu Tunturi, Markku Taittonen, Pirkka

More information

Normal and Abnormal. Heart Rate and Blood Pressure. Signs and Symptoms. Abnormal HR and BP responses. Normal Peak Blood Pressures.

Normal and Abnormal. Heart Rate and Blood Pressure. Signs and Symptoms. Abnormal HR and BP responses. Normal Peak Blood Pressures. Normal and Abnormal Exercise Response Potential Measurements Signs and symptoms Heart rate and blood pressure EKG Cardiac output, stroke volume VO2 Anaerobic threshold O2 pulse Systolic time interval Skin

More information

38 year old female with mild obesity. She is planning an exercise program to loose weight. She has no other known risk factors for CAD.

38 year old female with mild obesity. She is planning an exercise program to loose weight. She has no other known risk factors for CAD. Stress Testing: Wael A. Jaber, MD,FACC 38 year old female with mild obesity She is planning an exercise program to loose weight. She has no other known risk factors for CAD. You recommend: A. Exercise

More information

Pharmacologic Stress Test: Adenosine

Pharmacologic Stress Test: Adenosine Pharmacologic Stress Test: Adenosine OVERVIEW The purpose of this document is to specifically identify the critical components involved in performing a pharmacologic stress test with adenosine. This information

More information

Rb 82 Cardiac PET Scanning Protocols and Dosimetry. Deborah Tout Nuclear Medicine Department Central Manchester University Hospitals

Rb 82 Cardiac PET Scanning Protocols and Dosimetry. Deborah Tout Nuclear Medicine Department Central Manchester University Hospitals Rb 82 Cardiac PET Scanning Protocols and Dosimetry Deborah Tout Nuclear Medicine Department Central Manchester University Hospitals Overview Rb 82 myocardial perfusion imaging protocols Acquisition Reconstruction

More information

Coronary Artery Disease leading cause of morbidity & mortality in industrialised nations.

Coronary Artery Disease leading cause of morbidity & mortality in industrialised nations. INTRODUCTION Coronary Artery Disease leading cause of morbidity & mortality in industrialised nations. Although decrease in cardiovascular mortality still major cause of morbidity & burden of disease.

More information

CHEST PAIN EVALUATION TOOL

CHEST PAIN EVALUATION TOOL CHEST PAIN EVALUATION TOOL Chest pain or discomfort is one of the commonest causes for presentation to the Emergency Room (ER) or physicians office. There are many causes for chest discomfort. The serious

More information

Society of Nuclear Medicine Procedure Guideline for Myocardial Perfusion Imaging

Society of Nuclear Medicine Procedure Guideline for Myocardial Perfusion Imaging Society of Nuclear Medicine Procedure Guideline for Myocardial Perfusion Imaging version 3.0, approved June 15, 2002 Authors: H. William Strauss, MD (Memorial Sloan Kettering Cancer Center, New York, NY);

More information

Nuclear Medicine Coding 101 June 16, 2008 Contac me: DENISE@MERLINOHCCC.COM 1-888-60M-HCCC, 1-888-606-4222

Nuclear Medicine Coding 101 June 16, 2008 Contac me: DENISE@MERLINOHCCC.COM 1-888-60M-HCCC, 1-888-606-4222 Nuclear Medicine Coding 101 June 16, 2008 Contac me: DENISE@MERLINOHCCC.COM 1-888-60M-HCCC, 1-888-606-4222 Presented by: Denise A. Merlino, MBA, CNMT, CPC, FSNMTS Disclosures SNM ASNC Bracco Diagnostics

More information

6/5/2014. Objectives. Acute Coronary Syndromes. Epidemiology. Epidemiology. Epidemiology and Health Care Impact Pathophysiology

6/5/2014. Objectives. Acute Coronary Syndromes. Epidemiology. Epidemiology. Epidemiology and Health Care Impact Pathophysiology Objectives Acute Coronary Syndromes Epidemiology and Health Care Impact Pathophysiology Unstable Angina NSTEMI STEMI Clinical Clues Pre-hospital Spokane County EMS Epidemiology About 600,000 people die

