Cardiac Markers

Question 1

Acute myocardial infarction

Answer 1

“gross necorsis” of my myocardium due to interruptionn of the blood supply to the area

• also caused by atherosclerosis of the coronary arteries
• occurs during the period when circulation
• 40 to 60% of deaths occur within one hour

Question 2

athersclerosis

Answer 2

a disease process that causes plaque formation in large and medium sized arteries
- results after an event damaged the internal lining cells of blood vessels

Question 3

angina

Answer 3

chest pain, shortness of breath with mild excertion with reversible tissue injury

Question 4

ischemia

Answer 4

decreased blood flow

Question 5

acute coronary syndrome

Answer 5

a sudden disorder that varies from angina to unstable angina to myocardial infarction

Question 6

unstable angina

Answer 6

with minor myocardial injury

Question 7

congestive heart failure

Answer 7

ineffective pumping of the heart leads to an accumulation of fluid in the lungs

Question 8

road to AMI

Answer 8

advanced atherosclerosis -> stable angina caused by ischemia

• sporadically the fibrous cap of the plaque may rupture
• thrombotic formation may cause ACS
• total blockage leads to AMI
• partial blockage may lead to unstable anginga
• plaques predisposed to rupture are called vulnerable

Question 9

useful characteristics of an ideal cardiac marker

Answer 9

1. must be released rapidly into circulation from the heart and provide specific and sensitive information
2. analytic assay must be rapid and be able to detect low concentrations in the serum
3. should persist in circulation for several days to provide late diagnostic time window for patients who present late after event
   which is ….TROPIN

Question 10

ESC/ACC criteria for AMI

Answer 10

1. detection of rise and fall of cardiac markers above the 99th percentile of the upper reference limit together with evidence of ischemia with atleast one of the following
   - ischemic symptoms, ECG changes, occurs when blood flow to the region of the heart is obstructed and necrosis ensures, beings in the endocardium and spreads to the epicardium, necrosis that occurs through the full thickness of the myocadium called a transmural MI
2. development of abnormal Q waves on ECG
3. imaging evidence of new loss of viable endocardium
4. identification of an intracoronary thrombus by angiography or autopsy

Question 11

BNP

Answer 11

Type B natriuretic peptide

• cardiac hormone secreted from the myocardial ventricles
  a. increases the renal excretion of sodium and water
  b. causes rapid decrease in blood pressure
  c. causes an increase in hematocrit
• released in response to increased pressure on the ventricles
• may be causes by poor circulation from congestive heart failure
• inability of the heart to pump sufficient amounts of blood from the ventricles to meet metabolic demands of the body
• reference ranges vary- increases with age