CV Labs and Dx (Exam 1) Flashcards
Troponin
Most sensitive indicator of myocardial damage
Heart cell death
Troponin differentiates between
cardiac and non cardiac chest pain
Troponin is increased _____ and returns to baseline _______
2-3 hrs after MI
Baseline 10-14 days
Angina Serum Troponin Draw times
Initially
12 hours
Daily for 3-5 days
CK-MB
Monitored before troponin
Not as specific as troponin
CK-MB is elevated _______ after MI, peaks in ________ and returns in ________
3 hours after MI
peaks in 24 hrs
returns in 2 days
What does CK-MB show?
Muscle damage
CK-MB can also be elevated with
IM injection or any muscle trauma
C-Reactive Protein
Indicated non specific inflammatory illness
inflammation going on somwhere
What is more rapid and more sensitive, ESR or CRP?
CRP
CRP peaks in _______ after MI: failure to normalize may indicate…
18-72 hours
ongoing damage to heart muscle
Erythrocyte Sedimentation Rate
ESR (Sed rate)
Non Specific indicator of acute or chronic infection, inflammation, tissue infarction
CRP is more useful in monitoring
Acute inflammation
ESR is more useful in monitoring
Chronic inflammation
Brain Natriuretic Peptide (BNP)
Main source is cardiac ventricle
Aids in distinguishing cardiac vs respiratory cause of dyspnea
Patient comes into emergency room with shortness of breath, how can we distinguish whether this is cardiac or respiratory cause?
Draw a BNP
Elevated BNP indicates?
Left ventricular dysfunction
Pro-BNP
In normal subjects the same as BNP
When patient has left ventricular dysfunction plasma Pro-BNP concentrations are approximately fourfold higher than BNP concentrations
Cholesterol
Main lipid associated with CV disease
Diurnal Variations (chol check in morning will give different reading than afternoon)
Affected by malnutrition
Cholesterol Sources
endogenous and exogenous sources
Cholesterol checks are done as
a part of lipid profile testing (not totally accurate predictor of heart disease by itself)
If cholesterol is super low we should look at what lab?
Serum Albumin
We want to see if our patient is malnourished
Lipoproteins
HDL/LDL
Accurate predictor of heart disease
HDL = good cholesterols = remove cholesterol
LDL = bad cholesterol = deposit cholesterol in peripheral tissues
HDL job
Remove cholesterol in body
LDL job
Deposit cholesterol in tissue
Normal Cholesterol level
150-200
Risk level of CAD based on Serum Cholestrol
Low: Chol <200
Mod: 200-240
High: >240
Noninvasive Procedures and CV Disease
EKG / ECG
Holter Monitor
Exercise stress test
Echocardiogram
12-lead EKG (ECG)
Provides information about the electrical conduction of the heart
Snapshot in time
Can diagnose myocardial infarction (telemetry can not)
How long does a EKG take?
2-3 min
Patient on normal telemetry begins to have chest pain. What is the next best nursing action?
12 ECG stat
Ambulatory EKG/ECG (Holter Monitor)
EKG monitor worn for 24
Painless test, requires no prep, electrodes must be firmly attached
While wearing a holter monitoring a patient should
Keep a diary and write down any events that happen within the 24 hour period
Holter monitoring can be used to dx
atrial fib
reasons for fainting (syncope)
tachycardia
Stress test / Treadmill Test
Evaluates the heart’s response to exercise
Persons with CAD may have minimal sx with normalactivity and noraml ECG; Exercise can unmask sx of CAD / dysrhythmias
If patient can not be on a treadmill for stress test; the stress can be induced via
medication
Echocardiogram
Uses sound waves to create a moving picture of the heart
Echocardiogram evaluates
Valves and chambers of the heart
Echocardiogram can measure
Ejection fraction (EF)
Ejection Fraction
The percentage of blood pumped out of the left ventricle with each contraction
Is an indication of effectiveness of the heart
Normal EF
55-70%
EF Low values
Under 40% (HF)