More information

Pharmacologic Stress Agents

Pharmacologic Stress Agents Pharmacologic Stress Agents Donna Lesniak, RN, CCRC Mallinckrodt Institute of Radiology Washington University School of Medicine Saint Louis, Missouri Disclosure Neither I nor my immediate family members

More information

2/20/2015. Cardiac Evaluation of Potential Solid Organ Transplant Recipients. Issues Specific to Transplantation. Kidney Transplantation.

2/20/2015. Cardiac Evaluation of Potential Solid Organ Transplant Recipients. Issues Specific to Transplantation. Kidney Transplantation. DISCLOSURES I have no relevant financial relationships to disclose. Cardiac Evaluation of Potential Solid Organ Transplant Recipients Michele Hamilton, MD Director, Heart Failure Program Cedars Sinai Heart

More information

Is it really so? : Varying Presentations for ACS among Elderly, Women and Diabetics. Yen Tibayan, M.D. Division of Cardiovascular Medicine

Is it really so? : Varying Presentations for ACS among Elderly, Women and Diabetics. Yen Tibayan, M.D. Division of Cardiovascular Medicine Is it really so? : Varying Presentations for ACS among Elderly, Women and Diabetics Yen Tibayan, M.D. Division of Cardiovascular Medicine Case Presentation 69 y.o. woman calls 911 with the complaint of

More information

Objectives. The ECG in Pulmonary and Congenital Heart Disease. Lead II P-Wave Amplitude during COPD Exacerbation and after Treatment (50 pts.

Objectives. The ECG in Pulmonary and Congenital Heart Disease. Lead II P-Wave Amplitude during COPD Exacerbation and after Treatment (50 pts. The ECG in Pulmonary and Congenital Heart Disease Gabriel Gregoratos, MD Objectives Review the pathophysiology and ECG signs of pulmonary dysfunction Review the ECG findings in patients with: COPD (chronic

More information

12-Lead EKG Interpretation. Judith M. Haluka BS, RCIS, EMT-P

12-Lead EKG Interpretation. Judith M. Haluka BS, RCIS, EMT-P 12-Lead EKG Interpretation Judith M. Haluka BS, RCIS, EMT-P ECG Grid Left to Right = Time/duration Vertical measure of voltage (amplitude) Expressed in mm P-Wave Depolarization of atrial muscle Low voltage

More information

CV Disease : A Major Threat to Public Health

CV Disease : A Major Threat to Public Health CV Disease : A Major Threat to Public Health International Atomic Energy Agency United Nations, Vienna - Austria João V. Vitola, MD, PhD Cardiologist and Nuclear Medicine Physician QUANTA Diagnostico &

More information

Novartis Gilenya FDO Program Clinical Protocol and Highlights from Prescribing Information (PI)

Novartis Gilenya FDO Program Clinical Protocol and Highlights from Prescribing Information (PI) Novartis Gilenya FDO Program Clinical Protocol and Highlights from Prescribing Information (PI) Highlights from Prescribing Information - the link to the full text PI is as follows: http://www.pharma.us.novartis.com/product/pi/pdf/gilenya.pdf

More information

Cardiovascular Guidelines for DOT Physical Exams By Maureen Collins MSN, APRN, BC

Cardiovascular Guidelines for DOT Physical Exams By Maureen Collins MSN, APRN, BC Cardiovascular Guidelines for DOT Physical Exams By Maureen Collins MSN, APRN, BC The Federal Motor Carrier Safety Administration (FMCSA) administers the Federal Motor Carrier Safety Regulations (FMCSRs)

More information

Nuclear Cardiology. Andrew Kelion Oxford Heart Centre Oxford University Hospitals NHS Trust

