The document provides reference ranges and normal values for various cardiac tests and assessments including: - Blood gas analysis values such as pH, pCO2, and pO2. - Complete blood count components like hemoglobin, RBC count, WBC count and differentials. - Electrolytes including sodium, potassium, calcium and their normal ranges. - Kidney and liver function tests including creatinine, BUN, bilirubin and liver enzymes. - Lipid profiles like cholesterol, triglycerides, and lipoproteins. - Cardiac markers like CK-MB, troponin and their significance in diagnosing heart attacks. - Coagulation tests like PT

1. B Y M A N I S H K H A R E
CARDIAC ASSESSMENT
TEST

2. PH
•The normal range for pH is 7.35–7.45. As
the pH decreases (<7.35), it implies
acidosis, while if the pH increases (> 7.45)
it implies alkalosis. In the context of arterial
blood gases, the most common occurrence
will be that of respiratory acidosis.

3. PH

4. COMPLETE BLOOD COUNT (CBC)
•The complete blood count (CBC) is a
group of tests that evaluate the cells that
circulate in blood, including red blood
cells (RBCs), whiteblood cells (WBCs),
and platelets (PLTs). The CBC can
evaluate your overall health and detect a
variety of diseases and conditions, suchas
infections, anemia and leukemia.

5. COMPLETE BLOOD COUNT (CBC)
• Hemoglobin
• Male- 13.5 to 17.5 grams per deciliter.
• Female- 12.0 to 15.5 grams per deciliter.
• Polycythemia – abnormal increase in RBC count.
• RBCMale-4-6million/cumm
• Female- 4-5.5 million/cumm
• Infant- 8-10 million/cumm

6. TLC
• The normal values for TLC – 4000-11000/cu mm.
• Neutrophils 50-70%
• Eosinophils 2-4%
• Lymphocytes 20-30%
• Monocyte 2-6%
• Basophil - 0-1%
• Higher than the normal leukocyte count indicates an infection or
inflammation being treated by the body. Lower than the normal
leukocyte count indicates improper functioning of the immune
system.

7. PLATELETS
• A normal platelet count ranges from 150,000 to
450,000/cu mm of blood.
• Having more than 450,000 platelets is a
condition called thrombocytosis;
• Having less than 150,000 is known as
thrombocytopenia

8. CREATININE:
• Normal serum creatinine ranges are:
• -0.6–1.1 mg/dL in women and adolescents aged 16 and older
• -0.8–1.3 mg/dL in men and adolescents aged 16 and older
• -0.2 or more in infants, depending on muscle development
• Symptoms of high creatinine levels are typically those
associated with kidney dysfunction (renal insufficiency).

9. UREA
•Normal value - 5 to 20 mg/dl.
•The range is wide because of normal
variations due to protein intake,
endogenous protein catabolism, state of
hydration,hepatic urea synthesis, and
renal urea excretion.

10. SODIUM
• Normal blood sodium level - 135 and 145
(mEq/L).
• Hyponatremia occurs when the sodium in
your blood falls below 135 mEq/L.
• Hypernatremia occurs when the sodium in
your blood falls above 145 mEq/L.

11. POTASSIUM:
• Normal value of blood serum Potassium - 3.5-5 mmol/L.
• It helps keep the water (the amount of fluid inside and outside
thebody's cells) and electrolyte balance of the body.
• Potassium is also important in how nerves and muscles work.
• RBS
• RBS normal range between 80 mg/dl and 130 mg/dl prior to
eating,for healthy blood sugar levels in the body.
• RBS test done within one or two hours of eating then the

12. RBS
• RBS, normal value should be 180 mg/dl.
• A level of 200 mg/dl or higher is an indication of diabetes
mellitus.
• Blood sugar or glucose is a crucial unit of the body and serves
as the primary source of energy. It is crucial to the normal
functioning of varied tissues and most importantly the brain.
Glucose levels are low in the morning before the first meal of
the day and rises after having a meal. Continuous high levels of
blood sugar are known as Hyperglycaemia and low levels are
referred to as Hypoglycaemia.

13. LACTATE –
• Normal value of serum lactate level is - 2 mmol/L
• A serum lactate level measures the amount of lactic
acid in the blood and is a fairly sensitive and reliable
indicator of tissue hypoperfusion and hypoxia.
• Any disorder that causes an imbalance between lactate
production and clearance can lead to lactic acidosis,a
serious and sometimes life-threatening condition.

14. LFT
•Liver function tests are blood tests
used to help diagnose and monitor
liver disease or damage. The tests
measure the levels of certain
enzymes and proteins in the blood.

15. LFT
• Alanine transaminase (ALT). - 7 to 55 units per liter (U/L),
• ALT is an enzyme found in the liver that helps convert proteins
into energy for the liver cells. When the liver is damaged ALT
levels increase.
• Aspartate transaminase (AST) - 8 to 48 U/L,
• AST is an enzyme that helps metabolize amino acids. An
increase in AST levels may indicate liver damage, disease or
muscle damage.

