Cardiac diagnostic tests can be invasive or non-invasive. Common non-invasive tests include electrocardiography (ECG), echocardiography, nuclear heart scan, chest x-ray, cardiac CT scan, and cardiac MRI. ECG records the heart's electrical activity while echocardiography uses ultrasound to image the heart. A nuclear heart scan uses radioactive tracers to evaluate blood flow and pumping ability. These tests can diagnose conditions like coronary artery disease, heart failure, and past heart attacks. Invasive tests include cardiac angiography and intravascular ultrasound which use catheters and dyes to directly image the heart and blood vessels.
Cardiovascular assessment and diagnostic proceduresANILKUMAR BR
Cardiovascular disease is the leading killer for both men and women among all racial and ethnic groups in the world wide.
According to the Centers for Disease Control (CDC) studies among coronary heart disease (CAD) patients, 90% of patients have had prior exposure to at least one heart disease risk factor that contributed to their disease.
Cardiovascular assessment and diagnostic proceduresANILKUMAR BR
Cardiovascular disease is the leading killer for both men and women among all racial and ethnic groups in the world wide.
According to the Centers for Disease Control (CDC) studies among coronary heart disease (CAD) patients, 90% of patients have had prior exposure to at least one heart disease risk factor that contributed to their disease.
invasive non invasive procedures.pdf for bsc nursing studentsshanmukhadevi
Chest X-ray:
The chest X-ray is a noninvasive tool used to visualize internal structures, such as the heart, lungs, soft tissues, and bones.
Most chest X-rays are taken while the patient is inhaling so that the lungs are fully expanded.
Several types of chest X-rays can be used to assess heart size, contour, and position; other types reveal cardiac and pericardial calcification as well as physiologic alterations in pulmonary circulation.
A moderately frequent illness called congestive heart failure occurs when the heart is unable to pump enough blood to meet the body's demands. It frequently happens as a result of a chronic illness or aging. The body makes an effort to make up for this by boosting blood salt levels and fluid retention.
Swelling, weight gain, and shortness of breath may result from this. Diabetes and high blood pressure are other conditions linked to congestive heart failure. Congestive heart failure, however, is most frequently brought on by coronary artery disease (CAD). This occurs when the arteries that carry blood to the heart start to constrict and narrow.
When calling a doctor is important to question Dr. Sumit shejol Cardiologist from Hrudaysparsh Clinic Suggests that if you recognize the majority of the symptoms of heart failure. Certain signs and symptoms, such as chest pain, acute breathlessness, an irregular heartbeat, extreme weakness, or fainting, demand rapid medical attention. Do not delay in seeking assistance, do not self-diagnose, and do not self-medicate if you feel any of that. Some of these symptoms may also be a sign of heart failure or another serious lung, heart, or cardiovascular disease. Your condition is stabilized as emergency room doctors try to identify the source of your symptoms. Call your doctor right away if you've already been given a heart failure diagnosis and you realize that your symptoms have gotten worse or a new symptom has appeared.
Congestive heart failure is a fatal condition with a high mortality rate. Congestive heart failure has a wide range of risk factors. Smoking, high blood pressure, diabetes, high cholesterol, being obese, and having experienced a heart attack in the past are some of them. It can also be brought on by a hereditary condition like cardiomyopathy. The condition can cause the heart muscle to expand and become excessively thick, which can result in heart failure. Congestive heart failure can be exacerbated by lifestyle choices including smoking, excessive alcohol intake, or tobacco use.
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Anti ulcer drugs and their Advance pharmacology ||
Anti-ulcer drugs are medications used to prevent and treat ulcers in the stomach and upper part of the small intestine (duodenal ulcers). These ulcers are often caused by an imbalance between stomach acid and the mucosal lining, which protects the stomach lining.
||Scope: Overview of various classes of anti-ulcer drugs, their mechanisms of action, indications, side effects, and clinical considerations.
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfJim Jacob Roy
Cardiac conduction defects can occur due to various causes.
Atrioventricular conduction blocks ( AV blocks ) are classified into 3 types.
This document describes the acute management of AV block.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
3. Types
• Invasive
• Non invasive
▫ Electrocardiography
▫ Echocardiography/Ultraso
und
▫ Cardiac Angiography
▫ Intravascular Ultrasound
▫ Nuclear Heart Scan
▫ Chest X Ray
▫ Sphygmomanometer
▫ CT Scan
▫ MRI
4. Electrocardiography
• The recording produced by
this procedure is termed an
electrocardiogram
(ECG) from the German
Elektrokardiogramm).
