This is a brief overview of cardiac imaging modalities and clinical methods of visualizing the heart
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ADDITIONAL TAGS:
Cardiac Imaging Modalities
An overview of the clinical methods of visualizing the heart
Chest X-ray
Echocardiogram (TTE / TEE)
Myocardial Perfusion
Imaging
MRI
Catheterization
Cardiac CT
Chest X-ray (CXR)
Dates back to early 1900s → first used for diagnosing TB
Differentiate/resolve objects based on density
High density objects (solids: bone, metal) appear white
Low density objects (gas, lungs) appear black
Water-based tissues somewhere in between
Cannot resolve cardiac structures, but see silhouette
Use to calculate cardiac ratio
Can find lung manifestations of heart disease
Pleural edema, pulmonary effusion
Cheap, small radiation exposure → used frequently with chest pain presentations
Chest X-ray
Echocardiogram (TTE / TEE)
Myocardial Perfusion
Imaging
MRI
Catheterization
Cardiac CT
Echocardiogram
Ultrasound waves emitted from piezoelectric transducer bounce off tissues; reflected waves are measured → no risk/toxicity, low cost
Transthoracic echocardiogram (TTE) or transesophageal echocardiogram (TEE)
TEE is gold standard for excluding intracardiac thrombus
M mode (one beam) or 2D (multiple beans in arc to capture a beama) or 3D (similar multibeam reconstruction)
Doppler echocardiography
Visualize blood flow → identify turbulent regions
Gold standard for find valvular abnormalities
Chest X-ray
Echocardiogram (TTE / TEE)
Myocardial Perfusion
Imaging
MRI
Catheterization
Cardiac CT
Myocardial Perfusion Imaging
Heavy element radioisotopes (such as thallium-201) are used to mark areas of myocardial perfusion
Perfusion is ability to deliver blood to capillaries
Imaging the heart when exposed to these markers allows us to identify areas of low perfusion (indicating ischemia)
Nuclear stress test → imaging before and after stress
Chest X-ray
Echocardiogram (TTE / TEE)
Myocardial Perfusion
Imaging
MRI
Catheterization
Cardiac CT
Cardiovascular MRI
Noninvasive use of magnetic fields and radio waves to form images of structures in the heart
Downside: expensive, exposure to contrast
Produces moving and still images
Gold standard for assessing cardiac structure and function
Chest X-ray
Echocardiogram (TTE / TEE)
Myocardial Perfusion
Imaging
MRI
Catheterization
Cardiac CT
Cardiac Catheterization
Involves insertion of catheter into the chambers of vessels of the heart
Allows for therapy (stents) and diagnostics
Downsides: radiation exposure, expensive, invasive (albeit minimally)
Right heart cath → insert through vein (femoral) to measure right heart, pulmonary artery pressures
Gold standard for assessing intracardiac pressures and cardiac output
Left heart cath → insert through artery to measure left heart pressures, insert dye for coronary angiography
Coronary angiography is gold standard for visualizing coronaries and identifying stenosis
Chest X-ray
Echocardiogram (TTE / TEE)
Myocardial Perfusion
Imaging
MRI
Catheterization
Cardiac CT
Cardiac CT
Computed tomography of the heart: extensive heart x-ray
Used to assess extent of coronary stenosis
Visualize thoracic aorta
Benefits: less invasive than catheterization, produces 3D models
Drawbacks: still requires radiation exposure, contrast that damages kidneys
Chest X-ray
Echocardiogram (TTE / TEE)
Myocardial Perfusion
Imaging
MRI
Catheterization
Cardiac CT