16. LFT
• Alkaline phosphatase (ALP). . 40 to 129 U/L,
• ALP is an enzyme found in the liver and bone and is important for breaking
down proteins. Higher-than-normal levels of ALP may indicate liver damage or
disease, such as a blocked bile duct, or certain bone diseases.
• Albumin and total protein. . 3.5 to 5.0 grams per deciliter (g/dL)
• Albumin is one of several proteins made in the liver. Lower-thannormal levels
of albumin and total protein may indicate liver damage or disease.
• Bilirubin. 0.1 to 1.2 milligrams per deciliter (mg/dL),
• Bilirubin is a substance produced during the normal breakdown of red blood
cells,bilirubin passes through the liver and is excreted in stool, elevated levels
of bilirubin (jaundice) might indicate liver damage or disease or certain types of
anemia.

17. LFT
• Gamma-glutamyltransferase (GGT). 8 to 61 U/L,
• GGT is an enzyme in the blood, higher-than-normal levels may
indicate liver or bile duct damage.
• L-lactate dehydrogenase (LD). . 122 to 222 U/L,
• LD is an enzyme found in the liver, elevated levels may indicate
liver damage but can be elevated in many other disorders.

18. PT / INR
• INR (international normalized ratio). 0.8 to 1.1.
• PT-11 to 13 seconds.
• PT is the time it takes your blood to clot,
increased PT may indicate liver damage but can
also be elevated if you're taking certain blood-
thinning drugs, such as warfarin.

19. ACTIVATED COAGULATION TIME
ACT
• The normal value of ACT- 80-120 sec.
• Recommended value during CPB should be more than
480 Sec.
• To monitor treatment with heparin or other blood-
thinning medications (anticoagulants) when undergoing
heart bypass surgery, coronary angioplasty, or dialysis
.

20. • High doses of heparin are given before, during, and for a short
time after, some medical procedures that require extracorporeal
life support (ECLS).
• During these procedures, the patient's blood is filtered and
oxygenated outside of the body using mechanical devices. The
blood's contact with artificial surfaces activates the clotting
process.
• Special cell fragments in the blood called platelets and proteins
called coagulation factors are activated in a sequence of steps
that results in blood clot formation.
• A high dose of heparin prevents clot from forming during ECLS
but results in a delicate balance between clotting and bleeding.
ACTIVATED COAGULATION TIME
ACT

21. URINE TEST
• Urinalysis is one way to find certain illnesses in their earlier stages.
• They include:
• -Kidney disease
• -Liver disease
• -Diabetes
• Acidity, or pH. If the acid is abnormal, have kidney stones, a urinary tract
infection (UTI) or another condition.
• Protein. This can be a sign of the kidneys are not working properly. Kidneys
filter waste products out of the blood.
• Glucose. A high sugar content is a marker for diabetes.

22. URINE TEST
• White blood cells. These are a sign of infection or
inflammation, either in the kidneys or anywhere else along
urinary tract.
• Nitrites. This means that there is an infection with certain
kinds of bacteria.
• Bilirubin. If this waste product, which is normally eliminated
by the liver, shows up, it may mean the liver isn’t working
properly. Blood- Sometimes this is a sign of infections or
certain illnesses.

23. SICKLING TEST
• Sickle cell tests determine the presence and relative amount of
hemoglobin S in a blood sample or detect mutations in the genes
thatproduce hemoglobin to help diagnose sickle cell anemia and/or
identify people with sickle cell trait.
• Hb S can form crystals that change the shape of the RBC from a round
disc to a characteristic sickle shape. This altered shape limits the
RBC's ability to flow smoothly throughout the blood vessels in the
body, limits the hemoglobin's ability to transport oxygen to tissues,
and decreases RBC lifespan from 120 days to about 10-20 days.
• A person with sickle cell disease (homozygous for Hb S) can become
severely anemic because the body cannot produce RBCs as fast as
they are destroyed. The affected person can suffer painful episodes
and a variety of complications when sickled cells become lodged in
and obstruct small blood vessels (vaso-occlusion).

24. HBSAG-
• Primarily to screen for and diagnose acute or
chronic hepatitis B virus (HBV) infection, to
detect a previous, resolved hepatitis B infection,
• Hepatitis B is an infection of the liver caused by
the hepatitis B virus (HBV). Hepatitis B blood
tests detect viral proteins (antigens), the
antibodies that are produced in response to an
infection.

25. HCV
• To screen for and diagnose a hepatitis C virus
(HCV) infection and to monitor treatment of the
infection
• Hepatitis C (HCV) is a virus that causes an
infection of the liver that is characterized by liver
inflammation and damage.
• The most common test for HCV looks for
antibodies in the blood that are produced in
response to an HCV infection.

