Diagnostic Procedures

Esther TharakaturiWeek 5

Introduction• In this presentation I will talk about 3

procedures Echocardiography, Holter Monitor, and Thrombolytic Therapy.

• I will go over why each procedure is performed and what to expect before and after the procedure is done.

Echocardiography

• This test is done by using sound waves to get a more detailed picture of the heart in a noninvasive method.

• The benefits of this test are that the doctor can see the size and shape of the heart. Also, at the same time can see how well your heart's chambers and valves are working.

• Some examples of what could be diagnosed through a ECHO test are heart murmurs, abnormal heart valves, or if an area of the heart muscle has been damaged due to an heart attack.

Echocardiography

• In order to perform the test a transducer is used. This instrument transmits high-frequency sound waves.

• A gel will be applied to your chest, this will help the sound waves reach your heart.

• In some cases dye needs to be injected through the vein in order to get a clearer picture.

Echocardiography• Before the test begins you

have to remove clothing from the waist up.

• You will lay either on your back or on your left so the sonographer can get better access to your heart.

• Electrodes which are soft sticky patches will be applied to the chest, for an EKG to be done (this is a test used to record the heart’s electrical activity).

• During the test you may be asked to breathe a certain way or hold your breath, to help get accurate pictures of your heart.

Echocardiography• After the test the results will be

evaluated by a doctor.• If the results are normal then the test

will show normal heart movement, chambers and valves.

• If the test comes back abnormal then extra evaluation is needed by a specialist.

• There are no known risks associated with the test.

Holter Monitor• The Holter monitor is a portable device and

is about the size of a deck of cards.

• A Holter monitor records the heart’s electrical activity; it is similar to a electrocardiogram (EKG).

• One of the reasons that a person might have to wear an Holter monitor is to detect any irregularities in the rhythm of the heart.

Holter Monitor• The Holter monitor is usually worn

for 24 to 48 hours, during normal activity.

• Before starting the test you must shower, once the test starts you will not be able to shower.

• You will have to wear electrodes that will attached to your skin with sticky patches.

• Since this monitor is worn for at least 24hrs this increases the chances of detecting any abnormalities that a EKG might not be able to pick up in the short time span that it is done in.

Holter Monitor

• During the test you may be asked to keep a diary of activities you are doing, especially if you feel any symptoms.

• You can not get the monitor wet, since all the results are being stored in the device.

• At the end of the test you will return the monitor to the doctor’s office and then they will review the results.

Thrombolytic therapy

• This drug therapy is mainly used to prevent heart attacks and strokes or help dissolve or break up blood clots.

• The most common drug used in thrombolytic therapy is tissue plasminogen activator (tPA).

• According to the American Heart Association if a thrombolytic drug is given within 12 hours after a heart attack starts you have a better chance of recovering or surviving.

Thrombolytic therapy

• A heart attack usually occurs because of a blood clot blocking the blood flow in the arteries. The heart muscle will die or get damaged if it does not receive the oxygen which is being delivered by the blood.

• If a Thrombolytic drug is administred then it can start dissolving the blood clot quickly, so that the blood can start flowing again. This will help prevent damage to the muscle.

• Even through the drug will help, this alone is not enough. Other procedures, such as angioplasty, may be required.

Thrombolytic therapy

• These are some factors that will be used to determine if one needs Thrombolytic therapy such as –

• age• gender• medical history• results of an EKG • history of chest pain

Thrombolytic therapy• Some examples of thrombolytic drugs are

Lanoteplase, Reteplase, Staphylokinase.

• There are risks associated with this treatment, such as hemorrhage or bleeding. These are the most common effects, but they are also life threatening.

• About 25% of people who take the drug experience minor bleeding from the gums or nose. About 1% of people experience bleeding into the brain. This risk is the same for both stroke and heart attack patients.

Thrombolytic therapy

• Strokes are caused by a blood clot traveling to a blood vessel in the brain, which then stop the blood flow to a certain area.

• Thrombolytic therapy can be used to help dissolve the clot.

• When an Thrombolytic drug is given within 3 hours of the first symptoms of a stroke, it can help minimize the damage and disability that can be caused.

Thrombolytic therapy

• Certain things are looked at before giving this therapy for stroke patients such as a -

• Brain CT scan to make sure there is no bleeding

• A physical exam that shows a significant stroke

• Your medical history