Electrocardiography (ECG) is a
transthoracic interpretation of the electrical
activity of the heart over a period of time, as
detected by electrodes attached to the outer
surface of the skin and recorded by a device
external to the body(electrocardiograph).
5. • The ECG device detects and amplifies the tiny electrical
changes on the skin that are caused when the heart
muscle depolarizes [ contracts ]during each heartbeat.
• This depolarization is detected as tiny rises and falls in
the voltage between two electrodes placed on either side
of the heart which is displayed as a wavy line either on a
screen or on paper.
6. Procedure
• Patient lies down on his back.
• Several areas on skin of arms,
legs, and chest are cleaned and
shaved, and small patches i.e
electrodes are attached to these
areas.
• The patches are connected by
wires to the ECG machine
• The heart's electrical signals
are printed into wavy lines on
paper.
• Variations in size and length of
the different parts of the
tracing may indicate a problem
in the part of the heart
associated with that particular
lead.
10. Feature Description Cause
P wave Impulse travels from Atrial depolarization
the SA node towards [contraction]
the AV node, and
spreads from the right
atrium to the left atrium
QRS complex From beginning of Q
wave to end of S wave
Ventricular
depolarization
T wave Relaxation of ventricles Ventricular
repolarization
11. Featur
es
Descirption Cause
PR
interval
Onset of P wave to onset of Q wave Atrial depolarization and
conduction through AV node
QT
interval
Onset of Q wave and end of T wave Electrical activity in ventricles [
depolarization and repolarization]
ST
segment
End Of S wave and onset of T wave Ventricles already depolarized
12. Indications:
To measure:
• Any damage to the heart
• Heart disease
• The effects of drugs[Digitalis] or
devices (pacemaker) used to control
the heart
• The size and position of the heart
chambers
• Heart rate
• Heart rhythm
Symptoms like:
• Cardiac murmurs
• Syncope or collapse
• Seizures
• Perceived cardiac
dysrhythmias
• Angina, palpitations,
breathlessness.
15. Echocardiography
• It is the diagnostic
procedure which uses
ultrasound to produce
2D 0r 3D image slices of
the heart muscle.
• It determines size, shape,
movement of valves and
heart chambers and flow
of blood through the
heart.
16. • A transducer containing crystals converts electrical
energy into an ultrasound beam.
• This beam is directed towards heart.
• The beam is reflected when it strikes the surface between
tissues of different densities.
• Reflected ultrasound/echo is converted to electrical energy
which constructs image based on
▫ Intensity of echos
▫ Time taken for echoes to return
19. ▫ Invasive and must be performed
under supervision.
• Doppler echocardiography:
▫ Assessment of
Cardiac valve areas and function
Abnormal communications
between the left and right side of
the heart
Valvular regurgitation
Calculation of the cardiac output
and ejection fraction.
Heart valve defect
21. Advantages
• No known risks or
side effects.
• No radiation
involved.
• Both 2D and 3D
images can be viewed.
22. Cardiac Angiography
• Cardiac
Angiography or arteriography is
a medical imaging technique used to
visualize the lumen of the blood
vessels [ arteries, veins] and the heart
chambers.
• This is traditionally done by inserting
a catheter followed by injecting a
radio-opaque contrast agent[dye
which absorbs the x-rays] into the
blood vessel and imaging using a
camera and X-ray based techniques.
23. Procedure
• Cardiac Catheterization + X ray fluoroscopy
• Patient lies on his back on the X-ray table.
• A round cylinder or rectangular box that takes the pictures
during fluoroscopy will be moved under the patient during
the test.
• The place where the catheter is inserted is shaved and
cleaned.
• The doctor numbs the area with a local anesthetic.
24. • A needle is put into the femoral artery
/vein [near groin] or brachial
artery/vein[above elbow].
• A guide wire is put through the needle
into the blood vessel and the needle is
removed.
• The thin flexible catheter is placed over
the guide wire and moved into the
blood vessel.
• The catheter is then guided through
the blood vessels until it reaches the
area to be studied [aorta, coronary
arteries, left ventricle and atrium and
inferior vena cava , right atrium and
ventricles, pulmonary artery etc
25. • The fluoroscope is used to watch
the movement of the catheter in
the blood vessels.
• When the catheter is in place,
Iodine dye is injected through it.
• Several X-ray pictures are taken
one after another which may either
be still images, displayed on
a image intensifier or film, or
motion images stored digitally on
computer.
