When our cardiac enzymes released into the bloodstream?
When the heart muscle is injured.
Can diagnose myocardial infarction (MI).
What are the indications for cardiac enzymes and lipid profile?
Angina
MI
Heart disease
Hyperlipidemia
How long to fast prior to a lipid profile?
12-14 hours prior
Cardiac Enzymes:
When would Creatine Kinase MB levels be elevated?
Expected Range: 0% of total CK
Within 3-6 hrs and up to 2-3 days after myocardial injury
When would Troponin I & Troponin T levels be elevated?
Within 2-3hrs and up to 7-10 days (Troponin I) or 10-14 days (Tropinin T) after myocardial injury
Expected Range: Less than 0.03 ng/mL (I) OR 0.1 ng/mL (T)
When would Myoglobin be elevated?
Within 2-3 hrs and up to 24 hrs after myocardial injury
Expected Range: Less than 90 mcg/L
This lipoprotein transports cholesterol from the liver to the body’s cells. Levels should be less than 130 mg/dL.
LDL
This type of cholesterol transports cholesterol from the body’s cells to the liver. Expected range is >55 mg/dL (women) and >45 (men)
HDL
Pure cholesterol can’t mix with or dissolve in blood. Instead, your liver packages cholesterol with ____ and proteins called lipoproteins. The lipoproteins move this fatty mixture to areas throughout your body.
triglycerides
Expected Range: <150 mg/dl
When would you use transesophageal echocardiography (instead of transthoracic EKG)?
Transesophageal echocardiography provides clearer ultrasonic images, than a transthoracic echocardiogram, because the waves pass through less tissue. A small transducer is passed through the mouth and into the esophagus to provide images of the heart.
Indications: Heart defects or clots, surgeries
Dipyridamole, adenosine, regadenoson, & dobutamine may all be prescribed for what cardiac test?
Chemical stress tests
How to perform EKG?
-Monitor HR & dysrhythmias
-“Any chest pain, shortness of breath, or dizziness?”
-Check BP frequently after test
Where arterial lines for hemodynamic monitoring placed?
Radial (most common), brachial, femoral artery
Hemodynamic monitoring involves special indwelling catheters, which provide information about blood volume and perfusion, fluid status, and how well the heart is pumping.
Which part of a Pulmonary Artery catheter may be used to administer IV fluids?
The proximal lumen (inserted into a large vein such as jugular, femoral, subclavian, or brachial) can be used to measure right atrial pressure (CVP), infuse IV fluids, and obtain venous blood samples.
The distal lumen can be used to measure PAPs (PA systolic, PA diastolic, mean PA pressure, and PA wedge pressure) and is NOT used for IV fluids.
What position is used for the insertion of a central line?
Trendelenberg (head lowered 10-15 degrees)
For femoral insertion, supine is preferred.
What class are the following:
Amlodipine (Norvasc).
Diltiazem (Cardizem, Tiazac, others).
Felodipine.
Isradipine.
Nicardipine.
Nifedipine (Procardia).
Nisoldipine (Sular).
Verapamil (Verelan).
Calcium Channel Blockers
Indications for Calcium Channel Blockers
Coronary artery disease.
Chest pain, called angina.
Irregular heartbeats, also called arrhythmias.
Blood vessel conditions, such as Raynaud’s disease.
Side effects of calcium channel blockers
Constipation.
Dizziness.
Fast heartbeat you can feel.
Extreme tiredness.
Flushing.
Headache.
Nausea.
Swelling in the feet and lower legs.
Effects of calcium channel blockers
Slow heart rate
Lower BP
They stop calcium from entering the cells of the heart and arteries. Calcium makes the heart and arteries squeeze more strongly. By blocking calcium, calcium channel blockers allow blood vessels to relax and open.
