Cardiac Catheterization Procedures Flashcards

Which pressure waveform abnormality on right heart catheterization indicates severe tricuspid regurgitation?

Answer: Giant V-waves in right atrial pressure trace

Severe tricuspid regurgitation causes large V-waves in the right atrial pressure trace due to systolic backflow into the atrium.

During coronary angiography, the LAD is found to supply both the anterior wall and the inferior wall of the left ventricle. This pattern is called a:

Answer: Wrap-around LAD

A wrap-around LAD extends past the cardiac apex to supply the inferior wall, which is normally supplied by the RCA.

What is the significance of a fractional flow reserve (FFR) value of 0.75 in a coronary stenosis?

Answer: The lesion is hemodynamically significant and warrants revascularization

An FFR ≤0.80 (commonly cutoff 0.75-0.80) indicates a hemodynamically significant lesion that benefits from revascularization.

A patient undergoing cardiac catheterization develops a sudden onset of hives, bronchospasm, and hypotension after contrast injection. What is the first-line treatment?

Answer: Epinephrine 0.3 mg IM or IV

Epinephrine is the first-line treatment for anaphylaxis because it reverses bronchospasm, vasodilation, and urticaria simultaneously.

During ventriculography, the technologist observes an hourglass appearance of the left ventricle. This finding is associated with which condition?

Answer: Hypertrophic obstructive cardiomyopathy (HOCM)

HOCM causes dynamic mid-cavity obstruction that produces an hourglass or figure-8 appearance during systole on ventriculography.

To assess the severity of aortic regurgitation during catheterization, the technologist performs an aortogram. Which injection site is used?

Answer: Aortic root just above the aortic valve

Contrast injected in the aortic root just above the valve regurgitates into the left ventricle, allowing grading of aortic regurgitation severity.

Which catheter is specifically designed for selective engagement of the right coronary artery via the femoral approach?

Answer: Amplatz Right catheter

The Amplatz Right catheter (or Judkins Right) is designed to selectively engage the right coronary ostium from the femoral approach.