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Focuses on the anatomy and physiology of heart as well as Blood Pool Imaging

myocardial perfusion imaging

used to diagnose and evaluate ischemic heart disease, myocardial infarction, as well as radionuclide to diagnose CAD, valvular or congenital heart disease, and cardiomyopathy.

thallium-201 scan

thallium is injected into blood via IV to identify myocardial blood flow

thallium stress test

thallium injections are given intravenously in conjuction with the stress test to determine if there are changes in coronary blood flow during exercise. Changes may be indicative of ischemia, severe coronary narrowing, or infarction

positron emission tomography (PET)

an invasive imaging technique that provides color-coded images of brain activity by tracking the brain's use of a radioactively tagged compound, such as glucose, oxygen, or a drug


a procedure in which a small balloon is used to open a partially blocked coronary artery by flattening the plaque deposit and stretching the lumen


occlusion of a blood vessel by an embolus (a loose clot or air bubble or other particle)

nuclear cardiology

diagnostic specialty that uses radiologic procedures to aid in the diagnosis of cardiologic conditions


procedure in which a surgeon withdraws fluid from the pericardial space by means of a needle inserted percutaneously into the space


a stainless steel tube placed within a blood vessel or a duct to widen the lumen


Temporary deficiency in blood supply due to either the narrowing or blockage of a blood vessel

reversible ischemia

when a heart artery is clogged and heart muscle performs at low level as result of lack of blood

irreversible ischemia

when heart artery is clogged and heart muscle dies


a clot that breaks loose and travels through the bloodstream. When it causes sudden closure of a blood vessel, this dangerous event is an embolism.


outermost layer of the heart


middle, thick, muscular layer


Inner layer of the heart

Sinoatrial Node (SA)

pacemaker of heart.. generates impulses, which are passed to the atrioventricular node

Atrioventricular Node (AV)

inferior portion of the interarterial septum and passes the wave of depolarization in to the atrioventricular branches

Purkinje Fibers

extend from branches of A-V bundle, stimulate muscle fibers in the ventricular walls


ventricular contraction from the heart to drive blood into the aorta and pulmonary artery


ventricular relaxation - period in the cardiac cycle when blood enters the relaxed ventricles from the atria

Cardiac Output (CO)

measurement of the amount of blood ejected from either ventricle of the heart per minute

Stroke Volume (SV)

volume of blood pumped out by a ventricle with each beat

Left Chamber

systemic circulation-oxygenated blood

Right Chamber

pulmonary circulation-deficient in oxygen

Blood Circulation In Heart

right atrium - right ventricle - out the lungs - left atrium - left ventrible - out the aorta

Pulmonary Arteries

carry deoxygenated blood out of the right ventricle and into the lungs

Left Anterior Descending (LAD)

Septum, anterior wall of Left Ventricle

Left Circumflex (LCx)

Left atrium, posterior, lateral wall of Left Ventricle

Right Coronary Artery (RCA)

Right heart, inferior wall of Left Ventricle


localized necrosis resulting from obstruction of the blood supply

AV Bundle

enters interventricular septum, divides into 2 branches, then pass into R & L ventricles

Electrocardiogram (ECG)

a record of the electrical activity of the heart that, if abnormal, may indicate heart disease.



P Wave

Depolarization of atria

QRS Complex

depolarization of ventricles

T Wave

Repolarization of the ventricles



Q Wave

first negative deflection; sign of infarction/ischemia

ST Elevation

(also known as ST Inversion)transmural ischemia, pericarditis, ventricular aneurysm - heart attack

ST Depression

subendocardial infarct or myocardial ischemia

Premature Ventricular Contraction (PVC)

a ventricular contraction preceding the normal impulse initiated by the SA node


Pattern in which every other complex is a premature beat (2 beats = 1 normal / 1 abnormal)


pattern in which every 3rd complex is a premature beat (3 beats = 2 normal / 1 abnormal)

Ventricular Tachycardia (V-Tech)

occurs when three or more successive PVCs occur. usually 140-240 bpm; , Abnormal rapid rhythm in ventricles

Atrial Fibrillation

cardiac arrhythmia characterized by chaotic, rapid electrical impulses in the atria; also can cause problems when gating

