DMS 104 Exam 3 Review (limited)

TEE

TEE advantages

better picture quality, less attenuation, can be performed on someone who has had chest trauma (where they may not be able to have a TTE)

Members of the TEE team

nurse, anesthesia, cardiologist, sonographer

Who controls the probe?

cardiologist

Who provides patient education?

everyone on the team

Who controls the ultrasound machine?

sonographer

What does a bubble study help assess for?

ASD or VSD

What kind of probes are used for a TEE?

multiplane (omniplane), biplane, single plane

Of the kinds of probes used for TEEs, which one is most commonly nowadays?

multiplane (omniplane)

what does the array rotation gauge control?

the angle of rotation of the end of the transducer

where is the array rotation gauge?

shown on the top right or left of the screen

where is the bite block placed?

in the patients mouth, specifically their incisors

what is the depth for the midesophageal window?

30-40 cm deep

what is the depth for the upper esophageal window?

20-25 cm deep

what is the depth for the transgastric window?

40-50 cm deep

what is the depth for the deep gastric window?

50+ cm deep

About how many images are there for a typical TEE (with no pathology)?

20

What are the two main types of stress echos?

exercise or pharmaceutical

What are the doctors trying to rule out by performing a stress echo?

rule in or out CAD/ischemic heart disease

What are the two main types of exercise stress echos?

treadmill and supine bike

What is the pharmacological stress echo also known as?

dobutamine stress echo

What does ischemia mean?

lack of blood flow or restriction of blood flow

What is a wall motion abnormality?

abnormal motion of the heart wall (hyper/hypo/dyskinetic/aneurysmal)

What is the goal during a stress echo?

have the patient reach their target heart rate for at least one minute

How do you know what a patients target heart rate is?

it is 85-90% of their predicted max heart rate

How do you know what a patients predicted max heart rate is?

220 minus their age in years

what does the LV demonstrate in a normal response to stress?

decreased volume, decreased size, and increased thickening

What does a positive stress echo show?

positive signs of ischemia

what does the LV demonstrate in a positive stress echo?

decreased contractility of heart walls, increase in volume, increase in size, and possible WMA

In a stenotic valve, does the proximal or distal chamber to the valve have a higher pressure?

proximal chamber

PCTA stands for what?

percutaneous transluminal coronary angioplasty

What is a PCTA?

A catheter with a small balloon is guided to the blockage via an artery in the wrist or groin, inflated to compress plaque and restore blood flow, often followed by inserting a stent to keep the artery open