467
edits
Diagnostic Testing: Difference between revisions
no edit summary
No edit summary |
No edit summary |
||
| Line 334: | Line 334: | ||
Commonly used agents include: | Commonly used agents include: | ||
*Vasodilators acting as adenosine receptor agonists, such as Adenosine itself, and Dipyridamole (brand name | *Vasodilators acting as adenosine receptor agonists, such as Adenosine itself, and Dipyridamole (brand name ''Persantine''),<cite>Nine</cite> which acts indirectly at the receptor. | ||
*Regadenoson (brand name | *Regadenoson (brand name ''Lexiscan''), which acts specifically at the Adenosine A2A receptor, thus affecting the heart more than the lung. | ||
*Dobutamine. The effects of beta-agonists such as dobutamine can be reversed by administering beta-blockers such as propranolol. | *Dobutamine. The effects of beta-agonists such as dobutamine can be reversed by administering beta-blockers such as propranolol. | ||
| Line 356: | Line 356: | ||
*The detection of high-grade coronary artery stenosis by a cardiac stress test was the key to recognizing people who have heart attacks since 1980. From 1960 to 1990, despite the success of stress testing to identify many who were at high risk of heart attack, the inability of this test to correctly identify many others is discussed in medical circles but unexplained. | *The detection of high-grade coronary artery stenosis by a cardiac stress test was the key to recognizing people who have heart attacks since 1980. From 1960 to 1990, despite the success of stress testing to identify many who were at high risk of heart attack, the inability of this test to correctly identify many others is discussed in medical circles but unexplained. | ||
*High degrees of coronary artery stenosis, which are detected by stress testing methods are often, though not always, responsible for recurrent symptoms of angina. | *High degrees of coronary artery stenosis, which are detected by stress testing methods are often, though not always, responsible for recurrent symptoms of angina. | ||
*Unstable atheroma produces | *Unstable atheroma produces ''vulnerable plaques'' hidden within the walls of coronary arteries which go undetected by this test. | ||
*Limitation in blood flow to the left ventricle can lead to recurrent angina pectoris. | *Limitation in blood flow to the left ventricle can lead to recurrent angina pectoris. | ||
| Line 362: | Line 362: | ||
<biblio> | <biblio> | ||
#One Rimmerman, Curtis (2009-05-05). The Cleveland Clinic Guide to Heart Attacks. Kaplan Publishing. pp. 113–. ISBN 978-1-4277-9968-5. Retrieved 25 September 2011. | #One Rimmerman, Curtis (2009-05-05). The Cleveland Clinic Guide to Heart Attacks. Kaplan Publishing. pp. 113–. ISBN 978-1-4277-9968-5. Retrieved 25 September 2011. | ||
#Two Gibbons, R., Balady, G.; Timothybricker, J., Chaitman, B., Fletcher, G., Froelicher, V., Mark, D., McCallister, B. et al. (2002). | #Two Gibbons, R., Balady, G.; Timothybricker, J., Chaitman, B., Fletcher, G., Froelicher, V., Mark, D., McCallister, B. et al. (2002). ACC / AHA 2002 guideline update for exercise testing: summary article ''A report of the American College of Cardiology / American Heart Association Task Force on Practice Guidelines'', Journal of the American College of Cardiology | ||
#Three American College of Cardiology, | #Three American College of Cardiology, ''Five Things Physicians and Patients Should Question'', Choosing Wisely: an initiative of the ABIM Foundation (American College of Cardiology), retrieved August 17 2012 | ||
#Four Taylor, A. J.; Cerqueira, M.; Hodgson, J. M. .; Mark, D.; Min, J.; O'Gara, P.; Rubin, G. D.; American College of Cardiology Foundation Appropriate Use Criteria Task Force et al. (2010). | #Four Taylor, A. J.; Cerqueira, M.; Hodgson, J. M. .; Mark, D.; Min, J.; O'Gara, P.; Rubin, G. D.; American College of Cardiology Foundation Appropriate Use Criteria Task Force et al. (2010). ACCF/SCCT/ACR/AHA/ASE/ASNC/NASCI/SCAI/SCMR 2010 ''Appropriate Use Criteria for Cardiac Computed Tomography''. Journal of the American College of Cardiology 56 (22): 1864–1894. doi:10.1016/j.jacc.2010.07.005. PMID 21087721. edit | ||
#Five Douglas, P. S.; Garcia, M. J.; Haines, D. E.; Lai, W. W.; Manning, W. J.; Patel, A. R.; Picard, M. H.; Polk, D. M. et al. (2011). | #Five Douglas, P. S.; Garcia, M. J.; Haines, D. E.; Lai, W. W.; Manning, W. J.; Patel, A. R.; Picard, M. H.; Polk, D. M. et al. (2011). ACCF/ASE/AHA/ASNC/HFSA/HRS/SCAI/SCCM/SCCT/SCMR 2011 ''Appropriate Use Criteria for Echocardiography''. Journal of the American College of Cardiology 57 (9): 1126–1166. doi:10.1016/j.jacc.2010.11.002. PMID 21349406. edit | ||
#Six Hendel, R. C.; Abbott, B. G.; Bateman, T. M.; Blankstein, R.; Calnon, D. A.; Leppo, J. A.; Maddahi, J.; Schumaecker, M. M. et al. (2010). | #Six Hendel, R. C.; Abbott, B. G.; Bateman, T. M.; Blankstein, R.; Calnon, D. A.; Leppo, J. A.; Maddahi, J.; Schumaecker, M. M. et al. (2010). ''The role of radionuclide myocardial perfusion imaging for asymptomatic individuals''. Journal of Nuclear Cardiology 18 (1): 3–15. doi:10.1007/s12350-010-9320-5. PMID 21181519. edit | ||
#Seven Henzlova, Milena; Cerqueira, Hansen, Taillefer, Yao (2009). | #Seven Henzlova, Milena; Cerqueira, Hansen, Taillefer, Yao (2009). ''Stress Protocols and Tracers''. Journal of Nuclear Cardiology. doi:10.1007/s12350-009-9062-4. | ||
#Eight Weissman, Neil J.; Adelmann, Gabriel A. (2004). Cardiac imaging secrets. Elsevier Health Sciences. pp. 126–. ISBN 978-1-56053-515-7. Retrieved 25 September 2011. | #Eight Weissman, Neil J.; Adelmann, Gabriel A. (2004). Cardiac imaging secrets. Elsevier Health Sciences. pp. 126–. ISBN 978-1-56053-515-7. Retrieved 25 September 2011. | ||
#Nine Nicholls, Stephen J.; Worthley, Stephen (2011-01). Cardiovascular Imaging for Clinical Practice. Jones & Bartlett Learning. pp. 198–. ISBN 978-0-7637-5622-2. Retrieved 25 September 2011. | #Nine Nicholls, Stephen J.; Worthley, Stephen (2011-01). Cardiovascular Imaging for Clinical Practice. Jones & Bartlett Learning. pp. 198–. ISBN 978-0-7637-5622-2. Retrieved 25 September 2011. | ||
</biblio> | </biblio> | ||