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Equipment

Cardiac Imaging Equipment – an Overview | Cardiology

What Is Cardiac Imaging Equipment?

Cardiac imaging equipment i.e., As innovative technology advances in the medical field, there is also the possibility of inadvertently visualizing the heart and its vascularity. The practice of modern cardiovascular medicine requires not only the diagnosis but also the management of various cardiovascular diseases, as well as the guidance of invasive procedures.

These cardiac imaging equipment methods include myocardial perfusion imaging, magnetic resonance imaging (MRI), and computed tomography (CT) by echocardiography and nuclear scintigraphy. The Cardiac imaging method par excellence for visualizing the coronary arteries remains the invasive technique of coronary angiography by coronary catheterization.

Each model can be used individually or in combination as cardiac imaging equipment, depending on the desired diagnostic requirements. These studies are now commonly used in conjunction with the medical history, physical examination, and laboratory tests including cardiac imaging equipment to define the practice of modern cardiovascular medicine.

In addition, the appropriate guidelines for the use of these cardiac imaging equipment techniques are now standardized to optimize diagnosis and cost-effectiveness and to evaluate the ideal imaging technique to be used in specific patient situations to minimize risk to the patient. Cardiac imaging tests can explain the structure and function of the heart.

Standard imaging tests & equipment used

Here are the Cardiac imaging tests

  • Chest x-ray
  • CT
  • MRI
  • Echocardiography

Chest x-ray

Chest x-rays are often used as a starting point in diagnosing the heart. Posterior and lateral views provide insight into the atrial and ventricular size and shape and pulmonary vasculature, although additional testing including Cardiac imaging tests is almost always necessary for accurate classification of the structure and function of the heart.

CT

The scanner uses a series of x-ray images along with a body relief contrast dye to provide the most detailed images of the heart and surrounding structures. It provides accurate cardiac visualization and analysis in 30 seconds. UC San Diego Health has three high-definition 64-slice CT scanners.

These 64-slice scanners take images of the heart between beats, providing clearer and more detailed images of the heart that could not be obtained with previous technology.

These advanced CT scanners can deliver radiation only when needed during heart snapshots, further reducing the patient’s exposure to radiation. Since high levels of radiation can cause lifelong health problems, the goal is to get the best quality images with the lowest radiation.

MRI

Magnetic resonance imaging which is one of the parts of Cardiac imaging tests visualizes the heart by detecting hydrogen atoms using superconducting magnets, especially those attached to water and fat molecules. These hydrogen atoms are called nuclear spin.

Although the direction of this spin is usually random, the spin can be aligned by a strong magnetic field. When the arrangement of these hydrogen atoms is temporarily altered, faint electromagnetic signals are emitted, which can be detected and used to create a reflection of the heart.

MRI can measure the size, shape, function, and characteristics of heart tissue in a single session. It can reproduce more than echocardiography with low interobserver variability, allowing for more precise reference ranges to better distinguish health from disease.

Additional benefits of cardiac MRI include the ability to detect scarring in the heart using late growth of gadolinium and detect other abnormalities in the heart muscle, such as infiltration of iron or amyloid protein. The drawbacks of MRI include the potential for lengthy protocols and claustrophobia.

Also, some types of pacemakers cannot be scanned by MRI by some people who have metal implants, such as defibrillators, although most modern pacemakers are safe to use with an MRI scanner. Other metallic structures, such as prosthetic valves and coronary stents, are usually not problematic.

Echocardiography

The biological effects of diagnostic ultrasound have been documented in experimental studies conducted at the molecular, cellular, and animal levels.17 The effects depend on the characteristics of the sound wave, the sensitivity of the exposed tissue, and the duration of exposure. Effects can be broadly classified as thermal and mechanical effects. With current diagnostic ultrasound technology, biological effects are unlikely to occur directly through the heating of tissues.

Among the mechanical effects of ultrasound, the potential risk is cavitation: formation of microbubbles and rhythmic oscillations produced from gases dissolved in living tissue. The mechanical indicator of the acoustic cavity is developed as an ICT and is displayed as a safety parameter on modern ultrasound machines.

