Cardiology Diagnostics: Serum Studies and PCI

AST

enzyme present in tissues of high metabolic activity

-heart, liver, and skeletal muscle cells have higher concentrations of this when compared to kidney, pancreatic, and red blood cells

36, pregnancy, liver

Aspartate Aminotransferase (AST/SGOT)

-Peak elevation: 24-__ hours, clearing from the body after that

-Interfering factors: __________, pyridoxine deficiency (decreases), DKA, _____ disease (increases), and uremia (increases)

-Females tend to have slightly lower levels than males

5, total, hemolysis

Lactic Dehydrogenase (LDH)

-Enzyme found in many types of cells like heart, liver, RBCs, kidneys, skeletal muscle, brain, and lungs

-_ isoenzymes

-LDH measures ______, meaning throughout the whole body

-Interfering factors = _________ of sample and strenuous exercise

LDH1, 2, 3

LDH isoenzyme most specific for the heart, where elevation is indicative of myocardial injury

-not as useful as troponin or CK-MB

-peaks in _-_ days

LDH 2

LDH isoenzyme associated with the reticuloendothelial system, where elevation is indicative of pulmonary injury or disease

oxygen, myocardium, 6, trauma

Myoglobin

-Myoglobin is an ________ binding protein found in cardiac and skeletal muscle, which provides early index of damage to the _______________

-Peak at 4-_ hours

-Interfering factors include IM injection, _______, inflammation or ischemic changes to non-cardiac skeletal muscle

-Can occur in the urine, turning it red

3, 18, surgery, pregnancy

Creatine Phosphokinase (CPK)

-Predominantly found in heart muscle, skeletal muscle, and the brain. There are _ isoenzymes (CK-BB, CK-MB, CK-MM)

-Peak at __ hours but will stay elevated if damage is not resolved

-Interfering factors include IM injections, strenuous exercise, recent _______, and early _________

CK-MB, 12-24

CPK isoenzyme specific for myocardial cells, which helps to quantify the degree of MI and timing (onset)

-Peaks at __-__ hours but elevates in 3-6 hours

-Rises only in MI

CK-MM

CPK isoenzyme predominantly found in skeletal muscle, varying according to a person’s muscle mass

CK-BB

CPK isoenzyme predominantly found in brain / lung

disease, MI, 12, 24, dialysis

Cardiac Troponins: Troponin I/T

-Biochemical markers for cardiac ________, specific for cardiac muscle injury

-Utilization = evaluation of a patient with unstable angina, detection of reperfusion associated with coronary recanalization, estimation of __ size, detection of perioperative MI, severity of pulmonary emboli, and ventricular strain due to CHF

-Peak = I at __ hours, T at 12-__ hours

-Interfering factors = ________

peptides, renin, failure, BNP, older

Natriuretic Peptides

-Neuroendocrine ________ that oppose the activity of the ____-angiotensin system

-Utilized to identify and stratify patients with heart _________

-___ is the most specific subtype for cardiac issues

-Interfering factors are ________ age, cardiac surgery 1 month post op

lipid, vascular, familial, risk, pregnancy

Total Cholesterol

-Main _____ associated with arteriosclerotic _________ disease. It’s required for the synthesis of steroids, sex hormones, bile acids, and cellular membranes

-Used to screen for ________ lipid disorders, establish the ____ of cardiovascular disease, and evaluate lipid disorders

-Interfering factors include ___________, post oophorectomy, and post menopausal state

HDL

“healthy” cholesterol

-high density lipoproteins

-cholesterol minimal component

LDL

“lousy” cholesterol

-low density lipoproteins

-75% of cholesterol bound to LDL

Triglycerides

form of fat in the blood stream that constitutes most of the fat in the body

-part of the lipid panel test

-identifies the risk of developing coronary heart disease

-interfering factors include ingestion of fatty meals or alcohol and pregnancy

400

If a patient’s triglycerides are above ____ on a non-fasting panel, you need to repeat with a fasting panel

amino acid, coronary, malnutrition, renal, B

Homocysteine

-Intermediate ______ ____ formed during the metabolism of methionine

-Important predictor of __________, cerebral, and peripheral vascular disease. Can also be used for evaluation of ___________

-Interfering factors are increased age, ______ impairment, men/them, Vitamin _ deficiency, and smoking

Aortic arch

#1

Superior vena cava

#2

Right pulmonary artery

#3

Right descending pulmonary artery

#4

Right atrium

#5

Right ventricle

#6

Left pulmonary artery

#7

Descending aorta

#8

Left ventricle

#9

Inferior vena cava

#10

Paratracheal stripe

#1

Aortic knob

#2

AP window

#3

Hila

#4

nonsurgical, flow, circulation, structural, balloon

Percutaneous Coronary Intervention (PCI)

-Minimally invasive ___________ procedure performed to improve blood ____ in one or more segments of coronary ___________

-Can be used for evaluation/interventional treatment for ___________ heart disease like adult congenital heart disease or valvular heart disease

-Most commonly used revascularization procedure

-Primarily involves the use of ________ angioplasty + intracoronary stenting

catheter, artery, blockage, widen, increase, stent

Balloon Angioplasty

-A specifically designed _________ is placed in a peripheral ______, and a tiny balloon is guided through the artery to a _________ within coronary circulation

-Balloon is inflated to _____ the opening and _______ blood flow to the heart. Part of PCI

-_____ is often placed during procedure to keep artery open after the balloon is deflated and removed