heart catheterization

心臓カテーテル法

WordNet

1. a plane figure with rounded sides curving inward at the top and intersecting at the bottom; conventionally used on playing cards and valentines; "he drew a heart and called it a valentine"
2. the courage to carry on; "he kept fighting on pure spunk"; "you havent got the heart for baseball" (同)mettle, nerve, spunk
3. an inclination or tendency of a certain kind; "he had a change of heart" (同)spirit
4. a playing card in the major suit that has one or more red hearts on it; "he led the queen of hearts"; "hearts were trumps"
5. the locus of feelings and intuitions; "in your heart you know it is true"; "her story would melt your bosom" (同)bosom
6. the hollow muscular organ located behind the sternum and between the lungs; its rhythmic contractions move the blood through the body; "he stood still, his heart thumping wildly" (同)pump, ticker
7. a firm rather dry variety meat (usually beef or veal); "a five-pound beef heart will serve six"
8. able to perceive sound
9. an opportunity to state your case and be heard; "they condemned him without a hearing"; "he saw that he had lost his audience" (同)audience
10. (law) a proceeding (usually by a court) where evidence is taken for the purpose of determining an issue of fact and reaching a decision based on that evidence
11. the ability to hear; the auditory faculty; "his hearing was impaired" (同)audition, auditory sense, sense of hearing, auditory modality
12. a session (of a committee or grand jury) in which witnesses are called and testimony is taken; "the investigative committee will hold hearings in Chicago"
13. receive a communication from someone; "We heard nothing from our son for five years"
14. examine or hear (evidence or a case) by judicial process; "The jury had heard all the evidence"; "The case will be tried in California" (同)try
15. perceive (sound) via the auditory sense
16. the operation of introducing a catheter into the body (同)catheterisation
17. a form of whist in which players avoid winning tricks containing hearts or the queen of spades (同)Black_Maria

PrepTutorEJDIC

1. 〈C〉『心臓』;胸 / 〈C〉(感情の中心をなす)『心』,気持ち / 〈U〉愛情,同情 / 〈U〉『勇気』,元気,熱意 / 《the ~》『中心』,内部,(物事の)本質,核心 / 〈C〉ハート形の物;(カードの)ハートの札
2. 〈U〉『聴力』,聴覚〈U〉〈C〉(…を)『聞くこと』,(…の)聞き取り《+『of』+『名』》・〈C〉聞いてもらう機会,聞いてやること・聴取・聴聞会〈C〉(法廷などでの)尋問,審問,;(刑罰の減免を求める)釈明,意見陳述 / 〈U〉聞こえる距離(範囲)
3. 〈音〉‘が'『聞こえる』,‘を'聞く(進行形にできない) / 〈人の言うこと〉‘に'『耳を傾ける』,‘を'注意深く聞く(listen);(裁判官などが)…の申し立てを聞く / 〈うわさ・ニュースなど〉‘を'『耳にしている』,聞いている / 『耳が聞こえる』 / 《しばしば命令形で》耳を傾ける,注意を向ける / 『うわさ』(『消息』)『を聞く』

Wikipedia preview

出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2017/01/07 20:22:32」(JST)

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Cardiac catheterization lab

Cardiac catheterization (heart cath) is the insertion of a catheter into a chamber or vessel of the heart. This is done both for diagnostic and interventional purposes. Subsets of this technique are mainly coronary catheterization, involving the catheterization of the coronary arteries, and catheterization of cardiac chambers and valves of the cardiac system.

Procedure

"Cardiac catheterization" is a general term for a group of procedures that are performed using this method, such as coronary angiography and left ventricle angiography. Once the catheter is in place, it can be used to perform a number of procedures including angioplasty, percutaneous coronary intervention (PCI), balloon septostomy, electrophysiology study or catheter ablation.

Procedures can be diagnostic or therapeutic. For example, coronary angiography is a diagnostic procedure that allows the interventional cardiologist to visualize the coronary vessels. Percutaneous coronary intervention, however, involves the use of mechanical stents to increase blood flow to previously blocked (or occluded) vessels. Other common diagnostic procedures include measuring pressures throughout the four chambers of the heart and evaluating pressure differences across the major heart valves. Interventional cardiologists can also use cardiac catheterization to estimate the cardiac output, the amount of blood pumped by the heart per minute.

A patient undergoing a procedure where an 8 F introducer was placed in the right jugular vein using a 5F MAK access kit. A 7 F balloon tipped catheter was introduced via the venous sheath, the balloon was inflated and the catheter was advanced through the right heart chambers into the pulmonary capillary wedge position. Right sided pressures were obtained and cardiac output was measured using thermodilution.

Cardiac catheterization requires the use of fluoroscopy to visualize the path of the catheter as it enters the heart or as it enters the coronary arteries. The coronary arteries are known as "epicardial vessels" as they are located in the epicardium, the outermost layer of the heart. Fluoroscopy can be conceptually described as continuous x-rays. The use of fluoroscopy requires radiopaque contrast, which in rare cases can lead to contrast-induced kidney injury (see Contrast-induced nephropathy).