Tissues containing gas-filled contrast agents may show capillary rupture when exposed to ultrasound, but so far there is no evidence that patients or clinical staff pose a significant health risk due to the condition. Exposure to medical ultrasound.

Here are the types of Cardiac imaging tests which are clearly explained how these Cardiac imaging tests are conducted.

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Specialists

Overview of Non-Invasive Cardiology | Cardiology

What is non-invasive cardiology?

Non-invasive cardiology focuses on the detection and treatment of heart disease,  using external tests, rather than instruments inserted into the body such as needles, fluids, or other instruments, to evaluate and diagnose heart disorders. Patients with a history of heart disease, suspected valve disease, or unexplained chest pain may be referred by their physician for a noninvasive evaluation.

Non-invasive cardiology tests

Nuclear cardiology: Non-invasive study of cardiovascular disorders using various types of images that can use radioactive elements.

Echocardiography: The use of ultrasound waves to create images of the heart and surrounding structures in order to identify how well the heart pumps blood, infections, and structural abnormalities.

Cardiac electrophysiology: Study and test the electrical currents that generate the heartbeat.

Stress tests: Stress tests generally involve exercise controlled by your cardiologist. These exercises give your cardiologist information about how your heart works under physical stress.

Heart monitors: Heart monitors may also be called a Holter monitor or cardiac occasion recorder. Heart monitors are essentially tape recorders for the electrical activity of your heart over a set period of time.

CT scans: CT scans produce images that your cardiologist can examine for heart disease and atherosclerosis. Once your specialist has identified risk factors or existing conditions, he or she may recommend medications and lifestyle changes to improve your heart health.

Chest x-ray: An X-ray test can help physicians diagnose and monitor conditions such as heart failure, pneumonia, lung cancer, sarcoidosis, tuberculosis, and fibrosis. Doctors also use chest X-rays to see how treatments are working and to check for complications after a patient has undergone specific surgeries or procedures.

Electrocardiogram (EKG / ECG): The electrocardiogram test records the electrical activity of your heart to conclude if you have had a heart attack or if one is developing one. It also detects changes in the heart rhythm, which helps doctors identify complexities.

Computer imaging: Computer images can take the form of a CT scan or an MRI. The computer generates a three-dimensional image that can help show blockages in your heart caused by a heart condition or calcium deposits that you may have in your arteries. It can also notice pulmonary embolism or other heart ailments or cardiovascular diseases.

  • Exercise stress test
  • Tape test
  • Cardiac exercise stress test
  • General exercise test

These tests are carried out to check aspects such as:

  • Breathing
  • Blood pressure
  • Heart rate
  • Resistance

The test can diagnose various heart problems, including coronary artery disease or the possible cause of chest pain. It could also simply determine your safe level of exercise, especially if you’ve already had heart surgery.

Nuclear scan of the heart

A nuclear scan of the heart is a test similar to a standard stress test but is done with photos of the heart in action. Patients will receive an injection of dye to make problems more visible before the test begins. The images can help find blockages, measure blood flow, or identify heart muscle damage caused by a heart attack.

Results-based treatment

If your cardiologist signs that something is wrong, you will receive a set of dietary and nutritional recommendations and lifestyle changes to join. People with heart disease can be healthy with the right tests and management plan. These plans can also include medication, meditation, and other relaxation methods in addition to diet and lifestyle changes, as mentioned above. If the situation is not curable with the means indicated above, the non-invasive cardiologist refers the patient to a specialist who can treat him.

An invasive cardiologist, meanwhile, will offer surgery and other treatments in addition to medication and lifestyle, as mentioned above these changes could cure the ailment facing the patient.

Responsibilities of Non-Invasive Cardiology

Non-invasive cardiology must complete an internal medicine residency program after they have completed their medical degrees. However, after residency, they are required to spend two years completing a fellowship in cardiology. The standard procedure for cardiologists is to serve as a non-invasive cardiologist and focus on performing pre-diagnostic tests and treating patients.

Those training to become invasive cardiologists can do similar work with cases, but can also perform medical tests to find arterial blockages. However, non-interventional invasive cardiologists do not complete the same procedures as interventional cardiologists.

