cardio day 1 Flashcards
Myoglobin creatine phosphokinase (CK or CPK)
CK-MB isoenzyme
Both go up with ANY muscle damage, not just heart damage
Increased sensitivity but decreased specificity
Early enzyme markers:
Cardiac troponin (ng/_____)
mL
High sensitivity troponin T/hs-cTnT (ng/____)
L
Flagged if over 0.1
Get 2-3 readings 4-6 hrs apart
Get two 2 hr troponins in ED to r/o MI
Troponin protocol
Look at whole clinical picture Get 1st reading within 2 hrs of sx r/o MI if low Rule in MI if high Get a 2nd reading if in the middle r/o MI if change is less than 3 Rule in MI if change is over 10 Compare to 1st reading
High sensitivity troponin T/hs-cTnT (ng/L) protocol
2 D ECHO
size and structure
wall mortion abnormalities
pump performance
TEE
Thrombus
Valve opening
Vegetation
PFO
pass the tilt test?
give nitro
what do you look for in treadmill stress tests?
ischemic ekg changes
in healthy ppl
what do you look for in treadmill stress echos
EF and wall motion abnormaities
Used for people with ekg abnormalities or in healthy ppl with comorbid conditions
what do you look for in dobutamine stess echos
Check EF and wall motion abnormalities
ppl who cant exercise
radioactive isotope absorbed by cardiomyocytes that detects effectiveness of cardiac perfusion
Technetium-99m-
Directly observes myocardial perfusion
Nuclear Stress testing
what do you give in a nuclear stress test
Adenosine, lexiscan, and dipyridamole
who gets cardiac cath
For higher risk pts with past coronary issues such as stent or bypass
