Cardiac Catherterisation

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  1. Indications for coronary cath?
    • Suspected/Known CAD
    • MI
    • SCD
    • Congestive Heart Disease
    • Angina
    • Positive ETT
    • Reevaluate Stent
  2. Contraindications for Coronary Cath:
    • Fever
    • Electrolyte Imbalance
    • Systemic illness needing stabilation
    • Mental State of Patient
  3. What energies does the transducer convert from - to?
    Physical pressure - Electrical stimulus
  4. How will the calibration square appear if underdamped?
    Bow down
  5. How will the calibration square appear if overdamped?
    Bend upwards
  6. How will the pressure tracing look if underdamped?
    Give wavey pressure lines
  7. How will the pressure tracing look if overdamped?
    Be slurred
  8. Explain the seldinger method:
    • Insert Syringe into femoral artery
    • Insert guide wire
    • Remove syringe
    • Insert Sheath
    • Remove guidewire
    • Insert catheter through sheath
  9. What is the purpose of the guide wire:
    Provide regidity whilst advancing the catheter
  10. What are vessels advancing off the LAD called?
  11. What are vessles advancing off the circumflex called?
  12. What is the quation for calculating Pressure mean (Pmean):
    Pmean = ((2 x Diastolic) + Systolic)/3
  13. How is the mean pressure calculated from 120/80mmHg
    ((2x80) + 120)/3 = 280/3 = 93mmHg
  14. What is the anachrotic notch?
    First phase of V systole (isovolumetric contraction) a presystolic rise in pressure may be seen before opening of the aortic valve
  15. What does the Dichrotic nitch symbolise?
    End of systole and beginning of diastole
  16. What is the quation for pulse pressure?
    Systolic - diastolic = PPressure
  17. What shows diastolic dysfunction on the LV pressure trace?
    Upsloping gradient from beginning diastole to beginning of systole
  18. What is the post A wave also known as?
    End diastolic pressure (reflective of A pressure)
  19. What different landmarks are seen on the atrial waveform?
    • A
    • C
    • X
    • V
    • Y
  20. What is the A wave?
    Increase in A Pressure during A contraction
  21. What is the X descent?
    Drop in pressure following A relaxation
  22. What is the C wave?
    May come as an interruption to the x descent respresenting the movement of the AV valve towards the atrium in AV closer (beginning of isovolumetric V contraction)
  23. What is the V wave?
    Increase in pressure during V systole, causing the AV valve to bulge into the atrium
  24. Where would the V wave be exaggerated?
    AV valve regurgitation
  25. What may cause differences in RV-LV pressures?
    • Constrictive Pericarditis
    • BBB
    • Pulm Hypertension
    • MI
  26. What are the normal pressures for LV:
    • 100-140mmHg Systolic
    • 60-90mmHg Diastolic
  27. Normal pressure for RA?
  28. Normal pressure for RV:
  29. Normal pressure for PA:
  30. What is the purpose of a Pulmonary capillary wedge?
    Indirect measure of left atrial pressure
  31. How is a PCW peformed:
    RA - RV - PA - Wedged in PCs
  32. Explain PA - RV pullback
    No gradient systolic pressure
  33. Explain RV - RA pullback
    No gradient in diastolic pressure
  34. Pressure in PA is 20mmHg
    Pressure in RV is 40mmHg
    Whats the diagnosis?
    Pulmonary stenosis
  35. Pressure of RV is 20/5
    Pressure in RA is 10
    Whats the diagnosis?
    Tricuspid stenosis
  36. Pressure in Ao is 170/70
    Pressure in LV is 200/10
    Whats the diagnosis?
    • Mixed valvular disease
    • Difference in systolic pressure suggests Ao Stenosis
    • Difference in diastolic pressure suggests Ao regurgitation
  37. Whats a normal LV - Ao pullback?
    No change in systolic pressure
  38. What does the area under the graph for LV on Ao suggest?
    Mean gradient is difference between LV/Ao during the open Ao valve
  39. Normal valve area should be?
  40. What does a slow upsloping rise in Ao pressure suggest?
    Ao Stenosis
  41. What does a large pulse pressure suggest?
  42. How can you tell mitral stenosis from pressure traces?
    • PCWP > EDP
    • Due to increase in LA pressure
  43. From a pressure trace, how is mitral regurgitation seen?
    Large V wave (due to backflow of blood and hence increase pressure in LA) on PCWP trace on LV trace
Card Set:
Cardiac Catherterisation
2012-05-17 19:16:29
Cardiac Cath

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