Flashcards in Cardio 4 Deck (85):
Troponin levels that are not significant, are grayish,a nd indicate an MI.
• < 0.04 not significant
• 0.04 - 0.20 grey area
• > 0.20 possible/positive
So there really is only two numbers here, .04 and .2, so know that below 0.04 is nothing, in between 0.04-0.2 is grayish, and above 0.2 is where the trouble is.
Troponin to go up when there is an MI? Is that the only time that Troponin will go up? If not, then when else?
Anytime that there is heart damage, surgery, stenting, even defibrillation.
Will cause very high CPK values when ...
– Heat Stroke
– Side Effect From Statins (rare)
Total cholestrol is supposed below?
Less than 200
Ldls are supposed to be less than
Ldls above ______ is at risk for CAD
hdlS below _____ is at risk for CAD
HDLs above ________ is good
Triglycerides above _______ is at risk for aboloc syndrome
Normal triglyceride levels are?
Cholestral ratio is
total chol = 200 and
HDL = 50
Ratio would be
200/50 or 4:1
AHA recommends ratio < 5:1, with the idealbeing close to 3.5:1
New recommendation: consider risk profile
(computed by a risk assessment calculator) not just lipidpanel
Previously emphasis was placed heavily on
cholesterol values esp LDL # in deciding whoshould take statins
Statins Now Recommended For:
People 40 to 75 years old,
with a ≥ 7.5percent risk (computed by a risk calculating tool) for stroke or MI W/I
• Anyone with a history of a cardiovascular event (MI,
stroke, stable or unstable angina, PAD, TIA, or post any revascularization
• People 21 and older who have a very high LDL level
(190 mg/dL or higher)
• People 40 to 75 years old with Type 1 or Type 2
CBC names and ranges.
Plt 50 is too low
Hgb is supposed to be what and if below what you hold exercise?
10-20 and below 8.
Hct is supposed to be what and if below what is bad?
40-50, and below 25 is bad.
WBC is supposed to be what and if it is too much waht does it indicate.
Fish bone is what?
Look at a fish,
Do you add salt, Na+, cl-,
Do you eat it on a BUN
Is it sweet, GLUCOSE, at its tail
cr eat I nine, I eat nine fish
Have some buffer HCO3-
If the fasting blood glucose is above what and how many tines so will it indicate a problem?
Casual blood glucose of 200mg/dl indicates what?
If the electrolytes are altered what can change?
Mental status and heart rhythms.
What at the fish bone indicates either heart or kidney dysfunction?
Increased BUN, blood urea nitrogen.
Just think of urea, that it is what the kindneys make, so if it is at the blood, bad news.
Creatinine more than how much indicates renal failure?
Two things that indicate renal failure...
BUN and creatinine.
Below what and above what for glucose levels is exercise contraindicated?
Above three hundred because it shows that the body is breaking down the fats for energy and it will just get more.
And below 75 because it is just too low.
HbA1c (glycolated hemoglobin)
average amount of sugar in blood over 3 months
(between 4 and 5.6, > 5.6 can lead to dx of DM)
Pts who have known DM should try to keep HbA1c
ABG shows what?
(pH / CO2 / PO2 / HCO3 / O2 Sat)
All the things that you want to know.
And oxygen sat
PT prothrombin time nl
11.3 – 13.7 (coumadin)
partial thromboplastin time
PTT partial thromboplastin time
D-Dimer: mostly a R/O test
– ≤ 250 ng/mL D-Dimer Units (DDU)
– ≤ 0.5 mcg/mL Fibrinogen Equivalent Units (FEU)
= 95% likelihood there is no thrombus
• INR – international normalization ratio• the higher the #,
the thinner the blood
Like gauges, the higher the thinner the wire.
What happens if the INR is too high?
Nl for INR
INR for therapeutic
What is high INR?
At INR is too high to even get out of bed OOB
For the INRs
CRP – C Reactive Protein indicates what?
Blood test gives
non-specific evidence of inflammation, acts as “marker”
Crp is a blood marker that would indicate what?
Infection, illness, or a serious flare-up of arthritis, can all raise CRP levels
Is CRP correlated with heart disease?
What are the values that are correlated with heart disease for CRP?
• < 1.0 mg/L = low risk
• > 3.0 mg/L = high risk
• Pulse Ox
• Stress Test
• TEE Transesophageal echocardiogram
• PET, CT, SPECT, MUGA
• A + stress test indicates that pt became
symptomatic or had EKG changes at less than their predicted max heart rate
220-age=max heart rate
Tilt table treats
• Left Cardiac Cath
• Right Cardiac Cath
• EPS (electrophysiology study)
If there exists more in the world, surely they do, but these are the ones that we are responsible for.