Nuclear Cardiology. Andrew Kelion Oxford Heart Centre Oxford University Hospitals NHS Trust Nuclear Cardiology Andrew Kelion Oxford Heart Centre Oxford University Hospitals NHS Trust A brief history 1961 1 st Anger gamma camera to market 1971-4 MUGA scans 1976 Exercise MUGA for CAD 1976 201 Tl

More information

PET PROS PET Professional Resources and Outreach Source. A summary of the recommendations and practice guidelines of professional groups

PET PROS PET Professional Resources and Outreach Source. A summary of the recommendations and practice guidelines of professional groups PET PROS PET Professional Resources and Outreach Source A summary of the recommendations and practice guidelines of professional groups Background: The SNMMI PET/CT Utilization Task Force (UTF) was formed

More information

Consider delaying the administration of regadenoson in patients with uncontrolled hypertension.

Consider delaying the administration of regadenoson in patients with uncontrolled hypertension. December 2014 Rapiscan (regadenoson) - New important advice to minimise the risk of cerebrovascular accident and prolongation of Rapiscan-induced seizures following administration of aminophylline Dear

More information

BIPOLAR LIMB LEADS UNIPOLAR LIMB LEADS PRECORDIAL (UNIPOLAR) LEADS VIEW OF EACH LEAD INDICATIVE ECG CHANGES

BIPOLAR LIMB LEADS UNIPOLAR LIMB LEADS PRECORDIAL (UNIPOLAR) LEADS VIEW OF EACH LEAD INDICATIVE ECG CHANGES BIPOLAR LIMB LEADS Have both a distinctive positive and negative pole. Lead I LA (positive) RA (negative) Lead II LL (positive) RA (negative) Lead III LL (positive) LA (negative) UNIPOLAR LIMB LEADS Have

More information

Non Invasive Testing for CAD

Non Invasive Testing for CAD Non Invasive Testing for CAD Wael A. Jaber, MD Section of Cardiac Imaging Heart and Vascular Institute Cleveland Clinic 38 year old female with mild obesity She is planning an exercise program to loose

More information

Clinical Appropriateness Guidelines: Advanced Imaging

Clinical Appropriateness Guidelines: Advanced Imaging Clinical Appropriateness Guidelines: Advanced Imaging Appropriate Use Criteria: Imaging of the Heart Effective Date: October 31, 2016 Proprietary Date of Origin: 03/30/2005 Last revised: 07/26/2016 Last

More information

MEDICAL DIRECTIVE Advanced Life Support (ALS): Symptomatic Bradycardia

MEDICAL DIRECTIVE Advanced Life Support (ALS): Symptomatic Bradycardia Authorizing physician(s) LHO - Code Blue, Emergency Department & Critical Care Physicians LHB - Emergency Department and Critical Care Physicians LHPP - Emergency Department Physicians Authorized to who

More information

The P Wave: Indicator of Atrial Enlargement

The P Wave: Indicator of Atrial Enlargement Marquette University e-publications@marquette Physician Assistant Studies Faculty Research and Publications Health Sciences, College of 8-12-2010 The P Wave: Indicator of Atrial Enlargement Patrick Loftis

More information

West Shore Cardiology

West Shore Cardiology West Shore Cardiology Stress Testing The use of stress testing for the diagnosis of previously undiagnosed CAD in the symptomatic patient as well as following those with known CAD is a commonly used test.

More information

Electrocardiography Review and the Normal EKG Response to Exercise

Electrocardiography Review and the Normal EKG Response to Exercise Electrocardiography Review and the Normal EKG Response to Exercise Cardiac Anatomy Electrical Pathways in the Heart Which valves are the a-v valves? Closure of the a-v valves is associated with which heart

More information

Diagnostic Testing Protocol Recommendations Cardiac CT

Diagnostic Testing Protocol Recommendations Cardiac CT Diagnostic Testing Protocol Recommendations Cardiac CT 1. Patient Preparation Contraindications o Absolute Iodinated contrast allergy not amenable to pre-treatment Pregnancy Coronary artery stent(s) o

