Review of Cardiac Physiology for Medical Imaging

Targeted CE per ARRT’s Discipline, Category, and Subcategory classification:
[Note: Discipline-specific Targeted CE credits may be less than the total Category A credits approved for this course.]

Cardiac-Interventional Radiography: 2.50
Procedures: 2.50
Hemodynamics, Calculations, and Percutaneous Intervention: 2.50

Computed Tomography: 2.00
Procedures: 2.00
Neck and Chest: 2.00

Registered Radiologist Assistant: 2.50
Procedures: 2.50
Thoracic Section: 2.50

Outline

1. Introduction
2. Background of Important Concepts in Cardiac Physiology
   1. Cardiac Cycle
      1. Left Ventricular Systole
      2. Left Ventricular Diastole
      3. Pressure-Volume Loops and Cardiac Physiology
      4. Dilated Cardiomyopathy
      5. Hypertrophic Cardiomyopathy
      6. Restrictive Cardiomyopathy
3. Applying Cardiac Physiology Principles to Radiology
   1. Measuring Cardiac Volumes and Myocardial Mass
   2. Physiology of Valvular Stenosis
      1. Aortic Stenosis
      2. Mitral Stenosis
   3. Physiology of Valvular Insufficiency
      1. Aortic Insufficiency
      2. Mitral Insufficiency
   4. Physiology of Cardiac Shunts
   5. Heart Rate and Cardiac Gating
4. Conclusion

Objectives

Upon completion of this course, students will:

1. describe when left ventricular systole occurs
2. express what causes the aortic valve to open
3. choose the duration time of isovolumetric contractions
4. recall the definition of peak systolic pressure
5. define stroke work
6. recognize the components of the Wiggers diagram
7. define stroke volume
8. define ejection fraction
9. explain what affects cardiac output
10. define preload
11. compare dilated, hypertrophic, and restrictive cardiomyopathy
12. name the basic cardiac volumes quantified by a radiologist
13. differentiate between imaging procedures for measuring cardiac volume and myocardial mass
14. apply the formula for calculating myocardial mass
15. describe valvular stenosis
16. apply the formula for calculating blood flow to determine valvular stenosis and valvular regurgitation
17. recognize the modified Bernoulli equation
18. compare cardiac CT and MR imaging for measuring valve area
19. assign values to mild, moderate, severe, and critical aortic stenosis
20. recall areas of the heart affected by mitral valve stenosis
21. assign values to mild, moderate, and severe mitral valve stenosis
22. recall blood flow from the right side of the heart
23. explain the regurgitation fraction
24. define regurgitation percentages
25. explain aortic valve insufficiency
26. explain mitral valve insufficiency
27. state how cardiac shunts occur
28. list the most common left-to-right cardiac shunts
29. recall ratios denoting the possibility for significant hemodynamic compromise
30. compare imaging techniques for measuring the ratio of pulmonary to systemic blood flow
31. describe diastole at a resting heart rate of 70 beats per minute
32. name the time interval of one cardiac cycle
33. differentiate between electrocardiographic synchronization techniques
34. list dose reduction techniques for cardiac CT
35. understand how different heart rhythms can complicate cardiac MR and CT