10 minute topic Cardiovascular diagnostics and Procedures Flashcards
When are Cardiac enzymes released?
hen the heart muscle suffers ischemia
the heart isn’t getting enough oxygen
When is a lipid profile used
detects cholesterol levels and is used for early detection of heart disease
Indications for running cardiac enzyme or lipid tests
Angina
MI – s/s of MI
Heart disease – a patient with known heart disease and comes in with other s/s
Hyperlipidemia
CK-MB range
30-170 but really should be 0
CK-MB time of elevation
elevates within 4-6 hours of myocardial injury
stays elevated for 3 days
Troponin T range
<0.2ng/L
Troponin T time of elevation
elevates within 3 hours of MI
stays elevated for 2-3 weeks
Troponin I range
0.03 ng/L
Troponin I time of elevation
elevates within 3 hours of MI
Stays elevated for 10 days
Myoglobin range
<90mcg/L
Myoglobin time of elevation
elevates within 2 hours of MI
Only stays elevated for 24 hours
HDL ranges
35-65mg/dl for men
35-80 mg/dl for women
LDL cholesterol levels
<130-180 mg/dl
Triglycerides
should be <150
used to evaluate for atherosclerosis
Echocardiogram
ultrasound of the heart used to dx valve disorders
looking at the actual structure of the heart
Candidates for an ECG
cardiomyopathy
HF
angina
MI
Pharmalogical stress test
Adenosine is given if PT is unable to walk on treadmill
Stress test candidates
Angina
heart failure
MI
dysrhythmias
Cardiac Angiography (AKA cardiac catheterization)
invasive diagnostic procedure to evaluate the presence and degree of coronary artery blockage
Cardiac Angiography (AKA cardiac catheterization) procedure
occlusions are seen by injecting contrast media under fluoroscopy
Cardiac Angiography (AKA cardiac catheterization) indications
unstable angina w/ ECG changes
to determine extent and location of known heart disease
Cardiac Angiography (AKA cardiac catheterization) pre-procedure
NPO for 8 hours due to aspiration risk
Check BUN and creatanine because the dye is excreted through the kidneys
check for shellfish or iodine allergy
Cardiac Angiography (AKA cardiac catheterization) intra procedure
client is awake
local anesthetic
client will feel warm flushing
pressure to be placed on incision to prevent bleeding
Cardiac Angiography (AKA cardiac catheterization) post procedure
monitor pedal pulses
we are on the arterial side so a clot would go toward to feet
Supine position
Continuous cardiac monitoring
Cardiac Angiography (AKA cardiac catheterization) patient teaching
avoid strenuous activity for 4-6 days
Report bleeding, SOB, changes to extremity
have regular labs if on coumadin
Cardiac Angiography (AKA cardiac catheterization) complications
cardiac tamponade
Hematoma
Re-stenosis of treated vessel
retroperitoneal bleeding
cardiac tamponade
fluid accumulation in the pericardial sac
This is a cardiac emergency and they will do a pericardiocentesis
Give IV fluids to combat hypotension
cardiac tamponade s/sx
include hypotension, jugular venous distention, heart sounds will be muffled, paradoxical pulse and BP change of inhalation and exhalation
Re-stenosis of treated vessel
Clot reformation
Can occur immediately or several weeks after procedure
Pattern changes in the ECG and possible chest pain
Notify the MD
They will go back to the cath lab
retroperitoneal bleeding
Bleeding into retroperitoneal space (abdominal cavity behind the peritoneum)
Cause of retroperitoneal bleeding
femoral artery puncture
Retroperitoneal bleeding sx
Flank pain
hypotension
Retroperitoneal bleeding tx
give IV fluids and blood
Notify MD
Surgical repair required
this is an emergency