More information

THE MUSCLE AND CARDIOVASCULAR SYSTEM

THE MUSCLE AND CARDIOVASCULAR SYSTEM THE MUSCLE AND CARDIOVASCULAR SYSTEM The focus of this week s lab will be pathology of the cardiovascular system. The cardiovascular system is composed of the heart and its associated structures as well

More information

Scott Hubbell, MHSc, RRT-NPS, C-NPT, CCT Clinical Education Coordinator/Flight RRT EagleMed

Scott Hubbell, MHSc, RRT-NPS, C-NPT, CCT Clinical Education Coordinator/Flight RRT EagleMed Scott Hubbell, MHSc, RRT-NPS, C-NPT, CCT Clinical Education Coordinator/Flight RRT EagleMed Identify the 12-Lead Views Explain the vessels of occlusion Describe the three I s Basic Interpretation of 12-Lead

More information

Nuclear Cardiology Imaging Myocardial Perfusion Test. Information for patients

Nuclear Cardiology Imaging Myocardial Perfusion Test. Information for patients Nuclear Cardiology Imaging Myocardial Perfusion Test Information for patients What is Nuclear Cardiology? Coronary Artery Disease (CAD) is caused by the narrowing of the blood vessels that supply the heart

More information

Pharmacologic Stress Agents: Protocol and Safety

Pharmacologic Stress Agents: Protocol and Safety Pharmacologic Stress Agents: Protocol and Safety Donna Lesniak, RN, CCRC Mallinckrodt Institute of Radiology Washington University School of Medicine Saint Louis, Missouri Disclosure Neither I nor my immediate

More information

Systematic Approach to 12 Lead EKG Interpretation

Systematic Approach to 12 Lead EKG Interpretation Systematic Approach to 12 Lead EKG Interpretation Maureen Knechtel MPAS, PA-C Wellmont CVA Heart Institute Disclosure Statement of Financial Interest I, Maureen Knechtel, do not have a financial interest/arrangement

More information

Computed Tomography, Head Or Brain; Without Contrast Material, Followed By Contrast Material(S) And Further Sections

Computed Tomography, Head Or Brain; Without Contrast Material, Followed By Contrast Material(S) And Further Sections 1199SEIU BENEFIT AND PENSION FUNDS High Tech Diagnostic Radiology and s # 1 70336 Magnetic Resonance (Eg, Proton) Imaging, Temporomandibular Joint(S) 2 70450 Computed Tomography, Head Or Brain; Without

More information

12 Lead ECGs: Ischemia, Injury & Infarction Part 2

12 Lead ECGs: Ischemia, Injury & Infarction Part 2 12 Lead ECGs: Ischemia, Injury & Infarction Part 2 McHenry Western Lake County EMS Localization: Left Coronary Artery Right Coronary Artery Right Ventricle Septal Wall Anterior Descending Artery Left Main

More information

Nuclear Stress Test and Imaging. Presented by Tamra Rocsko BS, CNMT, CMRT, ARRT(N)

Nuclear Stress Test and Imaging. Presented by Tamra Rocsko BS, CNMT, CMRT, ARRT(N) Nuclear Stress Test and Imaging Presented by Tamra Rocsko BS, CNMT, CMRT, ARRT(N) Program outline What is a Nuclear Stress Test What does it detect Blood Flow Examination Basic Test Flow Clinical Indications

More information

Objectives. Cardiac Substrate Metabolism. 2004 SNM Mid-Winter Educational Symposium

Objectives. Cardiac Substrate Metabolism. 2004 SNM Mid-Winter Educational Symposium Myocardial Viability Imaging With PET Marcelo F. Di Carli,, MD Brigham and Women s Hospital Harvard Medical School Boston, MA Conflict of Interest: : No Relations to disclose To review: Basic principles