  • Assessment of cardiovascular and cardiac health problems of patients
  • Refer patients to other specialists
  • Interpret the results of ECG and other electronic tests.
  • perform cardiac catheterizations
Categories
Disease

Treatment and Diagnosis of Pericardial disease | Cardiology

What is a pericardial disease (pericarditis)?

Pericardial disease or pericarditis is an inflammation of any layer of the pericardium. The pericardium is a clash of thin tissue around the heart and includes:

  • Visceral pericardium: The inner layer that covers the entire heart. Fluid layer between the visceral pericardium and parietal pericardium to avoid friction
  • Parietal pericardium: The outer layer made of fibrous tissue.

Signs and symptoms of pericardial disease

You may not have symptoms. This occurs most often in the case of a mild spill. You may have symptoms from the causes of pericardial disease. For example, you may have a fever if you have a pericardial infection.

When the stroke is more severe, you may have symptoms similar to:

  • Chest pain or discomfort
  • Dilation of the neck veins.
  • Epilepsy
  • Breathe faster
  • Increase in cardiac frequency
  • Nausea
  • Pain in the upper right abdomen
  • Difficulty breathing
  • Swelling of the hands and feet

If the stroke is too severe, it can even lead to very low blood pressure. It causes symptoms of shock. In addition to:

  • Mild headache or dizziness
  • Cold hands and feet
  • Clammy skin
  • Weakness
  • Fast breathing
  • Nausea or vomiting
  • Pale skin
  • Less urination
  • Shock is a medical emergency.

The symptoms of the pericardial disorder are similar to other health problems. See your healthcare provider for a diagnosis.

Types of pericardial disease

Idiopathic pericarditis: The cause of acute pericarditis is very difficult to establish and idiopathic pericarditis remains the most common diagnosis. In most cases, a viral etiology is assumed.

Viral pericarditis: Coxsackievirus B and Echovirus are the most common viruses and diagnosis requires a four-fold increase in antiviral titers. Patients often experience a prodrome of upper respiratory infection. The prognosis for viral pericarditis is generally good, with a self-limited course, and if uncomplicated, patients can be treated on a patient basis.

Pure pericarditis: Before the age of antibiotics, pneumonia was the leading cause of purulent pericarditis. Currently, there are extensions of thoracic surgery, chemotherapy, immunosuppression, and hemodialysis, as well as pneumonia and emphysema. The appearance is usually severe with high fever, chills, night sweats, and dyspnea, but the classic findings of chest pain or friction rub are very rare. Cardiac tamponade is common (42–77% of patients in the selected series) and mortality is high.

If the purulent pericardial disease is suspected, hospitalization, treatment with broad-spectrum intravenous antibiotics, and emergency drainage are recommended. Pericardial fluid analysis findings include a high protein level (> 6 g / dL), a low glucose level (<35 mg / dL), and a very high white blood cell count (6,000 to 240,000 / mm3).

Tuberculous pericarditis: Tuberculous pericarditis occurs in 1% to 2% of pulmonary tuberculosis cases. It is the leading cause of pericardial disease in some developing countries. Human immunodeficiency or immunosuppressed virus (HIV): Patients are at risk. Special symptoms such as dyspnea, fever, chills, night sweats develop slowly and often there is no rubbing or chest pain. A patient with suspected or diagnosed pericardial tuberculosis should be hospitalized and antituberculous treatment started immediately.

Analysis of the pericardial fluid shows a high specific gravity, a very high protein level (often> 6 g / dl), and mainly lymphocytic cells. Pericardial biopsy with an acid-fast bacilli polymerase chain reaction test is recommended for all patients with tuberculous pericarditis. However, a simple pericardial biopsy does not rule out the diagnosis.

Uremic and dialysis-associated pericarditis: Uremic pericarditis occurs with moderate renal failure in 6% to 10% of patients before the start of hemodialysis; Blood urea nitrogen levels are usually above 60 mg / dL. Normal ST-segment elevation on ECG is usually absent. Although tamponade is very rare, heavy bleeding can occur, facilitated by impaired platelet function. Alternatively, a serous pericardial effusion related to fluid overload may occur. With both forms, the onset or severity of hemodialysis is indicated, which generally leads to improvement in 1 to 2 weeks5,6.

