8 Cardio LOM LabTests ClinicalProcedures
Terms
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- Lab Tests: lipid tests
- measurement of cholesterol and triglycerides in a bld sample. National Guideline for total cholesterol in the bld is less than 200mg/dL.
- Lab Tests: lipid tests, treatment of hyperlipidemia
- proper diet, Niacin vitamin helps reduce lipids. Statins, reduce the risk of heart attack, stroke, and cardiovascular death; they lower cholesterol by reducing its production in the liver.
- Lab Tests: lipid tests, examples of statins
- simvastatin (Zocor), atorvastatin (Lipitor), and pravastatin (Pravachol).
- Lab Tests: lipoprotein electrophoresis
- physical seperation of lipoproteins in bld samples. LDL, associated with atherosclerosis, National Guideline is less than 130mg/dL in normal individuals, and less than 100mg/dL in pats with CAD, PVD, and diabetes mellitus. HDL protects adults from atherosclerosis, increased by exercise, estrogen and alcohol in moderation.
- Lab Tests: serum enzyme tests
- chemicals measured in the bld as evidence of a heart attack. damaged hrt muscle releases enzymes into the bldstream. creatine kinase (CK), troponin-I (cTnI), and troponin-T (cTnT). Troponin is a protein released into circulation after myocardial injury.
- Clinical Diagnostic Procedures: X-Ray, angiography
- imaging of blood vessels after injection of contrast material. Arteriography is x-ray imaging of arteries after injection of contrast into the aorta or an artery.
- Clinical Diagnostic Procedures: X-Ray, digital subtraction angiography
- Video equipment and a computer produce x-ray images of blood vessels. An initial x-ray is taken and storend in a computer, then contract material is injected and a second image is taken of that area, computer compares the two images and subtracts the first from the second, leaving an image of vessels with contrast.
- Clinical Diagnostic Procedures: Ultrasound Tests, Doppler Ultrasound
- Sound waves measure movement of blood flow. An instrument focuses sound waves on bld vessels and echoes bounce off red bld cells. Various alterations in bld flow caused by vessel obstruction can be heard.
- Clinical Diagnostic Procedures: Ultrasound Tests, echocardiography (ECHO)
- High-frequency sound waves and echoes produce images of the hrt. Show the structure and movement of the hrt. In transesophageal echocardiography (TEE), a transducer placed in the esophagus provides ultrasound and Doppler information. Detects cardiac masses, prosthetic valve function, aneurysms, and pericardial fluid.
- Clinical Diagnostic Procedures: Nuclear Cardiology, positron emission tomography (PET) scan
- Images showing bld flow and function of the myocardium following uptake of radioactive substances. Detects coronary artery dz(CAD), myocardial function, and differences between ischemic hrt disease and cardiomyopathy.
- Clinical Diagnostic Procedures: Nuclear Cardiology, technetium (Tc) 99m Sestamibi scan
- Technetium 99m sestamibi is injected IV and taken up in the area of an MI. Also used with an exercise tolerance test (ETT-MIBI). Sestamibi is a radioactive tracer compound used to define areas of poor bld flow in hrt muscle.
- Clinical Diagnostic Procedures: Nuclear Cardiology, thallium 201 scan
- Concentration of a radioactive substance is measured in the myocardium. Thallium studies show the viability of hrt muscle. Infarcted or scarred myocardium shows up as "cold spots."
- Clinical Diagnostic Procedures: MRI, cardiac MRI
- images in multiple planes give info about aneurysms, cardiac output, and patency of coronary arteries.
- Other Diagnostic Procedures: cardiac catheterization
- A thin, flexible tube is guided into the heart via a vein or artery. Detects pressures and patterns of bld flow in the hrt. Contrast may be injected and x-ray images taken of the hrt and bld vessels.
- Other Diagnostic Procedures: electrocardiography (ECG, EKG)
- Recording of electricity flowing thru the hrt. Normal sinus rhythm begins in the SA node and is between 60 and 100 beats/minute.
- Other Diagnostic Procedures: Holter monitoring
- An ECG device is worn during a 24-hour period to detect cardiac arrhythmias.
- Other Diagnostic Procedures: stress test
- Exercise tolerance test (ETT) determines the heart's response to physical exertion (stress). three minute stages at set speeds and elevation of a treadmill. important in the diagnosis of CAD and left ventricular function.
- Treatment Procedures: cardioversion (defibrillation)
- very brief discharges of electricity, applied across the chest to stop arrhythmias.
- Treatment Procedures: coronary artery bypass graft (CABG)
- Arteries and veins are anastomosed to coronary arteries to detour around blockages. Internal mammary and radial(arm) arteries and saphenous(leg)grafts are used to keep the myocardium supplied with oxygenated blood. CABG is performed with minimally invasive surgery. Vein and artery grafts are removed endoscopically with small incisions as well.
- Treatment Procedures: endarterectomy
- Surgical removal of the diseased inner layers of an artery. Fatty deposits and thromboses are removed to open clogged arteries.
- Treatment Procedures: extracorporeal circulation
- A heart-lung machine diverts bld from the hrt and lungs while the heart is being repaired. The machine is an extracorporeal membrane oxygenator (ECMO).
- Treatment Procedures: heart transplantation
- While waiting for a transplant, a patient may need a left ventricular assist device (LVAD), a booster pump implanted in the abdomen with a cannula to the lft ventricle.
- Treatment Procedures: percutaneous coronary intervention (PCI)
- A balloon-tipped catheter is inserted into a coronary artery to open the artery; stents are put in place. Stents creat wide lumens and make restenosis less likely. New stents are coated with antiproliferative drugs to prevent scar tissue formation. Stents are also placed in carotid, renal, and other peripheral arteries.
- Treatment Procedures: PCI
- percutaneous transluminal coronary angioplasty(PTCA), stent placement, laser angioplasty (a small laser on the tip of a catheter vaporizes plaque), and atherectomy.
- Treatment Procedures: thrombolytic therapy
- Drugs to dissolve clots are injected into the bldstream of patients with coronary thrombosis. Tissue plasminogen activator (tPA) and streptokinase restore blood flow to the heart and limit irreversible damage to hrt muslce. The drugs are given within 12 hours after the onset of a hrt attack.