More information

ST Segment Elevation Nothing is ever as hard (or easy) as it looks

ST Segment Elevation Nothing is ever as hard (or easy) as it looks ST Segment Elevation Nothing is ever as hard (or easy) as it looks Cameron Guild, MD Division of Cardiology University of Mississippi Medical Center February 17, 2012 Objectives 1. Describe the electrical

More information

Case Report. Technetium-99m-sestamibi Redistribution after Exercise Stress Test Identified by a Novel Cardiac Gamma Camera: Two Case Reports E39

Case Report. Technetium-99m-sestamibi Redistribution after Exercise Stress Test Identified by a Novel Cardiac Gamma Camera: Two Case Reports E39 Case Report Technetium-99m-sestamibi Redistribution after Exercise Test Identified by a Novel Cardiac Gamma Camera: Two Case Reports Address for correspondence: Marcelo F. Di Carli, MD Brigham and Women

More information

Accurate Coding of Nuclear Medicine Procedures. Unravel Coding Basics

Accurate Coding of Nuclear Medicine Procedures. Unravel Coding Basics Accurate Coding of Nuclear Medicine Procedures Presented by: Denise A. Merlino, MBA, CNMT, CPC Merlino Healthcare Consulting Corp. 1 Unravel Coding Basics October 27, 2009 2 1 Coding Basic Steps diagnosis

More information

Marilyn Borkgren-Okonek, APN, CCNS, RN, MS Suburban Lung Associates, S.C. Elk Grove Village, IL

Marilyn Borkgren-Okonek, APN, CCNS, RN, MS Suburban Lung Associates, S.C. Elk Grove Village, IL Marilyn Borkgren-Okonek, APN, CCNS, RN, MS Suburban Lung Associates, S.C. Elk Grove Village, IL www.goldcopd.com GLOBAL INITIATIVE FOR CHRONIC OBSTRUCTIVE LUNG DISEASE GLOBAL STRATEGY FOR DIAGNOSIS, MANAGEMENT

More information

Noninvasive Cardiology Focused Review. Quantification of Valvular Aortic Stenosis. Aortic Jet Velocity

Noninvasive Cardiology Focused Review. Quantification of Valvular Aortic Stenosis. Aortic Jet Velocity Quantification of Valvular Aortic Stenosis Karen K. Stout, MD, Catherine M. Otto, MD, Division of Cardiology, Department of Medicine, University of Washington, Seattle, Washington Valvular aortic stenosis

More information

Specific Basic Standards for Osteopathic Fellowship Training in Cardiology

Specific Basic Standards for Osteopathic Fellowship Training in Cardiology Specific Basic Standards for Osteopathic Fellowship Training in Cardiology American Osteopathic Association and American College of Osteopathic Internists BOT 07/2006 Rev. BOT 03/2009 Rev. BOT 07/2011

More information

Tips and Tricks to Demystify 12 Lead ECG Interpretation

Tips and Tricks to Demystify 12 Lead ECG Interpretation Tips and Tricks to Demystify 12 Lead ECG Interpretation Mission: Lifeline North Dakota Regional EMS and Hospital Conference Samantha Kapphahn, DO Essentia Health- Interventional Cardiology June 5th, 2014

More information

ANNE ARUNDEL MEDICAL CENTER CRITICAL CARE MEDICATION MANUAL DEPARTMENT OF NURSING AND PHARMACY. Guidelines for Use of Intravenous Isoproterenol

ANNE ARUNDEL MEDICAL CENTER CRITICAL CARE MEDICATION MANUAL DEPARTMENT OF NURSING AND PHARMACY. Guidelines for Use of Intravenous Isoproterenol ANNE ARUNDEL MEDICAL CENTER CRITICAL CARE MEDICATION MANUAL DEPARTMENT OF NURSING AND PHARMACY Guidelines for Use of Intravenous Isoproterenol Major Indications Status Asthmaticus As a last resort for

