The Cardiovascular System and its Disorders
Walter F. Stanaszek, Mary J. Stanaszek, Robert J. Holt, Steven Strauss in Understanding Medical Terms, 2020
Cardiac catheterization is a specialized technique whereby a flexible catheter is passed along veins or arteries into the heart to explore structures, measure pressures and blood-gasses, and inject radiopaque dyes for angiography. Relying on fluoroscopy with an image intensifier and a television system, catheterization allows the physician to use radiopaque catheters and dyes to measure septal defects, locate and quantify partial occlusions, isolate the sources of arrhythmias, and determine vascular function. Invasive and requiring specialized training, cardiac catheterization is usually reserved for problems that cannot be resolved without it.
The patient with acute cardiovascular problems
Peate Ian, Dutton Helen in Acute Nursing Care, 2020
Investigations required for the patient with cardiogenic shock are based upon the evaluation of the extent of the damage to the heart and the effect that this has on the major organs of the body and include: Echocardiography to reveal the amount of ventricular damage that exists and the functioning of heart valves also affected. The presence of blood in the pericardium can be seen.12 lead ECG to show ST segment elevations in the region of an infarction, which is important for the consideration of the complications that might arise from it. For example, ST segment elevations in the leads V1 to V3 indicate an antero-septal MI, which is implicated in septal wall rupture.Cardiac monitoring, used continuously to quickly identify changes to the heart’s rhythm. Arrhythmia might occur because of the damage to the ventricular wall, or as a result of changes in blood chemistry caused by renal hypoperfusion.Cardiac catheterisation is a commonly used technique for the evaluation of coronary artery blood flow to the affected region of myocardium.
Coronary Artery Disease
Jahangir Moini, Matthew Adams, Anthony LoGalbo in Complications of Diabetes Mellitus, 2022
Diagnosis of CAD is based on medical history, physical examination, and routine blood tests. Other diagnostic tests include ECG, echocardiogram, an exercise stress test, a nuclear stress test, cardiac catheterization, and cardiac CT scan. Electrocardiogram can reveal evidence of a previous heart attack or even one that is currently happening. Echocardiogram allows for examination of all parts of the heart wall, revealing signs of CAD. An exercise stress test involves walking on a treadmill or riding a stationary bicycle as an ECG is being performed, and sometimes an echocardiogram is done as well. For some patients, a medication is used to stimulate the heart instead of exercise. A nuclear stress test is similar to an exercise stress test, but provides images as well as ECG recordings, measuring blood flow to the heart muscle during stress and at rest via specialized cameras. In cardiac catheterization, a catheter is inserted into a groin, neck, or arm artery or vein and carefully pushed to the heart, guided by the use of various imaging techniques. Dye may be injected to improve imaging of the blood vessels and any blockages. A cardiac CT helps visualize calcium deposits in the arteries that can narrow them, indicating likely CAD. Also, in a CT coronary angiogram, a contrast dye is injected intravenously to produce detailed images of the coronary arteries (see Figure 9.1).
Update on shunt closure in neonates and infants
Published in Expert Review of Cardiovascular Therapy, 2021
Karim A. Diab, Younes Boujemline, Ziyad M. Hijazi
Transcatheter PDA closure can be done via either the anterograde (venous) or retrograde (arterial) approach, with the former being preferred in very small infants in order to decrease the risk of vascular complications. The detailed protocol for the procedure has been previously reported [87]. Figure 3 illustrates the closure of a large PDA in a premature newborn with a weight of 9900 g. In brief, cardiac catheterization is performed under general anesthesia. An anteroposterior and lateral angiogram in the descending aorta is performed to evaluate the size, position and shape of the ductus and classify it as type A-E according to Krichenko et al.’s angiographic classification [88]. Recently, there has been more realization that the ductus in premature infants can be larger and longer PDAs which fits into what was termed a type F PDA, which helps with selecting the type of device for closure [89]. After delineating the anatomy and landmarks of the PDA, the appropriate device is chosen and deployed. After deploying the device, a descending aortogram is performed to confirm the position and stability of the device followed by a repeat aortogram 10 min after the release to assess the degree of residual shunt.
Mechanisms, diagnosis, and treatment of heart failure with preserved ejection fraction and diastolic dysfunction
Published in Expert Review of Cardiovascular Therapy, 2018
Gilman D. Plitt, Jordan T. Spring, Michael J. Moulton, Devendra K. Agrawal
The assessment of invasive hemodynamic using cardiac catheterization is currently the gold standard for diagnosing DD due to its ability to directly measure ventricular pressures throughout the cardiac cycle [31,32]. While this method provides a wealth of information about cardiac performance, the most useful parameters for measuring diastolic function are tau, the time constant of ventricular pressure decay, and LVEDP. Tau is an accepted measurement of myocardial relaxation, and LVEDP is helpful for determining the left ventricular wall compliance; both of which are central to the definition of DD [31,33]. With measurement of these parameters, cardiac catheterization currently provides the most detailed insight into diastolic function; however, the invasiveness and risks decrease the clinical value of this method, especially in patients with significant comorbidities and unstable patients. As a result, echocardiography has emerged as the preferred approach for diagnosing DD, though cardiac catheterization continues to serve as a useful tool for evaluating complicated cases and validating alternate methods of detection.
Image-based morphometric studies of human coronary artery bifurcations with/without coronary artery disease
Published in Computer Methods in Biomechanics and Biomedical Engineering, 2020
Xueping Chen, Jingxing Dai, Jiangguo Lin, Yueheng Wu, Jun Ouyang, Meiping Huang, Jian Zhuang, Ying Fang, Jianhua Wu
Studies reported that CAD can be asymptomatic, and heart attack may be its first manifestation (Nasarian et al. 2020). Moreover, CAD disease has a very high mortality rate and its treatment is very expensive. Therefore, early detection of CAD could save many patients’ life and reduce the cost of healthcare. Many tools have been developed for CAD diagnosis, among which the cardiac catheterization is the most direct and reliable approach (Tavakol et al. 2012). However, cardiac catheterization is costly and time-consuming, and it is an invasive and risky surgical operation. Hence, noninvasive detections are crucial to assess the status CAD disease rapidly and economically and tailor further treatment strategies. For this reason, a reliable noninvasive method for early detection of CAD is vital. Artificial intelligence (AI) or machine learning technique, such as support vector machine, is a rapidly developing computer big data mining technology, which can be used to classify common diseases with positive and negative attributes (Abdar et al. 2019; Chen et al. 2020). Our present study demonstrated that morphological attributes of coronary arterial trees indeed closely correlate with CAD disease. Therefore, combining the utilization of current advanced AI technology and our novel proposed morphological indicators, it is possible to build a powerful noninvasive model for the early detection of CAD.
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