Cardiopulm Lab Values

Name the 6 cardiac specific lab values

1. Troponin

2. Brain natriuretic peptide (BNP)

3. Creatinine Kinase cardiac muscle (CKMB)

4. lipid panel

5. Sodium

6. Magnesium

Leakage of ______ into the blood indicates damage to the heart muscle

Troponin

Troponin labs are drawn in a series of

3

Normal hsTnT

Women: <14 ng/L

Men: <22 ng/L

With injury to the cardiac muscle, troponin can stay high for how long?

1-2 weeks

Look at the following hsTnT labs... has healing occurred? Is therapy indicated?

1: 78

2: 96

3: 82

Yes. the plateau has occurred so you can assume their injury has healed and they are appropriate for therapy

Troponin evaluates

heart mm function status

Creatinine Kinase is commonly elevated during which cardiac event?

within 3-6 hours of an MI

After an MI, CKMB will remain elevated for

2-3 days before returning to normal

When do CKMB levels peak after an MI

18-24 hrs

CKMB is most useful for diagnosing

re-infarction

True or False: CKMB SN and SP are not as high as troponin levels

TRUE

If you have not seen a plateau in CKMB levels, is your patient appropriate for therapy?

NO

True or False

Carbon Monoxide poisoning may elevate CKMB levels

TRUE

_____ is released in association with stretch on the ventricular wall

BNP

Fluid overload and an overstretched ventricle causes BNP levels to

increase

1 multiple choice option

What BNP level is consistent with a diagnosis of heart failure?

>400 pg/mL

NT-pro-BNP is measured at some facilities as a precursor to BNP. What level is normal?

< 300 pg/mL

BNP is most useful in diagnosing

fluid overload and heart failure

Why is BNP measured?

helps determine severity of treatment and effectiveness of treatment

A BNP level of <100 pg/mL means

no heart failure

A BNP level of 101-300 pg/mL indicates

Class 1: cardiac disease but no symptoms or limitations in ordinary physical activity

A BNP level of >300 pg/mL indicates

Class 2: mild symptoms, angina, and slight limitation during ordinary physical activity

A BNP level of >600 pg/mL indicates

Class 3: Marked limitation in activity d/t symptoms even walking short distances and comfortable only at rest

A BNP level of >900 pg/mL indicates

Class 4: severe limitations with symptoms at rest

What is included in a lipid panel?

Cholesterol, triglycerides, lipoproteins (HDL and LDL)

Desirable cholesterol level

140-199

Borderline high cholesterol level

200-239

High cholesterol level

>240

Desirable triglyceride level

<150

Borderline high triglyceride level

150-199

High triglyceride level

200-499

Very high triglyceride level

>500

Triglyceride levels are used to help calculate

cardiac risk

Total cholesterol formula

LDL + HDL + VLDL

What HDL level decreases risk of CVD?

>60

What HDL level increases the risk of CVD?

<35

HDL is ideally ______

high

Optimal LDL level

<100

Near optimal LDL level

100-129

Borderline high LDL level

130-159

High LDL level

160-189

Very high LDL level

>190

Normal vLDL levels?

7-32 mg/dL

Normal pH range for ABG

7.35-7.45

Normal pCO2 range in ABG

45-35

Normal HCO3 range in ABG

21-28