Cardiology Procedures: A Clinical Primer by Robert C. Hendel, Carey Kimmelstiel

By Robert C. Hendel, Carey Kimmelstiel

This e-book offers a unmarried reference that describes the appliance and function of options and tactics played through cardiologists. It comprises descriptions of the technical points, medical program and interpretation of the information generated in the course of those trying out modalities. The authors have supplied a clinically centred advisor to cardiac techniques geared toward medical trainees and practitioners, together with physicians in addition to affiliated clinicians. Case stories are offered to extra illustrate how those suggestions are utilized in medical practice.

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Dobutamine Stress Patient preparation includes NPO status for at least 4–6 h and avoidance of beta-blockers for 24 h. A careful review of history and a physical exam is performed to detect any cardiac abnormalities such as severe AS. Informed consent is obtained after reviewing for appropriate indications. A peripheral IV is started and ECG electrodes connected and baseline BP recorded. ECG is reviewed to detect any contraindications for testing. Dobutamine is infused at gradual increasing doses from 5, 10, 20, 30, and 40 mcg/kg with the option of giving 1–2 mg atropine after 30 mcg/kg dose to achieve 85 % APMHR (Fig.

Arrhythmias Sustained VT and VF although rare, are abnormal findings that should prompt further evaluation. Time to recovery of both ST changes and heart rate are two additional parameters to analyze. If rapid recovery (<1 min) of ST changes occurs, the less likelihood ischemia is present. Heart rate recovery is another important prognostic indicator. It is considered abnormal if the difference between maximum HR at peak stress and at 1 min into recovery is 12 beats or less. Blood pressure monitoring is another important aspect of exercise testing for safety and diagnostic reasons.

8. 9. 2 Pretest probability of CAD Age (year) 30–39 40–49 50–59 60–69 Gender Men Women Men Women Men Women Men Women Typical/definite angina Intermediate Intermediate High Intermediate High Intermediate High High Atypical/probable angina Intermediate Very low Intermediate Low Intermediate Intermediate Intermediate Intermediate Non-anginal chest pain Low Very low Intermediate Very low Intermediate Low Intermediate Intermediate Asymptomatic Very low Very low Low Very low Low Very low Low Low 4 Exercise Stress Testing 37 There are several conditions in which exercise tests should be combined with an imaging modality; either myocardial perfusion imaging (MPI-SPECT or PET) or echocardiography.

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