Investigations CVD

Investigations

Angiography
• also known as arteriography
• X-ray examination that shows blood flow in the arteries and veins
• Shows whether blood vessels are narrow, irregular or blocked (eg. Due to arterosclerosis)
• Reveal thrombosis, aneurysm.
• Detects the development of clumps of new blood vessels (tumours, cysts)
How is it performed?
• Anaesthetic is given (usually local; children – general)
• Needle inserted into an artery (leg, arm, groin)
Femoral artery usually used
– access to heart’s left ventricle, aorta and all it’s branches
- Lowest complication rate
• Needle is in place, long thin guide wire guided into blood vessel that needs to be examined (using fluorescent screen)
• Catheter is slipped over it pushed along until tip is in the right position
• Guide wire removed and dye injected
• Image viewed on screen / rapid sequence of X-ray pictures for further investigation (flouroscopy)

Cardiac MRI
• Non-invasive test
• Uses radio waves and magnets to create pictures of organs and tissues
• No radiation
• Uses computer to create image of the heart and blood vessels (both still and moving)
• To diagnose and evaluate: -
- Coronary Artery Disease
- Damage due to Myocardial Infarction
- Heart failure
- Heart valve problem
• Sometimes dye is injected into veins to highlight heart or blood vessel in images

CT Scan
 X-ray pictures of the heart is taken (involves radiation)
 X-ray machine move around to capture images of different parts of the heart
 Each picture shows a small slice of the heart
 Computer puts picture together to make large image of the whole heart.
Use to investigate and diagnose:-
 Blocked or narrowed arteries
 Aneurysm in the aorta
 To locate a pulmonary embolism

Echocardiography
 High frequency sound wave to produce moving picture of heart
 Used to:
- detect weakened heart muscles
- measure size of the heart
- detect abnormalities in heart
(eg. Hole in septum)

Electrocardiogram
 Measure electrical activity of the heart
 used to measure:
- Any damage to the heart
- How fast your heart is beating and whether it is beating normally
- The size and position of your heart chambers

Cardiac Marker test
 To diagnose, evaluate and monitor patients with suspected acute coronary syndrome.
 Test blood for proteins which include:-
- Creatine kinase (CK)
- Creatine kinase-MB (CKMB)
- Myoglobin
- Cardiac troponin I or cardiac troponin T
 (CK, CKMB and Myoglobin found in other muscles, so troponin is usually used)
 Found in cardiac cells, released in blood after myocardial infarction

Links
http://www.nhs.uk/Conditions/Angiography
http://www.nhlbi.nih.gov/health/dci/Diseases
http://circ.ahajournals.org/cgi/content/full/109/3/e12
http://pathcuric1.swmed.edu/PathDemo/nrrt.htm#Chem
http://www.rcpamanual.edu.au/sections/pathologytest.asp?s=33&i=450
http://www.amarillomed.com/howto.htm