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105 Cards in this Set

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ASCVD
Aterosclerotic cardiovascular disease
CAD
coronary artery disease
IHD
ischemic heart disease
NTG
Nitroglycerin
AMI
acute myocardial infarction
CABG
coronary artery bypass graft
ACB
aortocoronary bypass
CK
creatine phosphokinase
CPK
creatine phosphokinase
LH
lactic dehydrogenase
LDH
lactic dehydrogenase
SGOT
serum glutamic oxalacetic transaminase
AST
serum glutamic oxalacetic transaminase
Type of angina: Symptom of pain caused by myocardial ischemia; provoked by stress, during exercise
Angina pectoris
What is another name for variant angina?
Prinzmetal's angina
Type of angina:
Chest pain that occurs at rest, people that have preserved exercise capacity
Prinzmetal's angina/Variant angina
Type of angina: Worst case scenario; occurs at rest, increase in frequency and duration over time; can lead to myocardial infarction and requires immediate medical attention
Unstable Angina/Crescendo angina
What is another name for unstable angina?
Cresendo angina
Type of angina: myocardial infarction without any chest pain
Silent myocardial infarction
S/S: May be described by the patient as pain, discomfort, tightness, ache or pressure
Angina
(S/S): Many patients do not use the word pain
Angina
(S/S): Located in the retrosternal area with or without feeling the sensations in the throat, mandible, shoulders, etc.
angina
(S/S): Size of the area of discomfort is usually that of a clinched fist or greater
angina
(S/S): Lasts 30 seconds to several minutes if the ppt cause is eliminated
angina
(S/S): Size of the area of discomfort is usually that of a clinched fist or greater
angina
(S/S): Does not last more than 15 minutes
angina
(S/S): Can be produced by effort or emotional stress or may occur spontaneously
angina
(S/S): May be ppt. by changes in the weather
angina
(S/S): An observer may detect facial pallor
angina
(S/S): substernal chest pain often accompanied by N/V, diaphoresis, pain that may radiate to back, jaw or left arm
myocardial infarction
(S/S): Pain may appear to be like indigestion
myocardial infarction
(S/S): anxiety, sob, dizziness, feeling of "impending doom"
myocardial infarction
(S/S): S4 gallop, murmurs
myocardial infarction
(S/S): ECG changes
myocardial infarction
PMH is a lab/diagnostic test used in ____________
angina and myocardial infarction
ST segment elevation or depression is a lab/diagnostic test used in ____________
angina
Exercise tolerance stress test is a lab/diagnostic test used in ____________
angina
Cardiac catheterization is a lab/diagnostic test used in ____________
angina
Serial isoenzymes is a lab/diagnostic test used in ____________
myocardial infarction
ST segment elevation, T wave inversion, appearance of Q waves is a lab/diagnostic test used in ____________
myocardial infarction
What does an ECG reading look like in a pt. with angina?
ST segment elevation or depression
What does an ECG reading look like in a pt. with a myocardial infarction?
ST segment elevation
T wave inversion
appearance of Q waves
What are some of the symptoms of unstable angina?
new onset
cresendo angina
occuring at rest
Definition: Continuted decrease in oxygen delivery resulting in permanent cell injury and death (thrombus formation/occlusion)
myocardial infarction
What are the three isoenzymes?
CK-MB
CK-BB
CK-MM
Where is CK-MB found?
myocardium and skeletal muscle
Where is CK-BB found?
brain, lungs and GI tract
Where is CK-MM found?
skeletal, cardiac muscle
Normal range of CK in males
40-200 IU/L
Normal range of CK in females
35-150 IU/L
Normal range for CK-MB
< 12 IU/L
Normal range for LDH?
100-210 IU/L
Normal range of AST for males
0-37
Normal range of AST for females
1-31
AST
aspartate aminotransferase
Normal range for Troponin I
< 1.5 ng/ml
Normal range for Troponin T
less than or equal to 2 ng/ml
Which enzyme stimulates transfer of PO4 groups?
CK
Which enzyme is concentrated in tissues dependent on aerobic metabolism?
CK
In AMI, which enzyme rises sharply in 608 hours after onset, maximizes in 24 hours and normalizes in 3-4 days?
