Cardiovascular Lab Tests Flashcards
Enzymes with Suspected MI
- creatine phosphokinase
- lactate dehydrogenase
- aspartate aminotransferase
Isoenzymes
- subtypes of broken down enxymes
- ex. CK-MB, LDH1
5 LDH Isoenzymes
-LDH1-LDH5
Cardiac Markers
- enzymes
- Mm proteins
Enzymes
- some are organ specific & get released with organ is damaged
- blood serum analyzed to detect presence of increased enzyme levels
-determine amount & time of damage
Muscle Proteins
- Troponin
- Myoglobin
3 CK Isoenzymes
- CK-MB (heart)
- CK-MM (muscle)
- CK-BB (brain)
Hb Normal Values
- male: 14-18 g/dL
- female: 13-16 g/dL
Ballpark CK Value Interpretation
5-75 Normal 200-400 Small MI 400-800 Med MI >800 Large MI >2000 very large MI
Myoglobin
- O2 binding heme protein
- found in cytosol of striated Mm
- Upper limit of reference interval: 70 microgram/L
CK-MB Mass
- measures protein concentration of CK-MB
- Elevates sooner than CK or CK-MB
Blood Analysis
- Hb
- Hct
- Leukocytes
- Platelets
Hct
-% of volume of blood that consists of RBC
the rest is plasma
Clotting Measurements
- PT
- PTT
- INR
INR
- method to standardize between labs
- normal: 0.9-1.1
- therapeutic: 1.5-2.5
-Increased #=slower to clot
Significance of increased Hb
-increased blood viscosity
<5,000 platelets
bed rest
5,000-20,000 platelets
- AROM
- walk in room
- light activities/ADLs
20,000-50,000 platelets
- light resistance
- walking as tolerated
- bike
50,000-150,000 platelets
- moderate resistance training
- walking as tolerated
- stationary bike
150,000-450,000 platelets
-normal activity
Significance of decreased Hb levels
- 8-10g/dL=fatigue & tachycardia
- s contraindicated
Platelet Normal Value
-150,000-450,000 cells/microliter
Hct Normal Values
- male: 42-52%
- female: 37-48%
Normal Leukocyte Levels
43,000-10,800 cells/microliter
Increased Hb levels due to:
- polycythemia
- dehydration
Decreased Hb levels due to:
- anemia
- iron insufficiency
- fluid overload (dilution)
AST
- (SGOT)
- increase 12 hours after MI
- peak at 24 hours
- return to normal in 4 days
CK-MB
- isoenzyme of heart
- 4-8 hours after MI
- peak: 12-24 hours
- return to normal 2-3 days
CK
- rises 1st, rapidly after MI
- rises: 3-4 hours
- peak: 33 hours
- return: 3 days
Troponin
- normal values are low
- rise: 4-6 hours
- peak: 10-24 hours
- return: 1 week
LDH1
- prominent in heart
- rise: 8-24 hours
- peak: 72-144 hours
- return: 14 days
LDH
- rise: 12-24 hours
- peak: 72 hours
- return: 5-14 days
PTT
- assess intrinsic coagulation pathway
- HEPARIN therapy monitored with PTT
- normal: 30-40 sec
-(on heparin=1.5-2.5x normal)
PT
- measures extrinsic coaculation pathway
- Warfarin (Coumadin) monitored with PT
- Normal range: 11-12.5 sec
-(on Wararin=1.5-2.5x normal)
Decreased Leukocyte Levels
- due to: viral infections, immunocompromised status
- result in pt being isolated
- ex’s not contraindicated, but follow guidelines
decreased platelet levels
- due to: leukemia, lymphomas, aplastic anemia, etc
- results in spontaneous bleeding
increased platelets
- due to: leukemia, cancer, primary thrombocytosis, post splenectomy
- ex’s not contraindicated unless blood flow to organs compromised
Increased Leukocyte levels
-due to: bacterial/parasitic infections allergic reactions, leukemia
