nuclear cardiology delaney

Angina

chest pain usually due to insufficient oxygen supply to the heart.

Aortic Valve

A semilunar valve between the left ventricle and aorta that prevents flow from the aorta back into the heart.

Apnea

No breathing.

Arrhythmia

variation of the heartbeat.

Asystole

No ventricular activity is present.

Atherosclerosis

Build up of cholesterol and fatty deposits inside arterial walls and can lead to ischemia.

Atrial Fibrillation

Multiple ectopic areas in the atria fire causing random impulses to reach the ventricles resulting in an irregular rhythm.

Atrial Flutter

Varying impulses reach the ventricles but in a more regular pattern, P-waves have a characteristic 'saw-toothed' configuration.

Atrial Pacemaker

The pacemaker lead is located in the right atrium, usually in the coronary sinus. It acts as a P-wave and causes the atria to contract.

AV Node

Receives the impulse from the SA Node, pauses for a fraction of a second to allow the ventricles time to fill with blood then passes the impulse down the His Bundle.

Blood Pressure

Force exerted on the walls of the blood vessels as the blood flows through them.

Bradycardia

Lower than normal heart rate, less than 60 beats per minute.

Bundle of His

Spreads impulse from apex to base of the heart to control the direction of the contraction.

Cardiac Cycle

One beat of the heart, which consists of systole, the period of ventricular contraction, and diastole, the period of ventricular relaxation.

(Cardiac) Ejection Fraction

The fraction of the total volume of blood of the left ventricle ejected per contraction.

Cardiac Output

The quantity of blood ejected by the heart over a one-minute interval. Usually 5 L/min at rest and 15 L/min during exercise in normal adults.

Congestive Heart Failure

inability of the heart to pump sufficient blood to meet the demands of the body.

Coronary Artery Bypass Graft (CABG)

Process in which blood flow is rerouted through a new artery (grafted from another vessel in the body) to areas of the heart muscle where diseased coronary arteries have reduced or blocked blood flow.

Coronary Artery Disease (CAD)

A narrowing or blockage of the arteries and vessels that deliver oxygen and nutrients to the areas of the heart

what can eventually lead to ischemia or infarct?

coronary artery disease

Diastolic Pressure

The heart in a state of relaxation, the bottom number of the blood pressure reading.

Dyskinesis

impairment in the movement of the heart wall.

Dyspnea

Difficulty breathing.

Ejection Fraction

is a measurement to how well the heart is functioning, it is the fraction of the total volume of blood that the heart can hold that is pushed out of the heart with each beat.

Electrocardiogram

Records the electrical activity of the heart and is a valuable record of the heart's function.

End-diastolic Volume

The quantity of blood in the ventricle at the end of diastole.

End-systolic Volume

The amount of blood in the ventricle at the end of a contraction.

Endocardium

inner most layer of tissue in the heart, membrane of epithelium and underlying connective tissue, including blood vessels and specialized fibers; functions as a protective inner lining of the chambers and valves.

what are the three layers of the heart

endocardium, myocardium, and epicardium

Heart Block

A disruption in the impulses from the atrium to the ventricles with varying degrees, 1st, 2nd, and 3rd degree.

Hypertension

elevated blood pressure.

Hypokinesis

Slow/decreased movement of the heart wall.

Hypotension

Low Blood Pressure. Is both a contraindication and a side effect for stress drug studies using a vasodilator.

Infarction

Area of tissue death due to local lack of oxygen.

Ischemia

decreased blood supply from the coronary arteries to the heart muscle, characterized by inverted T-waves.

Left Anterior Descending Artery

Supplies blood to the septal, apex, and anterolateral wall of the left ventricle.

Left Circumflex Artery

Supplies blood to the posterior, lateral walls of the left ventricle.

Left Ventricle

The chamber on the left side of the heart that receives blood from the left atrium and pumps it into the aorta, which pumps the blood to the rest of the body.

Mitral Valve

Valve between left atrium and ventricle, also called the bicuspid valve.

Myocardium

Muscle layer of the heart (imaged in MPI).

Myocardial Infarction

death of heart muscle, caused by a prolonged, severe reduction of blood flow, usually as a result of occluded arteries.

Normal Sinus Rhythm

impulse originates in the sinus node, generating a P wave in front of each QRS on an ECG.

Pacemaker

A small device that's placed under your skin near the heart to help control your heartbeat.

Pulmonary Valve

a valve located between the right ventricle and the pulmonary artery. Blood is pumped through the pulmonary valve to the lungs, where it becomes oxygenated, and returns to the heart via the pulmonary vein.

Purkinje Fibers

A specialized cardiac muscle fiber that is part of the conduction system of the heart that initiates ventricular contraction.

Repolarization

Recovery of the ventricles after contraction; return of the heart to the resting state.

Right Coronary Artery

Supplies blood to the posterior and inferior walls of the left ventricle.

Right Ventricle

The chamber on the right side of the heart that receives blood from the right atrium and pumps it into the pulmonary trunk, which brings blood to the lungs.

SA Node

Stimulates both atria to contract, the normal pacemaker of the heart.

Semilunar Valves

The valves within the arteries leaving the heart, aortic valve and pulmonary valve.

Septum

This is the muscular wall that divides the right atrium from the left atrium and the right ventricle from the left ventricle. Ventricular conduction goes through the septum.

Stenosis

A narrowing of a canal or vessel.

Stroke Volume

The amount of blood ejected in a single heartbeat.

Systolic Pressure

The heart in a state of contraction, the top number of the blood pressure reading.

Thrombus

the formation of a blood clot inside a blood vessel, obstructing the flow of blood through the circulatory system. Myocardial infarctions are often caused by the obstruction of a coronary artery by a thrombus.

Tricuspid Valve

Valve between right atrium and ventricle.

myocardial infarctions are often caused by

a thrombus

short axis

images from apex to base *

horizontal long axis

images from inferior to anterior *

vertical long axis

images from septal to lateral

ventricular conduction goes through the

septum

pericardium

outer membranous sac encasing the heart

myocardium

muscular tissue, what is imaged in nuc med

endocardium

lines inner tissues and chambers

how does blood flow in the heart

superior vena cava, right atrium, tricuspid valve, right ventricle, pulmonary valve, pulmonary artery, lungs, pulmonary vein, left atrium, bicuspid valve, left ventricle, aortic valve, aorta

pacemaker of the heart

SA node

transmits pulse to the ventricles

AV node

spreads pulse from apex to base to control direction of contraction

bundle of HIS

right coronary artery (RCA)

A

supplies blood to the right atrium, right ventricle, bottom portion of the left ventricle and back of the septum

left coronary artery (LCA)

travels through the coronary sulcus under the left auricle and divides into two branches

left anterior descending artery (LAD)

supplies blood to the front and bottom of the left ventricle and the front of the septum

left circumflex artery (LCX)

follows the atrioventricular groove (coronary sulcus) and supplies the atria and the posterior left ventricle

Tc99m sestamibi MOL

passive diffusion

Tc99m sestamibi clearance

hepatobiliary system (liver, gallbladder,gut)

Tc99m sestamibi biological half life in myocardium

3 hours

how much mibi localizes in myocardium

only 1-2%

patient exposure of mibi

16mRad/mCi

dose for mibi if <100kg

8mCi rest

32 mCi stress

dose for mibi if >/= 100kg

10mCi

40mCi

why should patient drink water before mibi scan

to separate GI system from the heart in images

what are the DSPECT images acquired with mibi scan

supine gated rest

supine gated stress

upright nongated stress

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