Right and Left cardiac catneter and electrophysiology study.
Left cardiac catheter is:
Goes and studies the left ventricles and the coronary arteries.
So it need a mojor artery to come back tto the aorta, it will make use of the femoral artery.
R Cardiac Cath looks for
Obtain pulm art Pulm wedge Pressures,
Used as Dx for Pulm HTN
Another name for the right cardiac catheter
Its yellow and its in the heart, so no pulling.
Find ectopic sites
RFA = radio frequency ablation
Freezing = Cryoablation
PTCA stands for
PTCA Balloon can be used for:
Angiography = Looking
Angioplasty = Intervening
They stick in a balloon, and they either do something to the athrosclerotic plaque, if they see it, or they just take a look around to see if they need to intervene.
Similar to the PTCA in the sense that they both can address plaques, but here by the PCI they don't just inflate the balloon and then allow the vessel to return back to the original occlusion but they leave in a stent to physicaly keep this vessel opened.
Stents are permanent?
PCI Brachytherapy is?
Radiation Seeds Implanted In stent
PCI Cutting Balloon
Is like another PCI but here we can cut away the plaque.
I wonder how careful one needs to be in order to avoid embolus formation?
Open ♥ sx has the incision from where to where?
Supraernal notch to the ziphoid process
After the incision of the open heart sx what oeeps the chest cavity open?
Wires are used to close the _________ after the open heart surgery.
Chest tubesa re inserted where and where?
Interpleural and intermediastinal.
After open heart surgery, now that e chest has been broken into and rewired shut, are there any sternal precautions?
What are these sternal precautions that are sto be observed after the open heart surgery?
• ≈ SIX WEEKS
• Ø heavy lifting > 10 lbs
• Ø pushing or pulling with force
• Ø driving or sitting in front seat of car
• Ø raising both arms overhead, or bringing them to the back simultaneously
(Pt is cleared for ↑ activity by cardiac surgeon at a follow-up visit)
What are two most common vlaces that require replacement?
Mitral, left av valve, and tricuspid, right av valve.
Maybe because they need to be able to withstand rhe pressure of the ventricles to not open up and regurgitate the blood, by the pulmonic and aorta, they open at the systolic and they close at the diastolic, which is lower pressure than at systolic, but the mv and tv they need to stay put at the systolic.
(s/p valve Pts are placed on blood thinners)What will happen to the INR?
Will go up
Will become thinner
More than 3 is elevated and
More than 5 is no OOB
They shave the heart muscle to change back the remodeling.
They remove the athrosclerosis from the carotid arteries
What sound wound one hear in the carotid artery if it is occluded?
A bruit, like a coffee brewer that it sends liquids through a tight area and there will be lots of turbulence.
AAA requires surgery at what size
More than 5 cm
Fem Pop Bypass
Similar to a cabg, but here it is FPBG.
And who can name that machine that made rain into food from "Cloudy with a Chance of Meatballs"?
Permanent pace maker
Placed over the pec ort he axillary
• no heavy lifting or stretching 7-10 d, similar to Sternal precautions.
• Do no lift arm on PPM side > 90° until clearedby MD
• Check incision for signs of infection daily. Normal incisional check ups.
Automatic, imp,antable, cardioverter, defibrillator.
• no heavy lifting or stretching 7-10 d
• Do not lift arm on PPM side > 90° until cleared by MD
• Check incision for signs of infection daily. NO MRI • PLUS: Call doctor if device discharges
–Avoid contact sports
–No driving for 3 mos
Similar to the PPM but if it goes off then a doctor needs to be contacted, also no driving for 3 minths, or sports.
What you see on ER or Any other knock off ED drama show, clear, fmump, give me 8 ccs, good job!
• Synchronized shock is administered to theheart via electrode pads to correct an
Left ventricular assistive device
Like a bypass oft he left ventricle to the aorta, if the LV is too weak to be able to kee p and do the job.
Look up the cow without the pulse.
• Some patients undergo REVERSE
REMODELING after LVAD is implanted
• In some cases pt’s heart recovers enough that LVAD is explanted and patient no longer
• Research is ongoing in this area
Molecular Changes After Left Ventricular Assist Device Support for HeartFailure, Emma J. Birks, Circulation Research [Circ Res] 2013 Aug 30; Vol.
113 (6), pp. 777-91
• Cardiac Transplant: last resort
• heterologous: from non-human primate
• homologous: from human donor
• PERFORMED AT SPECIALIZED CENTERS