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Note on LV mechanics and myocardial tissue strain Further reading 33 Stress Testing, Nuclear Imaging, Coronary CT Angiography, Cardiac MRI, Cardiopulmonary Exercise Testing I. Indications for stress testing II. Contraindications to all stress testing modalities III. Stress testing modalities IV. Diagnostic yields and pitfalls of stress ECG and stress imaging V. Mechanisms of various stress modalities VI. Nuclear stress imaging (see Figures 33.3, 33.4, 33.5) VII. Coronary CT angiography and coronary calcium scoring VIII.Cardiac MRI: summary of applications and findings IX.Cardiopulmonary exercise testing (CPET) References
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Part 11: CARDIAC TESTS: INVASIVE CORONARY AND CARDIAC PROCEDURES
34 Angiographic Views: Coronary Arteries and Grafts, Left Ventricle, Aorta, Coronary Anomalies, Peripheral Arteries, Carotid Arteries
I. Right coronary artery
II. Left coronary artery
III. Coronary angiography views. Recognize the angle of a view: LAO vs. RAO, cranial vs. caudal
IV. Coronary angiography views. General ideas: cranial vs. caudal views
V. Coronary angiography views. General ideas: foreshortening and identifying branches
VI. Left coronary views (see Figure 34.8)
VII. Right coronary views
VIII. Improve the angiographic view in case of vessel overlap or foreshortening: effects of changing the angulation, effects of respiration, and vertical vs. horizontal heart
IX. Saphenous venous graft views
X. LIMA-to-LAD or LIMA-to-diagonal views
XI. Left ventriculography
XII. Aortography for assessment of aortic insufficiency
XIII. Coronary anomalies
XIV. Lower extremity angiography
XV. Carotid angiography
QUESTIONS AND ANSWERS
Further reading
35 Cardiac Catheterization Techniques, Tips, and Tricks
I. View for the engagement of the native coronary arteries: RAO vs. LAO
II. Design of the Judkins and Amplatz catheters (see Figures 35.2–35.7)
III. Engagement of the RCA (see Figure 35.8)
IV. How to gauge the level of the RCA origin in relation to the aortic valve level
V. What is the most common cause of failure to engage the RCA? What is the next step?
VI. Tiger or JR4 catheter engages the conus branch. What is the next step?
VII. Left coronary artery engagement: general tips
VIII. Management of a JL catheter that is sub-selectively engaged in the LAD or LCx
IX. Specific maneuvers for the Amplatz left catheter
X. If you feel that no torque is getting transmitted, what is the next step?
XI. Appropriate guide catheters for left coronary interventions
XII. Appropriate guide catheters for RCA interventions (Figure 35.20)
XIII. Selective engagement of SVGs: general tips
XIV. Specific torque maneuvers for engaging the SVGs
XV. Appropriate catheters for engaging SVGs (see Figure 35.24)
XVI. Engagement of the left internal mammary artery graft
XVII. Left ventricular catheterization
XVIII. Engagement of anomalous coronary arteries
XIX. Specific tips for coronary engagement using a radial approach
XX. Damping and ventricularization of the aortic waveform upon coronary engagement, and role of side-hole catheters
XXI. Technique of right heart catheterization
36 Hemodynamics
I. Right heart catheter (see Figure 36.1)
II. Overview of pressure tracings: differences between atrial, ventricular, and arterial tracings (Figures 36.2, 36.3, 36.4)
III. RA pressure abnormalities
IV. Pulmonary capillary wedge pressure (PCWP) abnormalities
V. LVEDP
VI. Cardiac output and vascular resistances
VII. Shunt evaluation
VIII. Valvular disorders: overview of pressure gradients and valve area calculation
IX. Dynamic LVOT obstruction
X. Pericardial disorders: tamponade and constrictive pericarditis (see Figures 36.23, 36.24)
XI.