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Transcript
Heart Notes
Common Cardiac Diagnostics
• Blood enzymes:
– CPK-MB (Creatine Phosphokinase) – found in
brain and muscle tissue. Elevated in MI 2-3
hours after infarction; peaks in 12-24 hours.
– LDH (Lactic Dehydrogenase) – produced
during Krebs cycle. Elevated in MI 12-48
hours after infarction.
– SGOT (Serum Glutamic-oxaloacetic
Transamine) – produced during Krebs cycle.
Elevated up to 72 hours after infarction.
Wave Form Measurements
• ECG/EKG – record of electrical activity
produced by heart with each heartbeat.
Shows damage to heart muscle and/or
conduction.
• Holter Monitor – ECG recorded over
extended time (24-48 hours). Correlated to
activity via patient diary.
• Stress ECG – ECG recorded during
exercise; purposely stress heart.
Imaging Techniques
• CXR – Image of heart, lungs and great
vessels using gamma rays. Shows size
and shape of heart.
• ECHO – Image of myocardium, chambers,
valves, and blood flow using sound waves.
Shows these structures in action.
• MRI – Image of myocardium, chambers
and valves using magnetism. Shows soft
tissue best.
More Imaging Techniques
• PET – Image of metabolic heart activity.
Shows areas of necrotic tissue.
• Cardiac Catheterization (Heart Cath) –
Image of coronary arteries using contrast
medium and fluoroscopy. Shows patency
and/or occlusion of heart arteries. May
lead to angioplasty or CABG.
Common Cardiac Diseases
• CAD:
– Arteriosclerosis – hardening of coronary
arteries
– Atherosclerosis - hardening of coronary
arteries with deposits of plaque (fat and
cholesterol)
More Cardiac Diseases
• Angina – heart pain due to ischemia.
Usually not present when patient is
resting.
• Myocardial Infarction (MI) – Interruption in
blood supply to a part of the heart leading
to necrosis of the area.
Valve Disorders
• Rheumatic Heart Disease – inflammation
and damage to the mitral valve caused by
toxins from streptococci.
• Stenosis – narrowing of the opening of a
valve due to inflammation and calcium
deposits.
• Insufficiency/prolapse – blood leaks
backwards thru valve due to inflammation,
trauma, or congenital defect.
More Cardiac Disease
• Cardiomyopathy – inability of the heart
muscle to contract fully. The cause is
usually idiopathic, but may be due to
toxins, viruses, malnutrition or endocrine
disorders.
• CHF – inability of the heart chamber(s) to
empty completely due to kidney disease
(chronic) or MI (acute).
Common Treatments
• Medications:
– Cardiotonics – strengthen and slow heart
beat. Lanoxin
– Vasodilators – dilate coronary arteries to
relieve ischemia. Nitroglycerin
– Antiarrhythmics – interfere with extra
conduction sites. Lidocaine
– Diuretics – decrease volume of blood by
removing extra fluid via the kidneys. Lasix
More Medications
– Anticoagulants – increase clotting time.
Heparin (parantal) or Coumadin (PO)
– Clot Dissolvers – dissolve clots within 8 hours
of formation. Streptokinase, TPA.
– Antibiotics – kill microorganisms (not viruses).
PCN, Tetracycline, Bactrin, Septra, Cipro,
Gentamycin
– ASA – increase clotting time. Given as
prophylactic daily or 1st Aid for MI.
More Treatments
• Surgery:
– Angioplasty – decrease size of coronary
obstruction by inflating balloon at site during
Heart Cath. Keep open with a stint.
– CABG – use veins or artery from other sites to
bypass blocked coronary areas.
More Surgery
– Heart Transplant – replace all or part of heart
from donor. Must be on immunosuppressive
drugs for life. Cyclosporin
– Valve Replacement – replace damaged heart
valve with manmade device or one from pig,
or cadaver.
Cardiac Specialists
• Cardiologist – MD who dx and tx
cardiac/coronary disease/disorders
medically. Does stress test, heart cath and
angioplasty procedures.
• Cardiac Surgeon – MD who does heart
and coronary surgery. CABG and
transplant.
More Specialists
• CCU RN – nurse who cares for critically ill
heart patients.
• Cath Lab RN – nurse who assists
Cardiologist during heart caths.
• Cardiac Biomedical Technician – specialist
with 2-4 years of formal training who
maintains and repairs equipment used to
diagnose/treat heart problems.
More Specialists
• ECG Technician – on-the-job trained
person who operates ECG machine.
• ECHO Technician – ECG tech who has
specialized training in ultrasonography of
the heart.