This document discusses three cardiovascular procedures: stress tests, echocardiography, and thrombolytic therapy. Stress tests evaluate a patient's heart under physical or chemical stress to detect abnormalities. Echocardiography uses ultrasound to image the heart and detect defects. Thrombolytic therapy treats heart attacks and strokes by using clot-busting drugs to break up blood clots.

1. Cardiovascular System Jesse Hintz Bio 120 6/22/10

2. We are going to look at two diagnostic procedures and one therapy relating to the cardiovascular system. Diagnostic Procedure Stress Test Echocardiography Therapy Thrombolytic Therapy

3. Stress Test This is a test to determine the amount of stress a patient’s heart can endure before developing an abnormal rhythm or evidence of ischemia (lack of blood flow to the heart muscle). There are several reasons a doctor would order this test. -Determine the likelihood of coronary heart disease -Evaluate the effectiveness of heart medication -Evaluate effectiveness of previous heart procedures -Help develop an exercise program -Identify abnormal heart rhythms

4. Types of Stress Tests Treadmill Stress Test – This is the normal stress test performed. The patient walks on a treadmill or stationary bicycle while connected to the electrocardiogram (EKG). Blood pressure and heart rate are also recorded during this test. -Before the test begins, the technician will perform an EKG to have a measurement of the patient at rest. The patient begins exercising. The rate of exercise will increase gradually. The patient stops when they are exhausted. The exercise period is usually about 12 minutes. During the exercise period, the technician will ask how the patient is feeling at regular intervals. EKG, heart rate and blood pressure are all monitored during this time. What if the patient cannot exercise? Dobutamineor Adenosine Stress Test – This is done if the patient is unable to exercise. Drugs are given to the patient to make the heart simulate exercise.

5. Echocardiography This is a test that uses ultrasound to evaluate heart muscles, heart valves and can determine risk for heart disease. The standard echocardiogram is called the Transthoracic Echocardiogram. This is a painless test that uses hand held transducer placed on the chest. This transducer emits high frequency radio waves or ultrasound (this is similar to the procedure that pregnant mothers have to determine the baby’s health).These waves bounce off heart structures and provide the doctor with images that help determine heart defects or disease.

6. Other Types of Echocardiograms Transesophageal Echocardiogram – Instead of the transducer being outside the body, as in the transthoracic echocardiogram, the transducer is down the throat into the esophagus. The image of the heart is more clear this way since the chest and lungs are no longer in the way. Stress Echocardiogram – This is another type of stress test similar to what we learned about on the previous slides. This echocardiogram is taken while the patient is exercising on a treadmill or stationary bicycle. If the patient is unable to exercise, drugs can be used to stimulate heart activity during exercise. This is called a Dobutamine stress echocardiogram.

7. Thrombolytic Therapy Thrombolytic therapy is medication given to break up blood clots. These are very powerful drugs administered intravenously in a hospital. These are used to prevent ongoing damage from heart attack or stroke and to break up blood clots in other vessels in the body. Also known as Clot Busters These are powerful drugs so make sure your Doctor has an accurate medial history including: -Recent trauma or surgery -Pregnancy -High blood pressure -Liver Disease -Bleeding Disorder -Allergies Types of drugs administered -tissue plasminogen activator (TPA) -tenecteplase -alteplase -urokinase -reteplase -streptokinase.