Tiêu đề 14. TESTS ASSOCIATED WITH CARDIAC DISORDERS.pdf ✅

PHARMD GURU Page 1 The heart is a muscular organ in most animals, which pumps blood through the blood vessels of the circulatory system. Blood provides the body with oxygen and nutrients, as well as assisting in the removal of metabolic wastes. In humans, the heart is located between the lungs, in the middle compartment of the chest. CARDIAC DISORDERS:  Coronary heart disease  Stroke  Other cardiovascular diseases  Hypertensive heart disease  Inflammatory heart disease  Rheumatic heart disease. CARDIAC FUNCTION TESTS: There are 3 types of cardiac function tests. They are: 1) Laboratory tests 2) Cardiac biomarkers 3) Non laboratory tests. 1) LABORATORY TESTS:  White blood cell count (WBC) is the number of white blood cells in a volume of blood. Normal range is generally between 4,300 and 10,800cells per cubic millimeter (cmm).  White blood cell (WBC) differential count. White blood count is comprised of several different types that are differentiated, or distinguished, based on their size and shape. The cells in a differential count are lymphocytes, monocytes, eosinophils and basophils.  Red cell count (RBC) signifies the number of red blood cells in a volume of blood. Normal range: 4.2 to 5.9 million cells/cmm. This can also be referred to as the erythrocyte count and can be expressed in international units as 4.2 to 5.9 x 1012 cells/liter. TESTS ASSOCIATED WITH CARDIAC DISORDERS
PHARMD GURU Page 2  Hemoglobin (Hb). This is the amount of hemoglobin in a volume of blood. Hemoglobin is the protein molecule within red blood cells that carries oxygen and gives blood its red color. Normal ranges: 13 to 18 gm/dl for men. 12 to 16 gm/dl for women.  Haematocrit (Hct). This is the ratio of the volume of red cells to the volume of whole blood. Normal range: 42% to 52% for men. 37% to 47% for women. This is usually measured by spinning down a sample of blood in a test tube, which causes the red blood cells to pack at the bottom of the tube.  Mean corpuscular volume (MCV) is the average volume of a red blood cell. This is a calculated value derived from the haematocrit and red cell count. Normal range may fall between 80 to 100 fentoliters (a fraction of one millionth of a liter).  Mean Corpuscular Hemoglobin (MCH) is the average amount of hemoglobin in the average RBC. This is a calculated value derived from the measurement of hemoglobin and the red cell count. Normal range: 27 to 32 pictograms.  Mean Corpuscular Hemoglobin Concentration (MCHC) is the average concentration of hemoglobin in a given volume of red cells. This is a calculated volume derived from the hemoglobin measurement and the haematocrit. Normal range: 32% to 36%.  Red Cell Distribution Width (RDW) is a measurement of the variability of red cell size and shape. Higher numbers indicate greater variation in size. Normal range: 11 to 15.  Platelet count. The number of platelets in a specified volume of blood. Platelets are not complete cells, but actually fragments of cytoplasm (part of a cell without its nucleus or the body of a cell) from a cell found in the bone marrow called a megakaryocyte. Platelets play a vital role in blood clotting. Normal range: 1, 50,000 to 4, 00,000 Cells/mm3. 2) CARDIAC BIOMARKERS:  Cardiac biomarkers are substances that are released into the blood when the heart is damaged or stressed.  Measurement of these biomarkers is used to diagnose, monitor.

PHARMD GURU Page 4 CREATINE KINASE:  Creatine kinase (CK/CPK) is an enzyme expressed in a number of tissues. Function: it catalysis the conversion of creatine to phosphocreatine degrading ATP to ADP.  The CK enzyme consists of two subunits, B (brain type) or M (muscle type) Three different Isoenzymes: CK-MM, CK-BB and CK-MB.  CK-BB occurs mainly in tissues, rarely of any significance in the bloodstream.  Skeletal muscle expresses CK-MM (98%) and low levels of CK-MB (1%).  The myocardium has CK-MM at 70% and CK-MB at ~30%. MYOGLOBIN:  Myoglobin may be ordered as a cardiac biomarker, along with troponin, to help diagnose or rule out a heart attack.  Levels of myoglobin start to rise within 2-3 hours of a heart attack or other muscle injury, reach their highest levels within 8-12 hours, and generally fall back to normal within one day.  An increase in myoglobin is detectable sooner than troponin, but it is not as specific for heart damage and it will not stay elevated as long as troponin.  Sometimes, a urine test is ordered to evaluate myoglobin concentrations in those who have had extensive damage to their skeletal muscles (rhabdomyolysis). 3) NON-LABORATORY TESTS: These tests allow looking at the size, shape, and function of the heart as it is beating. They can be used to detect changes to the rhythm of the heart as well as to detect and evaluate damaged tissues and blocked arteries.  EKG (ECG, electrocardiogram).  Nuclear scan.  Coronary angiography (or arteriography)  Echocardiogram.  Stress testing.  Chest X-ray.  Cardiac catheterization.  Cardiac Stress Testing.  Nuclear imaging.