Interpreting and reporting
Principles of interpretation and reporting of cardiac catherisations
View
- Look at the whole film before reporting
- Look at each lesion in several views
- Eccentric plaques may look significant when viewed end on; may disappear when viewed side on
| View | Landmark appearances | Best artery views |
| Right anterior oblique |
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| Left anterior oblique |
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| Left anterior oblique | "spider view" |
Vessel
- Comment on the vessels systematically
- Left main stem (best seen in the RAO view)
- LAD / Diagonals (LAO cranial view)
- Circumflex system (RAO view)
- RCA / PDA
- Comment on the dominance (the system that results in the filling of the posterior descending artery - 80% right, 10% left, 10% co-dominance)
- Blocked vessels can fill retrogradely from other vessels
Disease
- In normal hearts, there is no impairment of maximal blood flow until 75% of the cross-sectional area is occluded (ie. 50% diameter reduction)
- Resting blood flow does not decrease until 90% of the cross-sectional area is occluded
- Significant stenosis = >60% cross-sectional area
- 50% diameter reduction = 75% reduction of cross-sectional area
- 75% diameter reduction = 95% reduction of cross-sectional area
Ventricular function
Regional akinesia
Calcification of vessels or valves
Summarize what you plan to graft