Pericarditis after myocardial infarction: Pericarditis after myocardial infarction is a common complication (25% to 40% of patients with myocardial infarction) and begins within 3 to 10 days after myocardial infarction. Its development is associated with the extent of necrosis, is more common earlier than malignant infarcts, and is associated with a 1-year mortality rate and an increased risk of circulatory heart failure.

The diagnosis of post-myocardial infarction pericarditis requires symptoms or new pericardial friction; Pericardial effusion alone is not specified. In addition to the general ST elevation seen with severe pericarditis, which is difficult to distinguish from true MI in this setting, ECG findings show normalization of positive T waves more than 2 days after MI or T waves previously transversal.

Post-cardiac injury syndrome: Dressler syndrome usually occurs 2 to 3 weeks after a heart attack or open-heart surgery. The sensitive autoimmune component is believed to be responsible for myocardial infarction during infarction. Fully expressed syndromes include pleurisy chest pain, fever, leukocytosis, and pericardial rubbing. Pleural effusions or pulmonary infiltrates may be observed.

Malignancy: Malignant pericarditis is caused mainly by metastatic disease. Bronchogenic metastatic pericarditis or breast carcinoma, common in Hodgkin’s disease and lymphoma 

Causes of pericardial disease

  • Pericardial disease is caused by inflammation of the pericarditis in response to illness or injury.
  • The pericardial disease also occurs when the flow of pericardial fluid is blocked or blood collects at the pericardium from a chest injury.
  • Sometimes the cause cannot be determined (idiopathic pericarditis).
  • Inflammation of the pericarditis after heart surgery or a heart attack.
  • Autoimmune disorders such as rheumatoid arthritis or lupus.
  • Cancer (metastasis), especially lung cancer, breast cancer, melanoma, leukemia, non-Hodgkin’s lymphoma, or Hodgkin’s disease
  • Heart cancer.
  • Radiation therapy for cancer if the heart is in the radiation field.
  • Chemotherapy treatments for cancer include doxorubicin (Doxil) and cyclophosphamide.
  • Dysfunctional thyroid (hypothyroidism).
  • Viral, bacterial, fungal, or parasitic infection.
  • Trauma or puncture wound near the heart after open-heart surgery.
  • Some prescription drugs, including hydrolyzing, a drug for high blood pressure; Isoniazid, a drug for tuberculosis; And phenytoin (Dilantin, Fenitech, et al.) and Antiepileptic drug.

Risk factors of pericardial disease

Pericarditis affects people of all ages, but men in their 20s and 50s are more likely to develop it.

The cause of pericarditis is unknown in many cases. However, some factors can trigger pericarditis:

  • Recovering from a heart attack
  • Autoimmune diseases
  • Injury or injury from an accident
  • Some bacterial, viral, and fungal infections
  • Renal insufficiency
  • In rare cases, some medicines, such as phenytoin to treat seizures and procainamide to treat irregular heartbeat

Diagnosis of pericardial disease

The doctor will do a physical exam and listen to your heart with a stethoscope. If you have signs or symptoms of pericardial disease, a series of blood and imaging tests will be done to confirm the diagnosis, identify possible causes, and determine treatment. Sometimes a pericardial disease is found when testing is done for other reasons.

  • Echocardiogram: An echocardiogram uses sound waves to create real-time images of your heart. This test allows your doctor to see how much fluid has accumulated in the space between the two layers of the pericardium. The echocardiogram also shows how well your heart is pumping blood and diagnostic tamponade or shock in one of the heart’s chambers.
  • There are two types of echocardiograms: Transthoracic echocardiogram. This test uses a sound-emitting device (transducer) that is placed on your chest and your heart.
  • Transoesophageal echocardiogram: A small transducer is placed in a tube in your digestive system that goes from your throat to your stomach (esophagus). Because the esophagus is so close to the heart, placing the transducer there provides a more detailed image of the heart.
  • Electrocardiogram: An electrocardiogram, also known as an ECG or EKG, records electrical signals as they travel through your heart. Your cardiologist can look for samples that indicate tamponade.
  • Chest x-ray: If you have too much fluid in the pericardium, a chest X-ray will show an enlarged heart.
  • Other imaging technologies: Computed tomography (CT) and magnetic resonance imaging (MRI) can detect pericardial effusion, although they are not commonly used to look for it.

