13 results
Syncope Diagnostic Testing and Evaluation: Cost Effectiveness
Frequency obtained - Abnormal findings - Helped determine etiology of
Syncope Diagnostic Testing ... ECG, Telemetry, Cardiac ... /S, EEG, Brain MRI ... , Cardiac stress ... #table #comparison
Interpreting Right Heart Catheterizations

Always interpret a RHC based on the indication for getting the test. This
Interpreting Right Heart Catheterizations ... indication for getting ... Pre-capillary, Post-capillary ... What is the cardiac ... #Right #Heart #Catheterization
Cardiac Stress Testing
Exercise:
 • Everyone who can exercise should!
 • They must be able to raise
Cardiac Stress Testing ... • They must be able ... ($$$), PET CT/MRI ... COREIMpodcast #Cardiac ... #Stress #Testing
Syncope Cost-Effectiveness Workup
Cost-effective tests for most patients: 
 • Orthostatic BP
 • ECG
 • Telemetry (if
Carotid US • Brain MRI ... • EEG • Cardiac ... stress testing ... • Cardiac Enzymes ... diagnosis #workup #testing
Inpatient Cath Lab Indications
Cath Lab ASAP:
STEMI
NSTEMI:
1. Unstable/cardiogenic shock
2. Severe LV dysfunction or
3. Recurrent/persistent rest angina despite
New/worsening MR ... Rx: NSTEMI/UA: stable ... #Indications #Cardiac ... #catheterization
Bedside Classification of Shock

Hypovolemic shock 

- Vomiting, diarrhea, overdiuresis 

- Hemorrhage (GI, peritoneal, RP) 

Distributive shock
Anaphylaxis - Post-cardiac ... Endocarditis - Post-MI ... Cardiogenic #Comparison #Table
Right Heart Catheterization - Pulmonary Artery Pressures and Calculations
PULMONARY VASCULAR RESISTANCE = (meanPAP-PCWP) / CO
 •
Right Heart Catheterization ... mortality in inferior MI ... CARDIAC POWER OUTPUT ... not available in most ... much as 40% in cardiac
Approach to Undifferentiated Shock - OnePager Summary
Shock occurs when there is inadequate blood flow (CO) &
), LV Failure (MI ... Valves (wide open MR ... Pneumothorax, Cardiac ... pancreatitis, post-cardiac ... Renal Losses(salt-wasting
Post Cardiac Catheterization Complications
Access site complications
 • Hematoma - Pain, swelling, bruising
 • Retroperitoneal bleed -
Post Cardiac Catheterization ... presyncope • MI ... diaphoresis • Cardiac ... KhurrumKhanMD #Post ... #Cardiac #Catheterization
Preoperative Risk Evaluation

Major Pre-Op Questions:
1. Does the patient have any modifiable risk factors that could be
exam Determine Cardiac ... they have one post ... surgery Stress Testing ... postoperative cardiac ... preoperative stress testing