More information

EKG Basics. Ben Taylor, PhD, PA-C

EKG Basics. Ben Taylor, PhD, PA-C EKG Basics Ben Taylor, PhD, PA-C Right Ventricular MI ST elevation in R-sided leads ST segment elevation greater in lead III than II Inferior wall MI P waves only in V 3-6 Biphasic T waves Right Ventricular

More information

HEART MONITOR TREADMILL 12 LEAD EKG

HEART MONITOR TREADMILL 12 LEAD EKG 2 HEART MONITOR TREADMILL 12 LEAD EKG Portable ambulatory monitoring system Continuously records electrical activity of the heart for 24 hours or more Also known as ambulatory electrocardiographic monitor

More information

GLOBAL INITIATIVE FOR CHRONIC OBSTRUCTIVE LUNG DISEASE GLOBAL STRATEGY FOR DIAGNOSIS, MANAGEMENT AND PREVENTION OF COPD

GLOBAL INITIATIVE FOR CHRONIC OBSTRUCTIVE LUNG DISEASE GLOBAL STRATEGY FOR DIAGNOSIS, MANAGEMENT AND PREVENTION OF COPD Marilyn Borkgren-Okonek, APN, CCNS, RN, MS Suburban Lung Associates, S.C. Elk Grove Village, IL www.goldcopd.com GLOBAL INITIATIVE FOR CHRONIC OBSTRUCTIVE LUNG DISEASE GLOBAL STRATEGY FOR DIAGNOSIS, MANAGEMENT

More information

Nuclear Cardiology Fellow Rotation Cardiology Fellow Curriculum Penn State Milton S. Hershey Medical Center

Nuclear Cardiology Fellow Rotation Cardiology Fellow Curriculum Penn State Milton S. Hershey Medical Center Nuclear Cardiology Fellow Rotation Cardiology Fellow Curriculum Penn State Milton S. Hershey Medical Center OVERVIEW The cardiovascular fellow on the nuclear rotation will learn to interpret nuclear studies

More information

Thrombolytics (Reteplase, Tenecteplase) Rpa/Tnk and Adjunctive Heparin

Thrombolytics (Reteplase, Tenecteplase) Rpa/Tnk and Adjunctive Heparin PRESENTATION Vials of reteplase 10 units for reconstitution with 10ml water for injection. Vials of tenecteplase 10,000 units for reconstitution with 10ml water for injection, or 8,000 units for reconstitution

More information

Atrial & Junctional Dysrhythmias

Atrial & Junctional Dysrhythmias Atrial & Junctional Dysrhythmias Atrial & Junctional Dysrhythmias Atrial Premature Atrial Complex Wandering Atrial Pacemaker Atrial Tachycardia (ectopic) Multifocal Atrial Tachycardia Atrial Flutter Atrial

More information

Procedure Guidelines for Radionuclide Myocardial Perfusion Imaging with Single-Photon Emission Computed Tomography (SPECT)

Procedure Guidelines for Radionuclide Myocardial Perfusion Imaging with Single-Photon Emission Computed Tomography (SPECT) Procedure Guidelines for Radionuclide Myocardial Perfusion Imaging with Single-Photon Emission Computed Tomography (SPECT) Adopted by the British Cardiac Society, the British Nuclear Cardiology Society,

More information

There are several resources available to you on the American Heart Association website at Here are some helpful kinks:

There are several resources available to you on the American Heart Association website at  Here are some helpful kinks: American Heart Links There are several resources available to you on the American Heart Association website at www.americanheart.org. Here are some helpful kinks: You can find information on cardiovascular

More information

INTERDISCIPLINARY CLINICAL MANUAL Policy and Procedure

INTERDISCIPLINARY CLINICAL MANUAL Policy and Procedure INTERDISCIPLINARY CLINICAL MANUAL Policy and Procedure TITLE: Management of Angina in NUMBER: Effective Date: January 2014 Page 1 of 6 Applies To: Interdisciplinary Clinical Manual Cardiac Rehabilitation

More information

Treating AF: The Newest Recommendations. CardioCase presentation. Ethel s Case. Wayne Warnica, MD, FACC, FACP, FRCPC