Bundle Branch Blocks

a condition that interferes with the heart's normal electrical activity.


left bundle branch block; can alter stress perfusion images creating a false positive


right bundle branch block; a defect in the heart's electrical conduction system.
Left ventricle contracts then right ventricle

Coronary Artery Disease

atherosclerosis of the coronary arteries that reduces the blood supply to the heart muscle due to plaque buildup on the walls


Chest pain

Coronary Artery Bypass Graph (CABG)

surgery that creates a bypass around a blocked segment of a coronary artery


(percutaneous transluminal coronary angioplasty) , dilation of an occluded vessel using a balloon catheter


measures a decrease in the ejection fraction. Is the most accurate noninvasive test that measures the left ventricle's ejection fraction during rest and activity

Blood Pool Imaging

also known as MUGA, GBP, RNA; mainly for patients who undergo chemotherapy; views their EF and wall motion; 16-64 frames per R-R Interval; Ranges of images of heartbeart are 16,20,24,32


toxicity to the heart

Sestamibi (Cardiolite)

A radioactive tracer compound used to define areas of poor blood flow in heart muscle.


a pharmaceutical that helps visualize the condition of the myocardium during a stress test

Ultra Tagged RBC Kit

In Vitro method; 10usp of Heparin within a 5ml syringe; take 3-4ml of patients blood within the same syringe as the heparin; inject blood mixture into vial and sit for 5 minutes; inject syringe 1 and syringe 2, inverting up to 5 times each insertion; insert Tc-99m sodium pertechnetate (around 40mCi) and invert up to 5 times - let sit for 20 minutes; inject after 20 minute timeframe and wait 30 minutes before scanning

In Vitro

"outside the body" - Procedures involving analysis of blood and urine specimens using radioactive chemicals.

In Vivo

"in the body" - traces amounts of radioactive substances within the body. Given directly to the patient to evaluate the function of an organ or to image it


Protein in blood; maintains the proper amount of water in the blood


Tc99m Pyrophosphate; inhibitor of calcification that occrus in parotid saliva of humans in variable amounts

ACD (Acid Citrate Dextrose)

an anti-coagulant for Heparin Allergy

R Wave

The first positive deflection of the QRS Complex after the P wave, denotes continued ventricular depolarization.


triggers R Wave of ECG/EKG

R-R Interval

duration of ventricular cardiac cycle (an indicator of ventricular rate) / (60 /HR)

Cine Mode

Movie frame containing 16 frames

Beat Rejection of Blood Pool Imaging

Percent window: 20% for beat rejection and arrythmias

Short Beat

a type of beat rejection; occurs outside the normal heart beat frames (24) and causes R-Wave to restart - no images for the last set depending on when short wave occur

Long Beat

a type of beat rejection; occurs outside a predetermined range and data is lost due to elongated time of heart beat / past recommended amount of frames

LAO for EF Calculation

best septal separation; 45 and 135

Views for Blood Pool Imaging

Besides LAO, Anterior (LT Vent), Left Lateral, LPO, RAO

Caudal Tilt

5-10 degree tilt to help separate the Left Artery from the Left Ventricle

End-Diastolic Counts

The number of counts received from the left ventricle at the end of diastole, just before systole (contraction)

End-Systolic Counts

The number of counts received from the left ventricles just after ventricular systole (heart contraction).

Ejection Fraction (EF)

measurement of the volume percentage of left ventricular contents ejected with each contraction; Normal LVEF is 50% or above / Formula: EF=(EDC-ESC)/EDC x 100%

Region Of Interest (ROI) Creation

automatic or manual; can cause RV/LV overlap which is not good for septal separation; poor labeling; background which will have to be subtracted to receive accurate counts

Regional Ejection Fraction

right side of the heart containing lateral wall of the free wall which has a higher EF because of the exterior wall

First Pass Imaging

a flow study of the heart to watch the radioactive tracer go through the heart in one flow at one time which is like a MUGA but cannot use Tc-MAA since it will just stay in the lungs / preferable for RVEF instead of MUGA Scan


removal of a part, pathway, or function by surgery, chemical destruction, electrocautery, freezing, or radiofrequency (RF)

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