• Duration: 1-3 hrs
• The catheter is taken out after the
angiogram, and pressure is put on
the needle site for 10 to 15 minutes
to stop any bleeding.
26. Side effects:
▫ A tear in a blood vessel (which can cause
blockage or internal bleeding)
▫ Haemorrhages
▫ Aneurysms
▫ Stenosis
▫ Pattern of blood flow to a tumor.
▫ Abnormal position of blood vessels
▫ Abnormal branching of blood vessels
since birth
▫ Changes in the blood vessels of injured
heart.
• Presence or absence of atherosclerosis
within the walls of the arteries cannot be
clearly determined.
27. Intravascular Ultrasound
• Principle:
▫ Coronary catheterization+ Ultrasound
• Ultrasound transducer attached at the
tip of catheter guided through coronary
arteries from femoral/brachial artery.
• Proximal end of catheter attached to
ultrasound equipment
• Evaluates
▫ Coronary plaques—structure and
composition [not seen in angiography]
▫ Wall of blood vessel
▫ Connective tissue surrounding vessel
28. Nuclear Heart Scan
• A nuclear heart scan is a type of medical test where a safe, radioactive
material called a tracer is injected through a vein into the bloodstream.
• The tracer travels to the heart and releases energy, which special cameras
outside of the body detect to create pictures of different parts of the heart.
• Using computer, the images are made to appear structure of heart.
29. Procedure
Pretest
• The radioactive tracer is injected into the
bloodstream through the intravenous line.
• ECG are attached to the body to check the
heart's electrical activity during the test.
• An exercise stress test maybe done as a part of
nuclear heart scan
• If Patient is unable to exercise, medicine is used to
make the heart beat faster. This is called a chemical
stress test.
30. • Before the exercise or the chemical stress test stops, the
tracer is again injected through the IV line.
• The patient then lies very still on a table.
• The nuclear heart scan camera, called a gamma
camera, which is put in several positions around the
body.
• The computer collects the pictures of the heart nearby
or in another room.
• Two sets of pictures is taken. One is taken right after
exercise /chemical stress test and the other is taken after
a period of rest.
• Each set of pictures takes about 15 to 30 minutes.
31.
32. Types
Two main types:
• Single positron emission
computed tomography
(SPECT)
• Cardiac positron emission
tomography (PET)
33. Uses
Detects :
• The flow of blood throughout the heart
muscle --myocardial perfusion
scanning.
• To look for damaged heart muscle due
to a previous heart attack, injury,
infection, or medicine---myocardial
viability testing.
• Pumping action of heart to the body--
ventricular function scanning.
34. Uses
Also evaluates:
▫ Coronary Artery Disease
▫ Heart valve diseases
▫ Past heart attack (myocardial infarction)
▫ Poor pumping function and heart failure
• Decides whether coronary angiography or cardiac
catheterization will be helpful.
• Decides whether angioplasty or coronary artery
bypass grafting (CABG) will be needed
• Monitors procedures or surgeries, such as CABG or a
heart transplant
36. Chest X ray
A chest X-ray uses a very small amount of radiation to produce an
image of the heart, lungs, and chest bones on film.
37. Procedure
• Patient has to remove all clothes and metallic jewelry from the waist
up and put on a hospital gown for the test.
• Patient then stands very still with his chest against the cassette that
contains the film.
• The X-ray machine sends a beam of ionizing radiation through an
X-ray tube.
• This energy passes through the chest and is absorbed on film to
create a picture.
• Bones and other dense areas show up as lighter shades of
gray
• Areas that don't absorb the radiation appear as dark gray.
• The entire test takes no more than 10 to 15 minutes.
38. Views
PA or postero-anterior view:
• Patient stands with his chest
against the container of the film
• The X-ray beam from the
machine comes from the
posterior/back and moves
through the chest to the
anterior/front.
Lateral view:
• Patient stands sideways in front
of the film with arms raised up.
• The X rays penetrate the chest
from the sides.
39. Uses
• Helps to diagnose heart diseases such as
▫ Cardiomegaly
▫ Aneurysm of aorta
▫ Acute Myocardial Infarction
▫ Heart failure
▫ Pericardial effusion with Tamponade
• Evaluates placement of devices (pacemakers,
defibrillators) or catheters, chest tubes placed
during hospitalization.
41. Cardiac CT Scan (CCT)
• Computerised Tomography (CT) is a
medical imaging method employing
tomography, created by computer
processing.
• Tomography refers to imaging by sections or
sectioning, through the use of any kind of
penetrating wave [radiation].