There are two major categories of cardiac catheterization:

• Left heart catheterization allows for direct intervention in cases of coronary artery occlusion. This technique is also used to assess the amount of occlusion (or blockage) in a coronary artery, often described as a percentage of occlusion. A thin, flexible wire is inserted into either the femoral artery or the radial artery and threaded toward the heart until it is in the ascending aorta. At this point, the wire can be maneuvered into the coronary ostia and into the coronary arteries. A catheter is guided over the wire and enters either the left or right coronary artery. In this position, the interventional cardiologist can inject contrast and visualize the flow through the vessel. If necessary, the physician can utilize percutaneous coronary intervention techniques, including the use of a stent (either bare-metal or drug-eluting) to open the blocked vessel and restore appropriate blood flow. In general, occlusions greater than 70% of the width of the vessel lumen are thought to require intervention. However, in cases where multiple vessels are blocked (so called "three vessel disease"), the interventional cardiologist may opt instead to refer the patient to a cardiothoracic surgeon for coronary artery bypass graft (CABG; see Coronary artery bypass surgery) surgery.
• Right heart catheterization allows the physician to determine the pressures within the heart (intracardiac pressures). In this case, the heart is most often accessed via the femoral vein; neither the femoral artery nor the radial artery are used. Values are commonly obtained for the right atrium, right ventricle, pulmonary arteries, and for the pulmonary capillary "wedge" pressures, which approximate the pressure values of the left-sided heart chambers. Right heart catheterizations also allow the physician to estimate the cardiac output, the amount of blood that flows from the heart each minute, and the cardiac index, a hemodynamic parameter that relates the cardiac output to a patient's body surface area. Determination of cardiac output can be done by releasing a small amount of normal saline in one area of the heart and measuring temperature changes over time in another area of the heart. It is important to note that the coronary arteries are not accessed during a right heart catheterization.

Coronary catheterization

Main page: Coronary catheterization

Indications for diagnostic use of coronary catheterization

Patients without cardiac symptoms or high-risk markers for a heart problem should not have a coronary catheterization to screen for problems.

Indications for cardiac catheterization include the following:

• Heart Attack (includes ST elevation MI, Non-ST Elevation MI, Unstable Angina)
• Abnormal Stress Test
• New-onset unexplained heart failure
• Survival of sudden cardiac death or dangerous cardiac arrhythmia
• Persistent chest pain despite optimal medical therapy
• Workup of suspected Prinzmetal Angina (coronary vasospasm)

Right heart catheterization, along with pulmonary function testing and other testing should be done to confirm pulmonary hypertension prior to having vasoactive pharmacologic treatments approved and initiated.

Investigative techniques used with coronary catheterization

• to measure intracardiac and intravascular blood pressures
• to take tissue samples for biopsy
• to inject various agents for measuring blood flow in the heart; also to detect and quantify the presence of an intracardiac shunt
• to inject contrast agents in order to study the shape of the heart vessels and chambers and how they change as the heart beats

Catheterization of chambers and valves

Catheterization of cardiac chambers and valves may be performed at the same time as a coronary catheterization, and may also involve nearby major vessels, such as the aorta. It is the main method of cardiac ventriculography (another being radionuclide ventriculography, whose use has largely been replaced by echocardiography).

It has the ability to measure the pressure gradient across a valve and derive valve area from it. Thereby, it can assist in diagnosis of, for example, aortic stenosis.

This is also the procedure used in balloon septostomy, which is the widening of a foramen ovale, patent foramen ovale (PFO), or atrial septal defect (ASD) using a balloon catheter.

Catheter Illustrations
Illustration depicting a catheter.  Illustration depicting a heart catheter.  Illustration depicting a catheter entering the coronary artery.  Illustration depicting left heart catheterization.  Illustration depicting right heart catheterization.  Illustration depicting a peripherally inserted central catheter vs. a midline catheter.

History

Further information: History of invasive and interventional cardiology

The history of cardiac catheterization dates back to Claude Bernard (1813-1878), who used it on animal models. Clinical application of cardiac catheterization begins with Werner Forssmann in the 1930s, who inserted a catheter into the vein of his own forearm, guided it fluoroscopically into his right atrium, and took an X-ray picture of it. Forssmann won the Nobel Prize in Physiology or Medicine for this achievement, though hospital administrators removed him from his position owing to his unorthodox methods. During World War II, André Frédéric Cournand, a professor at Columbia University College of Physicians and Surgeons who also shared the Nobel Prize, and his colleagues developed techniques for left and right heart catheterization.

Dr. Eugene A. Stead, founder of the Physician Assistant profession, also performed research in the 1940s which paved the way for cardiac catheterization in medicine today.

