Cardiac Function Flashcards

1
Q

Cardiovascular disease (CVD)

A

Coronary heart disease (CHD)
Cerebrovascular disease
Peripheral arterial disease (PAD)
aortic atherosclerotic disease

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2
Q

CHD

A

Chest pain
Myocardial infarction
heart failure

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3
Q

Cerebrovascular disease

A

blood supply cut off from the brain
stroke or mini stroke

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4
Q

PAD

A

Blockage in the arteries to extremeties, usually legs
PAD and DVT (deep vein thrombosis)

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5
Q

Aortic atherosclerotic

A

Aneurysms and dissection

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6
Q

Atherosclerosis

A

Chromic inflam disease w/ accumulation of lipid material in the veins and arteries. cases narrowing and hardening.

Most common locations
Right coronary artery
Right marginal artery
Left decending artery
Left coronary artery

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7
Q

Acute coronary syndrome (ACS)

A

chest pain
Angina
missed in about 1% of patients

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8
Q

Angina

A

classic symptom of ischemia
Squeezing of the chest, radiates to left arm or shoulder and neck, gets worse with stress

Nonclassical symptoms more common in women
stabbing pain, viselike pressure. nausea, shortness of breath, ab pain

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9
Q

Markers of initial cardiac damage

A

Cell death releases proteins
Ideally: sensitive and specific, persist for several days, detectable in low concentrations

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10
Q

Creatine Kinase

A

Cardiac biomarker
CK - Creatine kinase
Exceeed range in 6-8 hours
peak at 24 hours
return to range in 3-4 days

CK-MB is most reliable

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11
Q

Cardiac Troponins

A

Complex or 3 proteins responsible for muscle contractions
TnT: binds to tropomyosin
TnI: inhibits binding of actin and myosin
TnC: Binds to Ca to reverse TnI. specific for cardiac damage

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12
Q

Measuring cTnT

A

Use monoclonal antibodies to detect
sensitive and specific
detectable 3-12 hours after onset, peak at 12-24, elevated for more than a week

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13
Q

hs-CtnT

A

Rise and fall indicate acute myocardial injury
CV <= 10%
Can be interfered with from other diseases that cause MI

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14
Q

Kidney disease and cardiac disease

A

CKD - increased Trop levels
Dialysis increases cTnT
Hemodialysis filters and alters concentrations of markers

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15
Q

Myoglobin

A

half life of 9 minutes
present in all muscle tissues
not specific and hs-Tn faster

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16
Q

Cardiac Injury

A

Myocyte death
Apoptosis to necrosis
Apoptosis requires energy. Necrosis occurs if energy supply fails

Treatments
Intravascular balloons and stints
CABG
Tissue plasminogen activator

17
Q

Heart Failure

A

Fails to adequately supply
Manifested: Retention of fluid, shortness of breath, fatigue, lower extremely edema
Releases BNP and NT-proBNP - Hearts response to pressure/vol load

18
Q

NT-proBNP and BNP

A

released by myocardial cells
strong predictor in people w/ heart failure
BNP target fro drug manufacturers

19
Q

CHD risk

A

MPO and CRP indicate infalm response
MPO increased in ACS and CAD

20
Q

CRP

A

Inflam marker
rapid synth in liver

21
Q

hs-CRP

A

More sensitive than CRP
marker of choice for CHD risk

22
Q

homocystine

A

Sulfuric AA
4 forms in blood
Connected to vascular disease
Hyperhomocysteimia linked with CVD
every 5umol increase correlates to 20-30% increase risk of ischemic heart disease

23
Q

Pulmonary embolism

A

Circulating solid, liquid, or gas
Pulmonary arteries blocked
Risk increased for women - oral contraceptives.
treatment with anticoagulants effective

24
Q

Saddle embolism

A

bifurcation blocked
60% blockage

25
Q

D-dimer

A

presence indicates recent coagulation
Pre marker for PE
highly sensitive, quantitative
abnormal in 90% of PE patients

26
Q

Biomarker
ACS/Acute MI

A

CK-MB
TnI,TnT
hs-Tn

27
Q

Biomarker
Heart failure

A

BNP
NT-proBNP

28
Q

Biomarker
PE/risk stratification

A

TnI,TnT
BNP
hs-proBNP
D-Dimer

29
Q

Biomarker
CV risk

A

TnI,Tnt
hs-CRP
Homocystine

30
Q

Biomarker
Not used

A

Myoglobin
LD