Download tests associated with cardiac disorders

Chapter 4
M.G.Rajanandh,
Department of Pharmacy Practice,
SRM College of Pharmacy,
SRM University.
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INTRODUCTION OF HEART
TYPES OF CARDIAC DISORDERS ASSOCIATED
TEST
Non Invasive Test
Invasive test
COMMON SERUM ENZYME TEST
Creatinine kinase test
lactate dehydrogenase test
Troponin test
AST test.
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Heart is a hallow muscular organ
Contains 4 chambers
Situated in middle mediastinum
It is a closed circulatory transport system
Weight
Males: 300 gms
Female:250 gms
LAYERS:
Consists of three layers:
1.PERICARDIUM:
` Forms bag like structure. It contains
pericardial fluid.
` Protects the heart from the pressure created
by the other adjusted organs
2.MYOCARDIUM:
` Consists of specialized cardiac cells or
myocytes.
It is capable of producing contractions of heart.
3.ENDOCARDIUM:
` Innermost layer. Direct connection with
blood, very smooth surface of epithelial cells
so blood flows easily
ELECTRICAL ACTIVITY:
Junctional tissue of heart is highly
specialized tissue , of which generates and
conducts the cardiac impulse all over the
body.
` SA Node , AV Node , AVB
` Right &left branches of Atrioventricular
bundle.
` Purkinjee fibers.
FUNCTIONS OF HEART:
Circulates blood through the body to meet
their nutritive requirments.
Circulation:
` Short circuit starts from right ventricle &carries
impure blood to the lungs for purification.
` Again the oxygenated blood goes to the left
atrium.
Systemic circulation:
` Pumped from left ventricle through blood vessels
and reaches the tissue
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Exchange of various substances between
blood and tissue.
Then enters to the venous system & returns
to the right atrium.
CARDIAC DISORDERS:
` Angina pectoris
` Myocardial infraction
` Congestive cardiac failure
` Atherosclerosis
IMPORTANT OF DIAGNOSIS:
The clinician must have knowledge of
these disease & diagnostic techniques used
to measure the cardiac performance.
Significance:
These determination have a significant
impact on decisions regarding medical
&surgical management of patients.
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DIAGNOSTIC TESTS:
NON INVASIVE PROCESS:
1.chest x ray
2.ECG
3.Echocardiography
4.MRI scans
INVASIVE PROCESS:
Incision of the body by the external subject.
1.High speed computed Axial tomography.
NON INVASIVE PROCESS:
1.Chest x ray: It is used for the diagnosis of the
heart enlargement & about its size & shape.
2.ECG(Electrocardiography):By this technique
the electrical activities of the heart are
studied.
Graphical record of electrical changes
occuring during the cardiac cycle of the heart
is known as ECG.
Measurement:
use electrodes (or) leads placed on the
chest & limb of the patient.
Detect electrical activity of heart.
Transmit signals which when amplified &
transmitted to ECG machine.
Purpose:
Any deviation towards the lower side &
upper side indicates the abnormal function of
heart
3.Echocardiography:
- Simple non invasive test.
-Performed at unstable patients
-Using the ultrasound , we can
investigate&
- visualize the heart structural anatomy
size,
motion.
- This is preferred procedure for
.valvular dysfunction
.Wall motion abnormalities
.Congenital abnormalities
4.MRI Scans:
-Non invasive procedures
- It uses powerful magnets& radio waves to
produce picture of heart.
-It provides detailed picture of heart &
blood vessels.
-Useful auto diagnosing:
.congenital abnormalities
.Abnormal growth & tumers.
- Abnormal results indicates:
.Heart valve disorders , pericardial effusion
, atrial myxoma fibrosis congestive heart
failure.
. How much heart muscle is dead , after
heart attack.
- Types:
. M –Mode
. Two dimentional
.Doppler: Ultra sound record . The
direction of blood & wall motion
. Transesophagal Echo cardiography:
Image vertically & horizantally , visualize
cardiac muscle , thrombosis (or) valvular
leaks measured
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CARDIAC CATHETERIZATION:
CATHETER:
-It is a thin radio opaque tube , made up of
elastic , rubber (or) glass
-Invasive procedure in which catheter is
inserted intravenously into any chamber of
heart.
- It is used in both diagnostic & therapeutic.
Diagnostic use:
-Angiography (imaging technique)
- various pressures determined
Right heart
Left heart
RIGHT HEART
-Right atrial P
-Right ventricular P
-Pulmonary atrial P
-Pulmonary capillary
wedge P
LEFT HEART
-Aortic P
-Left atrial P
-Left ventricular P
Therapeutic use:
-Thrombolysis
-Percutaneous transfuminal coronary
angiography.
-Laser coronary angioplasty
-Catheter abtation.
1.HIGH SPEED COMPUTED AXIAL
TOMOGRAPHY:
-By this test we can detect cardiac function &
cardiac structure
-Provides precise visualization of cadiac
structure from the inner endocardial wall to
surface of the pericardium.
2.COMMON SERUM ENZYME TEST:
Enzyme – circulate in the blood all times
Tissue damage – large quantity of enzyme
released
This enzyme level- used in diagnosis.
(a) Creatinine kinase:
Purpose:
-To detect MI
-Causes of chest pain & monitor the
severity of myocardial ischemia after cardiac
surgery, cardiac catheterization.
Normal value:
men:55-170U/L
women:30-135 U/L
(b).Iso enzymes: CK , BB , CK-MM , CK-MB
normal CK-MB=<5%
Ck increases with MI , hypokalemia , copoisoning , alcoholic cardiac myopathy. CK
does not increases in heart failure, angina
pectoris.
(c) lactate dehydrogenase:
Purpose : detect MI , pulmonary infarction
Five enzymes: LDH1, LDH2, LDH3, LDH4,
LDH5
Normal: 71-207 u/l
LD1:14%-26%
LD2:29%-39%
In MI, LD1 will be higher than LD2. So
LD1/LD2 is greater than 1
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(d).Troponin:
Purpose : To detect MI cause for chest pain
CTn- I, CTn – T= markers of cardiac
damage.
CTn-<0.35 micro g/l
CTn-<0.1 micro g/l
Troponin level increases & are detectable
with in 1 hr of myocardial cell injury.
(e).Aspartate Aminitransferases:
-Found primarily in heart & liver
Damage of heart:(from MI)-AST level
increased.
AST level increases acute hepatitis ,
cirrhosis , fatty liver and congestion of liver.