Treatment for pericardial disease

Treatment for pericardial disease depends on the underlying condition causing it and whether the effusion produces severe symptoms, such as shortness of breath or shortness of breath. Medical history, the examination of the patient, diagnosis, examination of the pericardial fluid, and the physician will help determine the cause and treatment.

Depending on the cause, excess fluid may be high in protein (exudate) or water (translate). Both categories help doctors determine the best course of treatment for pericardial effusion.

Medical administration

The goal of medical treatment for the pericardial disease is to treat the underlying cause. Medical treatments for pericardial effusions:

  • Nonsteroidal anti-inflammatory drugs (NSAIDs) can be used to treat pericardial disease caused by inflammation. These medications include ibuprofen or aspirin.
  • Diuretics can be used to treat pericardial effusions caused by heart failure.
  • Antibiotics are used to treat pericardial disease caused by infection.
  • However, if the pericardial effusion is related to the presence of cancer, treatment may include chemotherapy, radiation therapy, or intramuscular injection.

Procedures for the treatment of pericardial disease

Regardless of whether the pericardial disease is transudative (watery fluid) or exudative (made from a protein-rich fluid), the large pericardial disease is caused by respiratory symptoms or cardiac tamponade may be the main cause of the elimination of excess fluid, to avoid its return or to increase the liquid.

Large pericardial effusions can be drained through:

  • Ultrasound-guided pericardiocentesis: It is a safe and effective procedure to remove excess fluid from the pericardium. This is more common after fluoroscopy.
  • Video-assisted thoracoscopic surgery (VATS): Also known as thoracoscopy, is the least invasive technique performed under general anesthesia. VATS allows visual evaluation of the pericardium and is used when the diagnosis of pericardial effusion has not yet been made despite previous less invasive tests. It is also used to drain excess fluid and prevent relapse. A pericardial disease that may not be treated with medical maintenance or drainage of excess fluid may require surgical treatment.
  • The pericardial window (subluxated pericardiotomy): It is a minimally invasive procedure in which an opening is made in the pericardium to drain fluid that has accumulated around the heart. The pericardial window can be completed with a small incision under the end of the breastbone or with a small incision between the ribs on the left side of the chest.
  • Percutaneous balloon pericardiotomy: It is a non-surgical procedure performed with an x-ray guide to view the pericardium and place the balloon dilator catheter. This approach is not common.

Complications of pericardial disease

  • Pericarditis can be one of two serious problems: cardiac tamponade and chronic gastric pericarditis.
  • Cardiac tamponade a medical emergency and, if left untreated, can quickly become fatal.
  • It develops when there is excess fluid between the heart muscle (myocardium) and the pericardium, putting obstructive pressure on the heart to prevent it from working properly.

Cardiac tamponade causes several symptoms, including:

  • Anxiety
  • Breathing problems and chest pain.
  • Dizziness and epilepsy
  • Swelling of the abdomen
  • Drowsiness
  • Weak pulse
  • Rare, even chronic, chronic constrictive pericarditis can be fatal if left untreated.

Pericarditis develops slowly when scar (fibrous) tissue forms on the pericardium, causing the sac to become thicker, harder, and firmer. Scar tissue shrinks over time, preventing the heart from fully expanding and filling with blood. Chronic constrictive pericarditis can lead to weakness and fatigue, shortness of breath, and swelling in the abdomen and extremities.

Prevention of pericardial disease

In general, acute pericarditis cannot be prevented. You can take steps to reduce the chance of another serious episode, complications, or chronic pericarditis. Getting prompt treatment during these stages, following your treatment plan, and getting ongoing medical care as advised by your doctor.