Download Answer Key for student worksheet for Cariac Normal ranges for

Answer Key for student worksheet for Cariac
Normal ranges for cardiac tests
Ejection fraction: 50-70%, usually around 55%
Stress Test:
6 MWT (6 minute walk test): 500 meters
MLWHFQ (Minnesota Questionnaire) Score: 50 or more means patient is severely impacted, zero is
no impact from heart failure, a change of 10 points or more means significant change in patient's life
and health.
Patient 1
Patient 2
71 years old, male
68 years old, male
Therapy: Plasmids (genetic material) were
Therapy: Stem cells were harvested via bone
injected in cells around the dead areas of the
marrow aspiration and cleaned and concentrated heart. These cells then began to produce SDF1, a
stem cells were injected into heart.
Baseline data (before treatment)
Ejection fraction: 30%
Stress Test: positive (student should draw wave
form)
6 MWT (6 minute walk test): 300 meters
MLWHFQ (Minnesota Questionnaire) Score: 50
signal that causes stem cells found naturally in
the body to migrate to the damaged heart tissue.
Baseline data (before treatment)
Ejection fraction: 35%
Stress Test: positive (draw wave form)
6 MWT (6 minute walk test): 325 meters
MLWHFQ (Minnesota Questionnaire) Score: 58
One month after treatment
One month after treatment
Notes on patient reaction to treatment:
Notes on patient reaction to treatment:
Hurt hip, some pain from bone marrow aspiration, No pain, worst comment was the waiting to leave
didn't like getting anesthesia twice.
One month check up continued
One month check up continued
Ejection fraction: 32%
Ejection fraction: 35%
Stress Test: (not performed at this time)
Stress Test: (not performed at this time)
6 MWT (6 minute walk test): 320 meters
6 MWT (6 minute walk test): 338 meters
MLWHFQ (Minnesota Questionnaire) Score: 42
MLWHFQ (Minnesota Questionnaire) Score: 47
Two month check up
Two month check up
Ejection fraction: 34%
Ejection fraction: 37%
Stress Test: positive, but better resting perfusion Stress Test: positive, but better resting perfusion
6 MWT (6 minute walk test): 328 meters
6 MWT (6 minute walk test): 353 meters
MLWHFQ (Minnesota Questionnaire) Score: 45
MLWHFQ (Minnesota Questionnaire) Score: 44
Four month check up
Four month check up
Ejection fraction: 36%
Stress Test: positive, but resting perfusion better
6 MWT (6 minute walk test): 340 meters
Ejection fraction: 40%
Stress Test: positive, but resting perfusion better
6 MWT (6 minute walk test): 380 meters
MLWHFQ (Minnesota Questionnaire) Score: 41
MLWHFQ (Minnesota Questionnaire) Score: 35
Additional notes on patient that might be pertinent Additional notes on patient that might be pertinent
to the study:
to the study:
• How does the patient look?
• How are they moving and reacting differently?
• What are they saying that might indicate a
change in health?
• How does the patient look?
• How are they moving and reacting differently?
• What are they saying that might indicate a
change in health?
For an assessment tool, teachers may want to have students put their names on the Worksheets
and turn them in. These should indicate if students completed the assigned activity.
A quick 12 question quiz can be found here.
Answers to the quiz questions can be found here.
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After students use the site, additional in class discussion questions (which can also act as
assessment tools) can be asked or assignments made:
If these two lines of research make it through clinical trials and are approved by the FDA
(Food and Drug Administration), what other applications do you see for this knowledge? (This is to
get students thinking about the future and applying knowledge in new ways.) This type of stem cell
therapy might be used for burn patients, to increase the amount of skin that will grow back; to limit
scarring in cosmetic surgery or repair of facial skin after an accident; and eventually might even be
used to re-grow digits or limbs lost in accidents.
How does heart disease develop and progress? What are the steps from first symptoms up
through congestive heart failure? (The answer can be found online or in a good anatomy text book.).
Where was the heart damaged in these two patients? Are there locations in the heart where
damage would not be so bad (not create as many symptoms)? What locations in the heart would be
the worst places to have damage? These two patients' left ventricles were damaged and it is this
chamber of the heart that pumps blood to the rest of the body. It is pretty much the worst place to
have damage. Damage to the atria would be less serious, but obviously, any damage to the heart
could be life threatening.
Describe the difference between a heart attack and cardiac arrest (the ventricles stop
altogether or go into fibrillation – a rapid, uncoordinated fluttering of the ventricle that does not pump
blood out of the heart). A heart attack or myocardial infarction is blood not reaching a relatively small
part of the heart muscle itself. This is usually due to a blockage in one of the arteries that feeds
blood to the heart muscle. A small section of the heart dies, as a result of lack of blood flow. During
cardiac arrest, blow flow to the entire body, including the brain, stops. Therefore, cardiac arrest is a
much more serious problem than a heart attack, although a heart attack can be fatal, as well.
What aspects of your students' lives would change if they had stage three congestive heart
failure? Remember, at this stage, walking for six minutes is not possible without resting several
times. Could they get from one class to another with congestive heart failure? Could they get to their
busses on time or get from the bus to their home? What other aspects of their lives would be limited
by this condition?
List all the careers you think might be involved with these lines of research from start to
finish, even those not specifically mentioned in the activity.
Minnesota Living with Heart Failure Questionnaire – If you would like to look up this test and
discuss the questions asked and what they mean to patients, the original can be found
at:http://www.license.umn.edu/Products/Minnesota-Living-With-Heart-FailureQuestionnaire__Z94019.aspx You do have to register and download the questionnaire, but it is free
to educators.
Have your students write a report describing which treatment they would recommend to the
FDA. Include sections that describe the methods used in the research, comparisons of the base line
data and final results, what the results were and why one particular method was recommended over
the other. The medical community is looking primarily at the SDF1 study as being the most cost
effective and viable, because it has many other potential uses (not just heart repair) and is easier on
the patient (no invasive bone marrow aspiration or second anesthesia) and easier on the hospital
(no five hour wait between aspiration and catheterization). Your students should explore these
issues in their paper.