Skill Lab Cath & Echo

8/12/2019 Skill Lab Cath & Echo

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Skill Lab Cath & Echo


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ApakahKateterisasi Koroner ?


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Primary PCI in AMI


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Predilation


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Stent Positioning


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Stent Deployment


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Successful Primary PCI


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Primary PCI- RCA


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PCI (Percutaneous Coronary Intervention)


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Apakah PTCA Koroner ?


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Apakah Stent ?


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Contoh Kasus I

Tn A

Usia 50 tahun

Perokok

Tekanan Darah Tinggi

(150/90 mmHg) Gemuk


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Primary PCI


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Pengembangan Balon


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Peletakan Stent


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Pengembangan Stent


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Successful Primary PCI


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Contoh Kasus II

Tn B

Pensiunan

Usia 67 tahun Penderita Kencing manis

Tekanan Darah Tinggi

(160/90 mmHg) Kolesterol Tinggi

Jarang Olahraga


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Diffuse LCA


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99% stenosis RCA


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Pengembangan Stent


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Contoh Kasus III

Ny Z, 35 tahun

Sering nyeri dada

Batu ginjal rencana operasi

Dikonsulkan ke Heart Center

EKG tanda iskemik Anjuran Kateterisasi Koroner


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Fistula


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Coil


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Contoh Kasus IV

Tn C

Usia 64 tahun

Merokok Tekanan Darah Tinggi

Kolesterol Tinggi

Pusing Bunyi bising di leher


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A severe tandem

stenosis of the

right internalcarotid artery


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Penyempitan Pembuluh Darah Leher


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Hasil Akhir


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Angioplasty (stent)


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Echocardiography


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Treadmill Stress Test


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TILT TABLE TEST


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Holter Monitoring


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C di i


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Cardioversion

Cardioversion

Chemical

Anti-Arrhythmias

Electrical

DC-Cardioversion

C di i


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CardioversionElectrical cardioversion (="direct-current" or DC cardioversion)

A procedure whereby a synchronized (perfectly timed) electrical

shock is delivered through the chest wall to the heart throughspecial electrodes or paddles that are applied to the skin of the chest

and back .

The goal of the cardioversion

To disrupt the abnormal electrical circuit(s) in the heart and

to restore a normal heart beat.

The shock causes all the heart cells to contract simultaneously,

thereby interrupting and terminating the abnormal electrical rhythm

(typically fibrillation of the atria) without damaging the heart.

This split second interruption of the abnormal beat allows

the heart's electrical system to regain control and restore a normal

heartbeat.

EPS


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EPS


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DSCT/MDCT/MSCT

Cardiac CT-Indications


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C C

1. Exclusion of coronary artery disease in the low to intermediate

risk patientIt is the best test that is now available with a

negative predictive value approaching 100%. It canvisualize early disease before it is detectable on cardiac

catheterization. It may be used to clear patients for surgery

instead of stress testing. Screening is controversial and

not supported by peer reviewed literature.

2. Evaluation for cardiac/pericardial anatomic abnormalities

including masses, thrombus, etc.

3. Triple rule out study for chest pain and can evaluate for other

causes of chest pain

4. Evaluate status of bypass grafts and stentsare they open? CT

may not be able to fully assess in stent stenosis and grafts

with metal clip artifacts.5. Evaluate wall motion and valve functionthis information

comes with extra reconstructions and post processing.

Cardiac MRI takes more imaging time but offers superior

capability and without radiation.

6. Detect anomalies including myocardial bridging


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Cardiac CT for Arrhythmias

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Cardiac MRI

Cardiac MRI- Indications


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Quantifying left and right ventricular function

Cardiomyopathy

Heart failure

Arrythmogenic right ventircular dysplasia (ARVD) Pulmonary hypertension Defining cardiac anatomy

Constrictive pericarditis

Cardiac neoplasm or thrombus

Congenital heart disease

Demonstrating the presence of a patent foramen ovale (PFO)Myocardial Perfusion:

for suspected ischemic heart disease (e.g. angina)

Quantifying blood flow

Valvular disease (e.g. aortic regurgitation,mitral regurgitation,

aortic stenosis, etc.) Shunts: ASD, VSD, PAPVR, and PDA

Assessing myocardial scar / viability

Identifying hibernating myocardium before revascularization

Differentiating cardiomyopathy from old myocarditis

Skill Lab Cath & Echo

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