Treating AF: The Newest Recommendations. CardioCase presentation. Ethel s Case. Wayne Warnica, MD, FACC, FACP, FRCPC Treating AF: The Newest Recommendations Wayne Warnica, MD, FACC, FACP, FRCPC CardioCase presentation Ethel s Case Ethel, 73, presents with rapid heart beating and mild chest discomfort. In the ED, ECG

More information

Listen to your heart: Good Cardiovascular Health for Life

Listen to your heart: Good Cardiovascular Health for Life Listen to your heart: Good Cardiovascular Health for Life Luis R. Castellanos MD, MPH Assistant Clinical Professor of Medicine University of California San Diego School of Medicine Sulpizio Family Cardiovascular

More information

Magnetic Resonance (Eg, Proton) Imaging, Temporomandibular Joint(S) MRI

Magnetic Resonance (Eg, Proton) Imaging, Temporomandibular Joint(S) MRI High Tech Radiology and s (Sorted by s) # Full Description 1 70336 Magnetic Resonance (Eg, Proton) Imaging, Temporomandibular Joint(S) 2 70450 Computed Tomography, Head Or Brain; Without Contrast Material

More information

Adult Drug Reference. Dopamine Drip Chart. Pediatric Drug Reference. Pediatric Drug Dosage Charts DRUG REFERENCES

Adult Drug Reference. Dopamine Drip Chart. Pediatric Drug Reference. Pediatric Drug Dosage Charts DRUG REFERENCES Adult Drug Reference Dopamine Drip Chart Pediatric Drug Reference Pediatric Drug Dosage Charts DRUG REFERENCES ADULT DRUG REFERENCE Drug Indication Adult Dosage Precautions / Comments ADENOSINE Paroxysmal

More information

CAUSES AND PREVENTION OF CARDIORESPIRATORY ARREST

CAUSES AND PREVENTION OF CARDIORESPIRATORY ARREST CAUSES AND PREVENTION OF CARDIORESPIRATORY ARREST B1 Objectives To understand: The causes of cardiorespiratory arrest in adults How to identify patients at risk The role of a Medical Emergency Team The

More information

ACLS PRE-TEST ANNOTATED ANSWER KEY

ACLS PRE-TEST ANNOTATED ANSWER KEY ACLS PRE-TEST ANNOTATED ANSWER KEY June, 2011 Question 1: Question 2: There is no pulse with this rhythm. Question 3: Question 4: Question 5: Question 6: Question 7: Question 8: Question 9: Question 10:

More information

Perioperative Cardiac Evaluation

Perioperative Cardiac Evaluation Perioperative Cardiac Evaluation Caroline McKillop Advisor: Dr. Tam Psenka 10-3-2007 Importance of Cardiac Guidelines -Used multiple times every day -Patient Safety -Part of Surgical Care Improvement Project

More information

ACLS PHARMACOLOGY 2011 Guidelines

ACLS PHARMACOLOGY 2011 Guidelines ACLS PHARMACOLOGY 2011 Guidelines ADENOSINE Narrow complex tachycardias or wide complex tachycardias that may be supraventricular in nature. It is effective in treating 90% of the reentry arrhythmias.

More information

INTRODUCTION TO EECP THERAPY

INTRODUCTION TO EECP THERAPY INTRODUCTION TO EECP THERAPY is an FDA cleared, Medicare approved, non-invasive medical therapy for the treatment of stable and unstable angina, congestive heart failure, acute myocardial infarction, and

More information

Anatomy & Physiology. Blood Flow through heart

Anatomy & Physiology. Blood Flow through heart Cardiac Arrhythmias Blood Flow through heart Superior and Inferior Vena Cava Right Atrium Right Ventricle Pulmonary Artery Lungs Pulmonary Vein Left Atrium Left Ventricle Aorta Body Anatomy & Physiology

More information

ACLS RHYTHM TEST. 2. A 74-year-old woman with chest pain. Blood pressure 192/90 and rates her pain 9/10.