CK
What is the sensitivity and specificity of CK?
Sensitivity - 98%
Specificity - 67%
What is the sensitivity and specificity limitations of LDH?
Sensitivity - 98%
Specificity - 30%
Which enzyme is more specific for cardiac tissue?
CK-MB
In AMI, which enzyme rises sharply in 4-8 hours after onset, mazimizes in 12-20 hours and normalizes in 2-3 days?
CK-MB
Which enzyme acts in the final step of glycolysis?
LDH
Which enzyme has high concentrations in skeletal muscle, kidneys, liver, RBCs and heart? (virtually everywhere)
LDH
Where is LDH found?
skeletal muscle, kidneys, liver, RBCs, heart, etc.
In AMI, which enzyme rises 12 hours after onset, maximizes in 2-3 days and normalizes in 8-14 days?
LDH
What is the sensitivity and specificity of LDH isoenzyme ratio?
sensitivity - 81%
specificity - 94%
If ratio is greater than 1 it is an indication of acute MI
LDH Isoenzyme ratio
Which enzyme is active in amino acid synthesis?
AST
Which enzyme is widely distributed throughout the body? (not very specific)
AST
In AMI, which enzyme rises within 12 hours after onset, mazimizes in 36 hours and normalizes in 3-4 days?
AST
In AMI, which enzyme rises within two hours after onset, but is rapidly cleared b the kidneys?
myoglobin
Which enzyme has low specificity?
myoglobin
Definition: low molecular weight hemeprotein found in heart and muslce; used for early detection
myoglobin
Which enzyme is the new gold standard for cardiac enzymes?
Troponins
Which enzyme is highly specific for cardiac muscle?
Troponins (99%)
In AMI, which enzyme rises within four hours of onset, mazimizes in fourteen hours and 3-5 days and normalizes in 5-7 days
troponins
Why are troponins the new gold standard for cardiac enzymes?
because they are highly specific (99%) for cardiac muscle
What is the specificity for troponins?
99%
What are the ECG changes in AMI?
1. T-wave inversion
2. ST-segment elevation
3. Q-wave appearance
Identify the ECG change:
nonspecific
T wave inversion
Identify the ECG change: often associated with transmural AMI
T wave inversion
Identify the ECG change: Indicates acute infarction with continued occlusion
ST segment elevation
Identify the ECG change: Diagnostic of AMI if at least mm elevation from baseline
ST segment elevation
Identify the ECG change: Indicates persistent occlusion and irreversible necrosis
Q wave appearance
Identify the ECG change: Diagnostic of AMI if wave is at least 1mm wide or 1/3 size of QRS complex
Q wave appearance
Definition: Uses ultrasound to evaluate the structural anatomy of the heart
Echocardiography
T wave inversion
nonspecific
often associated with transmural AMI
ST segment elevation
-Indicates acute infarction with coninuted occlusion
-Diagnostic of AMI if at least 1mm elevation from baseline
Q wave appearance
-Indicates persistent occlusion and irreversible necrosis
-Diagnostic of AMI if wave is at least 1nm wide or 1/3 size of QRS complex
DOPPLER
-Records velocity and direction for blood flow
-Useful for peripheral ischemia
TEE
Transesophageal Echocardiography
Transesophageal Echocardiography
-Visualizes cardiac valves
-Useful for diagnosing endocarditis
Visualizes cardiac valves
Transesophageal Echocardiography
Useful for diagnosing endocarditis
Transesophageal Echocardiography
Records velocity and direction for blood flow
Doppler
Useful for peripheral ischemia
Doppler
Definition: Used to identify, localize and estimate the size of infarct
Imaging Studies
What are imaging studies used for?
To identify, localize and estimate the size of infarct
MUGA
Multiple-Gated Blood Pool Imaging
What is the most common method to assess ventricular ejection fraction?
Multiple-Gated Blood Pool Imaging (MUGA)
What is the major predictor of mortality?
LVEF
Uses of Cardiac Catherization/Angiography?
-Determine the extent of CAD and define anatomy of coronary arteries
-Used in conjunction with baloon angioplasty/percutaneous transluminal coronary angioplasty and stent
-Often used with imaging to visualize abnormality