Heart Notes

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Heart Notes
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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.

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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.

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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.

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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.

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Common Cardiac Diseases

• CAD
• Arteriosclerosis hardening of coronary arteries
• Atherosclerosis - hardening of coronary arteries
  with deposits of plaque (fat and cholesterol)

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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.

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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.

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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).

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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

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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.

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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.

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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.

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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.

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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.

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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.