ACLS RHYTHM TEST. 2. A 74-year-old woman with chest pain. Blood pressure 192/90 and rates her pain 9/10. ACLS RHYTHM TEST Name Date Choose the best answer for each of the following questions. Each of the following strips is 6 seconds in length. 1. Identify the following rhythm a. Sinus bradycardia with 2

More information

Signal-averaged electrocardiography late potentials

Signal-averaged electrocardiography late potentials SIGNAL AVERAGED ECG INTRODUCTION Signal-averaged electrocardiography (SAECG) is a special electrocardiographic technique, in which multiple electric signals from the heart are averaged to remove interference

More information

Bradycardia (Unstable) Protocol revised October 2008

Bradycardia (Unstable) Protocol revised October 2008 Bradycardia (Unstable) Protocol revised October 2008 Preamble Occasionally, patients experiencing an acute cardiac event present with bradycardia that is hemodynamically unstable. Under these circumstances,

More information

Imaging of Muscular Dystrophy Cardiomyopathy. Sadaf Bhutta Seattle Children s Hospital University of Washington NASCI 2015 San Diego, CA

Imaging of Muscular Dystrophy Cardiomyopathy. Sadaf Bhutta Seattle Children s Hospital University of Washington NASCI 2015 San Diego, CA Imaging of Muscular Dystrophy Cardiomyopathy Sadaf Bhutta Seattle Children s Hospital University of Washington NASCI 2015 San Diego, CA Financial: None Disclosures Off label use of Gadolinium in CMR Muscular

More information

AI CPT Codes. x x. 70336 MRI Magnetic resonance (eg, proton) imaging, temporomandibular joint(s)

AI CPT Codes. x x. 70336 MRI Magnetic resonance (eg, proton) imaging, temporomandibular joint(s) Code Category Description Auth Required Medicaid Medicare 0126T IMT Testing Common carotid intima-media thickness (IMT) study for evaluation of atherosclerotic burden or coronary heart disease risk factor

More information

Procedure for Inotrope Administration in the home

Procedure for Inotrope Administration in the home Procedure for Inotrope Administration in the home Purpose This purpose of this procedure is to define the care used when administering inotropic agents intravenously in the home This includes: A. Practice

More information

Osama Jarkas. in Chest Pain Patients. STUDENT NAME: Osama Jarkas DATE: August 10 th, 2015

Osama Jarkas. in Chest Pain Patients. STUDENT NAME: Osama Jarkas DATE: August 10 th, 2015 STUDENT NAME: Osama Jarkas DATE: August 10 th, 2015 PROJECT TITLE: Analysis of ECG Exercise Stress Testing and Framingham Risk Score in Chest Pain Patients PRIMARY SUPERVISOR NAME: Dr. Edward Tan DEPARTMENT:

More information

NEONATAL & PEDIATRIC ECG BASICS RHYTHM INTERPRETATION

NEONATAL & PEDIATRIC ECG BASICS RHYTHM INTERPRETATION NEONATAL & PEDIATRIC ECG BASICS & RHYTHM INTERPRETATION VIKAS KOHLI MD FAAP FACC SENIOR CONSULATANT PEDIATRIC CARDIOLOGY APOLLO HOSPITAL MOB: 9891362233 ECG FAX LINE: 011-26941746 THE BASICS: GRAPH PAPER

More information

Rapid Access Chest Pain Clinic to Cath Lab.the journey.. Jenny Deane, Clinical Nurse Specialist, RACPC, RFH

Rapid Access Chest Pain Clinic to Cath Lab.the journey.. Jenny Deane, Clinical Nurse Specialist, RACPC, RFH Rapid Access Chest Pain Clinic to Cath Lab.the journey.. Jenny Deane, Clinical Nurse Specialist, RACPC, RFH Background In the UK: Chest pain is a very common symptom between 20% to 40% of the general population

More information