References

External links

• MedlinePlus Medical Encyclopedia: Cardiac catheterization
• eMedicine: Cardiac Catheterization (Left Heart)
• The Parachute Implant: a cardiac catheterization device for treating heart disease

UpToDate Contents

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• 1. 心臓カテーテル検査法：正常な血行動態 cardiac catheterization techniques normal hemodynamics
• 2. 診断的心臓カテーテル検査の合併症 complications of diagnostic cardiac catheterization
• 3. 脳卒中後の心臓カテーテル stroke after cardiac catheterization
• 4. 心臓カテーテル検査で測定した弁膜疾患の血行動態 hemodynamics of valvular disorders as measured by cardiac catheterization
• 5. 成人における確定診断を得られていない低血圧やショックの評価および初期アプローチ evaluation of and initial approach to the adult patient with undifferentiated hypotension and shock

English Journal

• Practice of hemodynamic monitoring and management in German, Austrian, and Swiss intensive care units: the multicenter cross-sectional ICU-CardioMan Study.

• Funcke S1, Sander M2, Goepfert MS3, Groesdonk H4, Heringlake M5, Hirsch J6, Kluge S3, Krenn C7, Maggiorini M8, Meybohm P9, Salzwedel C3, Saugel B3, Wagenpfeil G10, Wagenpfeil S11, Reuter DA3; ICU-CardioMan Investigators.
• Annals of intensive care.Ann Intensive Care.2016 Dec;6(1):49. doi: 10.1186/s13613-016-0148-2. Epub 2016 May 31.
• BACKGROUND: Hemodynamic instability is frequent and outcome-relevant in critical illness. The understanding of complex hemodynamic disturbances and their monitoring and management plays an important role in treatment of intensive care patients. An increasing number of treatment recommendations and g
• PMID 27246463

• Imaging right ventricular function to predict outcome in pulmonary arterial hypertension.

• Brewis MJ1, Bellofiore A2, Vanderpool RR3, Chesler NC4, Johnson MK5, Naeije R6, Peacock AJ5.
• International journal of cardiology.Int J Cardiol.2016 Sep 1;218:206-11. doi: 10.1016/j.ijcard.2016.05.015. Epub 2016 May 13.
• BACKGROUND: Right ventricular (RV) function is a major determinant of outcome in pulmonary arterial hypertension (PAH). However, uncertainty persists about the optimal method of evaluation.METHODS: We measured RV end-systolic and end-diastolic volumes (ESV and EDV) using cardiac magnetic resonance i
• PMID 27236116

• Comparison of Noninvasively and Invasively Managed Patients, With or Without Revascularization in Non-ST Elevation Myocardial Infarction (from the Acute Coronary Syndrome Israeli Survey).

• Blatt A1, Kalmanovich E2, Karny-Rahkovich O2, Brener S2, Shlezinger M3, Shlomo N3, Vered Z2, Hod H4, Goldenberg I4, Elbaz-Greener G2.
• The American journal of cardiology.Am J Cardiol.2016 Jul 1;118(1):1-5. doi: 10.1016/j.amjcard.2016.03.054. Epub 2016 Apr 20.
• Patients with non-ST elevation myocardial infarction who are managed noninvasively at presentation or are catheterized but without revascularization represent a heterogeneous and understudied population. We evaluated the clinical characteristics, management strategies, and outcomes of patients with
• PMID 27217207

Related Links

• Cardiac catheterization: MedlinePlus Medical Encyclopedia

Cardiac catheterization involves passing a thin flexible tube (catheter) into the right or left side of the heart, usually from the groin or the arm. How the Test is Performed You will be given medicine before the test to help ...

• Heart catheterization | Define Heart catheterization at ...

heart catheterization medical procedure by which a flexible plastic tube (catheter) is inserted into an artery or vein. It is used for injecting drugs for therapy or diagnosis, for measuring blood flow and pressure in the heart and central blood vessels ...

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★リンクテーブル★

リンク元	「心臓カテーテル法」
関連記事	「catheterization」「hearing」「hear」「heart」

「心臓カテーテル法」

　　[★]

英

cardiac catheterization, heart catheterization

同

心カテ、心カテーテル、心臓カテーテル、

関

心臓カテーテル検査

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「catheterization」

　　[★] カテーテル法, Cath、カテーテル法、カテーテル留置、カテーテル治療、カテーテル挿入、カテーテル処置

関

cannula、cannulation、catheter、catheter insertion、catheter intervention、catheter placement、catheterize

　

「hearing」

　　[★]

• n。

• 聴力、聴覚。聞くこと、聴取。聞こえる距離/範囲。聞いてやること、傾聴。聞いてもらうこと、発言の機会。(委員会などの)聴聞会、ヒアリング。(法)審問、尋問。

　 　 　 　 　 　

「hear」

　　[★]

• v.

• 聞く、聞こえる

　 　 　 　

「heart」

　　[★] 心臓