26. VDRL
• The VDRL test is a screening test for syphilis.
• It measures substances (proteins), called
antibodies, which your body may produce if you
have come in contact with the bacteria that cause
syphilis.

27. HIV
•HIV testing shows whether a person has
HIV.
•HIV is the virus that causes AIDS
(acquired immunodeficiency syndrome).
AIDS is the most advanced stage of HIV
infection.

28. ANTISTREPTOLYSIN O
• (ASO) titer is a blood test to measure antibodies against streptolysin O, a
substance produced by group A streptococcus bacteria. Antibodies are
proteins our bodies produce when they detect harmful substances.
• Bacterial endocarditis, an infection of the inner lining of the heart.
• -A kidney problem called glomerulonephritis
• -Rheumatic fever, which can affect the heart, joints, or bones
• -Scarlet fever
• -Strep throat
• The ASO antibody may be found in the blood weeks or month after the strep
infection has gone away.

29. CRP
• C-reactive protein (CRP) is produced by the liver. Its level rises
when there is inflammation in the body.
• LDL cholesterol not only coats the walls of the arteries, but it
also damages them. This damage causes inflammation that the
body tries to heal by sending a "response team“ of proteins , CRP
is one of these proteins.
• If we have high cholesterol, probably been told to lower the LDL
number from blood test.

30. CRP
• LDL is the "bad cholesterol," the type that contributes to plaque
that can clog the arteries. This can lead to a heart attack or
stroke.
• Research shows that only 50% of people who suffered heart
attacks had high LDL levels. So, many doctors use another test
called the C-reactive protein test to help figure out who’sat risk.
• CRP levels is a better indicator of cardiovascular disease (CVD)
than the LDL test. But, it's important to know that a CRP test is
not a test for heart disease. It's a test for inflammation in the
body.

31. LIPOPROTEINS
• Lipoproteins are substances (composed of fat and
proteins) which carry cholesterol and triglycerides from
the liver to wherever they are needed throughout the
body.
• There are several groups of lipoproteins. Measuring the
amounts of these lipoproteins can give an indicator of
how much fat is being carried in the blood stream that
may be harmful.

32. • LDL (low-density lipoprotein) is known as 'bad cholesterol'. It
carries cholesterol from the liver to the tissues around the
body. The recommended LDL level is below 3.0mmol / l
• HDL (high-density lipoprotein) is known as 'good cholesterol'
because it carries surplus cholesterol from the tissues back to
the liver to be recycled or excreted. The recommended HDL
level is above 1.0mmol / l (male) and above 1.2mmol / l
(female)
LIPOPROTEINS

33. CK MB- (CPK MB)
• Creatine kinase-MB (CK-MB) is a form of an enzyme found primarily
in heart muscle cells. This test measures CK-MB in the blood.
• If CK-MB is elevated and the ratio of CK-MB to total CK (relative
index) is more than 2.5-3, then it is likely that the heart was damaged.
• A high CK with a relative index below this value suggests that skeletal
muscles were damaged.
• Chest pain and increased CK levels plus elevated CK-MB indicate that
it is likely that a person has recently had a heart attack. Levels that
drop, then rise again may indicate a second heart attack and/or ongoing
heart damage.

34. TROPONIN
• The normal range for troponin is between 0 and 0.4 ng/mL.
• To determine have had a heart attack or injury to heart muscle;
to determine angina (chest pain related to heart trouble) is
worsening.
• High-sensitivity troponin tests are primarily ordered to help
diagnose a heart attack and rule out other conditions with
similar signs and symptoms.
• Either a troponin I or troponin T test can be performed;.

35. ECHO
•Echocardiography (echo) is a painless
test that uses sound waves to create
pictures of the heart. This test gives
information about the size and shape of
the heart and how well the heart's
chambers and valves are working.

36. CAG
•Coronary angiography is often done along
with cardiac catheterization. This is a
procedure which measures pressures in
the heart chambers. Before the test starts,
you will be given a mild sedative to help
you relax.

37. CAG
• An area of your body (the arm or groin) is cleaned and numbed
with a local numbing medicine (anesthetic). The cardiologist
passes a thin hollow tube, called a catheter, through an artery and
carefully moves it up into the heart. X-ray images help the doctor
position the catheter.
• Once the catheter is in place, dye (contrast material) is injected
into the catheter. X-ray images are taken to see how the dye
moves through the artery. The dye helps highlight any blockages
in blood flow.

38. THE PROCEDURE MOST OFTEN LASTS
30 TO 60 MINUTES.

39. ECG
•An electrocardiogram (ECG) is a medical
test that detects cardiac (heart)
abnormalities by measuring the electrical
activity generated by the heart as it
contracts. The machine that records the
patient's ECG is called an
electrocardiograph.