• A three-dimensional image of the inside of
the heart is generated from a large series of
two-dimensional X-ray picture taken around a
single axis of rotation.
• In simpler terms, it is an imaging method that
uses x-rays to create cross-sectional pictures of
the heart.
42. Procedure
• The patient will be asked to lie on a
narrow table that slides into the center of
the CT scanner.
• Once he is inside the scanner, the
machine's x-ray beam rotates around him.
• A computer creates separate images of the
body area, called slices.
• Three-dimensional models of the body
area can be created by stacking the slices
together.
• Sometimes an iodine-based dye (contrast
dye) is injected intravenously during the
scan. The contrast dye travels through the
blood vessels, which helps highlight them
on the x-ray pictures.
43. • These images can be stored/ viewed on a
monitor, or printed on film.
• Patient must be still during the exam, because
movement causes blurred images.
44. Uses:
Helps in evaluating:
• Calcium buildup in the walls of
the coronary arteries-
coronary calcium scan
• Coronary Artery Disease
• Problems with heart function
and heart valves.
• Aneurysm and Dissection of
Aorta
• Atrial Fibrillation
• Pericardial Disease
• Wall motion and Ejection
fraction
• Cardiac masses and post-
operative abnormalities
• Congenital Heart Diseases
45. Indications:
If Patient is Asymptomatic
• Family history of coronary artery disease
• Persistent high triglyceride levels
• Other high risk factors such as smoking, diabetes,
etc.
• ECG abnormalities
• Abnormalities on a routine stress test
• Moderate to severe hypertension
46. Indications
If Patient is Symptomatic :
• Atypical chest pain (right side,
shoulder tip, etc.)
• Suspected dilated cardiomyopathy
• Coronary arteries disease and
aneurysms
Other:
• Post-bypass: assessing the status of
bypass grafts.
• Post-stent: for assessing in-stent
lumen.
• Tumors and cardiac neoplasms
47. Cardiac Magnetic Resonance Imaging
• Cardiovascular magnetic
resonance imaging (CMR) /
cardiac MRI, is a medical imaging
technology that uses powerful magnets
and radio waves to create pictures of
the body.
• Single MRI images produced are called
slices.
• One exam produces dozens or
sometimes hundreds of images which
can be combined to produce 3D models.
• The images can be stored on a
computer or printed on film.
48. Principle
• The single proton of the nucleus of a hydrogen atom vibrates ,
or "resonates," when exposed to bursts of magnetic energy.
• When many hydrogen nuclei resonate in response to changes
in a magnetic field, they emit radiofrequency energy.
• The MRI machine detects this emitted energy, and converts it
to an image.
• Hydrogen nuclei are used because hydrogen atoms are
present in water molecules (H2O), and therefore are present
in every tissue in the body.
• Differences in the hydrogen atoms between various parts
of a tissue - emit different amounts of energy.
• These energy differences show up as different shades of gray
on the MRI which is helpful in detecting areas of cardiac
tissue that have poor blood flow (coronary artery disease) or
that has been damaged (heart attack).
49. Procedure
• Patient is asked to wear a hospital gown or clothing without
metal items or ornaments
• Patient will lie on a narrow table, which slides into a large
tunnel-shaped scanner.
• Sometimes a dye is usually injected before the test
intravenously in the hand or forearm to see images more
clearly
• During the MRI, the person who operates the machine will
watch you from another room.
• An intercom in the room allows patient to speak to the
monitoring person at any time.
• The test most often lasts 30-60 minutes, but may take longer.
51. Uses
• Helps in visualising
▫ Heart muscle scar or fat without using a contrast agent
▫ Heart function
▫ Infarct imaging using contrast
▫ Perfusion defects
▫ Congenital Heart Defects
▫ Aortic Dissection
▫ Cardiac tumor
▫ Cardiomyopathies
▫ Thrombus
▫ Pericarditis
▫ Stenosis of valves
52. ▫ Assessing
Volume of blood flow and
Ejection fraction
Damage caused by Heart
attack
Heart Failure
Coronary Artery Disease
▫ Distinguishing between
"stable
atherosclerotic plaques and
"vulnerable" plaques.
▫ Visualising blood vessels and
the flow of blood.
53. Advantages
• Safe, non-invasive test
• MRI uses radio waves, without ionizing radiation or X
rays
• Unlike CT does not carry any risk of causing cancer.
• The images generated remarkably complete, detailed
and precise
• MRI has the potential of replacing other cardiac tests
like:
▫ Echocardiogram,
▫ Thallium scan
▫ Diagnostic cardiac catheterization.