Cardiac Pathology Part 2 Flashcards by Connor Vankouwenberg

What is a lipid panel

Blood test to assess the amount and type of serum lipid

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What is a normal lipid panel

Less than 200 mg/dL

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What is the purpose of the lipid panel (2)

Identify risk of CAD and atherosclerotic lesion formation

2. Monitors response to therapeutic intervention

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What is lipid panel also called

Total cholesterol

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What does LDL do

Carry cholesterol from the liver to other parts of the body such as peripheral tissues and blood vessels

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At what level do LDLs start to cause atherogenesis

Above 100 mg/dL

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What does HDL do

Carry cholesterol to the liver for removal decreasing atherogenic plaque deposits in the blood

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What is atherogenesis

Plaque formation in the blood

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At what level in men and women does HDL star to decrease atherogenic plaques

Men: Above 40 mg/dL
Women: Above 50 mg/dL

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What is a triglyceride

A fat produced by the liver that is stored as glycerol, fatty acids, monoglycerides, and reconverted when body is in need

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What is a coagulation profile

Blood test used to assess clot formation activity

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What is the purpose of a coagulation profile (2)

Screen for clotting factor deficiencies

2. Assess therapeutic range of anticoagulation therapy

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What is the prothrombin time (PT)

Measures thrombin production and plasma clotting factors

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What does prothrombin time determine

How long it takes plasma to clots

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What does prothrombin time screen for

Bleeding disorders, anticoagulation effectiveness, and used to calculate international normalized ratio (INR)

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What is partial thromboplastin time (PTT)

Speed of clotting and plasma clotting factors

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In the presence of increased clotting time what should be considered for physical therapy (5)

Avoid high intensity impact aerobic exercise
Low resistance/high rep resistance exercise
Avoid vigorous manual techniques and modality use
Do not perform debridement
Hold exercise and manual intervetion when PT or PTT is greater than 2.5 times reference range or INR greater than 3.0

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In the presence of decreased clotting time what should be considered for physical therapy

Hold exercise until physician clearance determines emboli risk

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What is the purpose of blood glucose

Indicates carbohydrate metabolism

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What happens if fasting blood sugar is below 60 mg/dL

Hold PT due to CNS symptoms

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What happens if fasting blood sugar is above 250 mg/dL

Hold PT due to risk of ketoacidosis

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When is an oral glucose tolerance test done

Pregnancy

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What is the 2 hour postprandial blood sugar

Testing your blood sugar 2 hours after you eat

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What is the target range of glycated hemoglobin (HbA1c)

Regular: 4-5.9%

With DM: Below 7%

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What is the purpose of the cardiac angiography

Determine patency of coronary arteries and identify cardic valve disease

What is a cardiac angiography

Angiogram/catheterization where a long catheter is inserted into brachial or femoral artery which is passed to the heart chambers or coronary arteries where a contrast dye is injected and visualized by fluoroscopy

What can be visualized/monitored with cardiac angiography

Cardiac valves are visualized and chamber pressures can be monitored

True or False: | Activity should not be done for a while after undergoing a cardiac angiography

True

True or False: | PT should assess LE pulse, temperature and sensation frequently following a cardiac angiography

True

How long do you have to avoid resistance exercise after a cardiac angiography

2 weeks

When should a PT apply direct pressure to the catheter site

If bleeding or large bulge forms rapidly under the skin

What is the purpose of an echocardiography (3)

1. Determine heart structure abnormalities 2. Assess prosthetic valve function 3. Detect valve pathology (stenosis) and septal wall defects

What is an echocardiography

Ultrasound image used to create a dynamic image of the heart

What are the 4 different modes of an echocardiography (4)

1. M-mode 2. 2-D 3. Spectral doppler ECC 4. Color doppler ECC

What does an M-mode ECC do

Records heart motion

What does a 2-D ECC do

Provides a cross sectional view of the heart

What does a spectral doppler ECC do

Measures the blood flow detecting turbulence and septal defects

What does a color doppler ECC do

Shows the direction of blood flow detecting valve regurgitation and shunts

True or False: The PT should resume activity shortly after an ECC but take into consideration any findings on heart valve function or septal wall defects

True

What is the purpose of an electrocardiography (2)

1. Detect cardiac dysrhythmias | 2. Diagnose myocardial ischemia and determine region of involvement

What is an electrocardiography

Records electrical activity of the heart from different leads

True or False: The PT should resume activity shortly after and EKG but take into consideration findings on exercise induced ischemia or heart failure

True

True or False: | The PT should monitor patients closely that have dysrhythmias

True

What is a Holter monitoring

Ambulatory EKG worn for 24-48 hours that is able to relate symptoms or activities to cardiac dysrhythmias or diagnose variable angina

True or False: The PT should continue normal activity and record exercise intervention, vitals, exercise tolerance that day in patient's note

True

True or False: | The Holter monitor should never be removed of gotten wet

True

What are the 2 types of stress testing

1. Pharmacological stress test | 2. Exercise stress test (GXT graded exercise test)

Who is a pharmacological stress test for

Patients that cannot stress the cardiovascular system via treadmill

What is a pharmacological stress test

Agents are injected to dilate coronary arteries and mimic exercise demands and nuclear imaging techniques (PEt and SPECT) and ECC are used to determine areas of ischemia in the myocardium

What is an exercise stress test

Monitoring Hr, BP, and EKG while the patient is on the treadmill watching for changes in wave or presence of abnormal findings

What happens at the peak of exercise during an exercise stress test

Tracer is injected and images are acquired better able to see areas of ischemia or block with exercise

What does SPECT stand fo

Single Photon Emission Computed Tomography

What does a SPECT scan do

Assists in detecting CAD and assessing myocardial perfusion

True or False: | A SPECT scan is difficult if the patient cannot lie still for at least 15 minutes

True

What does PET stand for

Positron Emission Tomography

What does a PET scan do (3)

1. Determine reversible/permanent injury assessing amount of useful tissue fir surgical revascularization and coronary angioplasty 2. Assesses myocardial perfusion, tissue visibility, autonomic regulation 3. Assesses lung metabolism as well (pulmonary nodules/masses

Which scan is more useful at detecting cancer a SPECT or a PET scan

Pet scan

What does MUGA stand for

Multiple-uptake Gated Acquisition

What is another name for a MUGA scan

Thallium scan

What is a MUGA scan

First pass scan that allows for identification of all heart chambers and measurement of ejection fraction

What does ejection fraction equal

EF=stroke volume/end diastolic volume

True or False: | With a MUGA scan a radiolabeled bolus (thallium) of blood as it goes through the heart is monitored by a gamma camera

True

What triggers a picture to be taken on a MUGA scan

Each R wave on the EKG

What does the QRS complex equal

Ventricular depolarization/ventricular systole

True or False: | A MUGA scan is difficult if a patient has an irregular HR (afib)

True

True or False: | A MUGA scan is often performed with a stress test

True

What is a venography/arteriography

Fluoroscopy or x-ray of the deep leg veins or arteries after injection of a contrast dye

When is a venography/arteriography used

After a doppler ultrasound to confirm obstruction or insufficiency

What is a venography/arteriography used to help diagnose

DVT or check for vein patency for a CABG

How does the electrical impulse travel through the heart (5)

1. SA node 2. AV node where the single is delayed 3. Down the bundle of His' 4. Down the bundle branches 5. Up the purkinje fibers

What does the right coronary artery supply (6)

1. Right atrium 2. Right ventricle 3. Bundle of His 4. 55% of the SA node 5. AV node 6. Inferior part of the left ventricle

What are the 2 left coronary arteries

1. Left anterior descending coronary artery | 2. Circumflex coronary artery

What does the left anterior descending coronary artery supply (5)

1. Left ventricle 2. Inter-ventricular septum 3. Anterior right ventricle 4. Apex of the right and left ventricles 5. Right and left bundle branches (RBB/LBB)

What does the circumflex coronary artery (3)

1. Left atrium 2. Lateral left ventricle 3. 45% of the SA node