Cardiac function tests made easy and understandable with basic information for anyone who wants to learn it at a glance.

1. By-
Dipak H. Sutar (intern)
Cardiac function tes
By-
Dr. Dipak H. Sutar
(PharmD)

2. History
Physical Examination
Electrocardiography
Laboratory Tests (CPK, LDH, cholesterol,
etc.)
Cardiac imaging—
Echocardiography
CT Scan
MRI
Cardiac Catheterization
 Nuclear Imaging

3. Vital Signs
•BP both arms
hypertension
hypotension
orthostatic hypotension
•HR tachycardia
bradycardia
•Rhythm regular
regularly irregular
irregularly irregular
•Respirations tachypnea
•Temperature fever

4. Electrocardiography (ECG

5. ECG
 Simplest and most routine- test
 electrocardiogram (ECG) is a quick,
easy way to assess the heart’s
function
 By this technique the electrical
activities of the heart are studied.
 Risks associated with ECG are
minimal and rare
 No special preparation is necessary
for an electrocardiogram

6. What represent ?
P wave = atrial depolarisation
QRS = ventricular depolarisation
T = repolarisation of the ventricles

7. 1. To look for the cause of chest pain
2. To evaluate problems which may be heart-related,
such as severe tiredness, shortness of breath,
dizziness, or fainting
3. To identify irregular heartbeats
4. To help determine the overall health of the heart prior
to procedures such as surgery; and/or after treatment
for conditions such as a heart attack (myocardial
infarction, or MI), endocarditis (inflammation or
infection of one or more of the heart valves); and/or
after heart surgery or cardiac catheterization
5. To see how an implanted pacemaker is working
6. To determine how well certain heart medications are
working

8. Certain factors or conditions may interfere with
or affect the results of the ECG.
 Obesity
 Pregnancy
 Ascites (fluid buildup in the abdomen [belly])
 Anatomical considerations
 Movement during the procedure
 Exercise or smoking prior to the procedure
 Certain medications
 Electrolyte imbalances, such as too much or
too little potassium, magnesium, and/or
calcium in the blood.

9. 1. Heart rate
2. Heart rhythm
3. Conduction abnormalities
4. Evidence of increased thickness of heart
muscle (hypertrophy)
5. Evidence of damaged heart muscle
6. Acutely impaired blood flow to heart muscle
7. Warning signs of abnormal cardiac rhythm
disturbances
By analyzing the pattern and frequency of the ECG recor

11. Arrhythmia

12. Bradycardia

13. SVT

14. X-rays

15. X-ray
 A second routine test often used initially
after the medical history and physical
examination is the chestX-ray.
 There are no other risks involved in X-
rays; they are painless, fast, and relatively
inexpensive
 A chest X-ray may be ordered when an
person's symptoms include a persistent
cough, coughing up blood, chest pain, a
chest injury, or difficulty in breathing.

16.  The main advantages of the chest
X-ray are in differentiating primary
lung disease from heart disease
and in providing a clear view of
anatomical abnormalities such as
heart enlargement or congenital
defects.

17. Cardiomegaly

18. Cardiac Enzyme tests
 Enzyme levels to assess how well the
body’s systems are functioning.
 Used to determine whether there has
been any tissue damage.
 Tests performed to help diagnose a
heart attack and to determine the
extent of damage to the heart muscle.

19.  The two most common cardiac
enzyme tests performed are:
Creatine kinase (CK)
Cardiac troponin
lactate dehydrogenase (LHD)
aspartate aminotransferase (AST)
(Combination of troponin and CK
levels is more specific to the heart )

20. Serum Creatine kinase (CK)
 The muscle cells in your body need
CK to function properly.
 Creatine phosphokinase isoenzymes
play a key role in the intracellular
energy transport from mitochondria to
myofibrils and other sites of energy
utilization
 CK is made up of three isoenzyme
forms
CK-MB, CK-MM,CK-BB.

21.  CK-MB is the substance that rises if
your heart muscle is damaged. CK-
MM rises with other muscle damage.
 CPK-BB found mostly in the brain and lungs
 CPK-MB found mostly in the heart
 CPK-MM found mostly in skeletal muscle

22. Creatine kinase (CK)
 CK-MB
Normal range- 5 to 25 IU/L.
 The primary indicator used to diagnose a
heart damage because it exists in the
highest amount in the heart.
 CK-MB is the substance that rises if your
heart muscle is damaged
 If CK-MB makes up more than 5 percent of
a total CK level, a heart attack is
suspected.
 CK-MB levels typically increase to above
normal levels about six hours after a
person has had a heart attack.

23. CK-BB
 Rare present in cardiac tissue
 CK-BB is found mostly in the brain.
 CK-BB can be an important indicator of
tissue damage in the brain from stroke,
trauma or other causes.
 Unless tissue damage in the brain has
occurred, CK-BB levels will be
undetectable.
CK-MM ( 5 to 70 mcg/ lit)
 Exists primarily in skeletal muscle

24.  Total creatine kinase level (CK total).
male - 25 to 130 mcg/lit
female- 10 to 150 mcg/lit
female
 Much higher in very muscular people,
and infants up to 1 year
 According to the American College of
Cardiology (ACC), total CK levels
should not be used in the diagnosis of
heart attack.

25. Cardiac troponin
 There are two types – Troponin T (cTNT)
Troponin I
(cTNI).
 These proteins control the interactions of
two other substances (actin and myosin)
that cause the heart muscle to contract
or squeeze.
 Normal levels in the blood are very low,
but they rise sharply and quickly in
response to a heart muscle injury,
usually within two or three hours after the
beginning of a heart attack.

26.  cardiac troponin will also rise in
response to angina, which is one
reason the two tests are often
performed together.
 sensitive to damage than CK, valuable
at detecting mild heart attacks and
early detection.
 elevated levels are specific to a heart
injury.

27. lactate dehydrogenase
 Normal LDH levels - 140-280 U/L
 lactate dehydrogenase testing is no longer
considered a diagnostic tool for heart.
 LD is an enzyme that is found in almost all
of the body's cells (as well as in bacteria)
and is released from cells into the fluid
portion of blood when cells are damaged
or destroyed.
 the blood level of LD is a general indicator
of tissue and cellular damage.

28. The American College of Cardiology
(ACC) does not recommend measuring
LDH in the diagnosis of heart attack.

29. Aspartate aminotransferase
 Normal range- 8 to 20 IU/L
 Also known as serum glutamic-oxaloacetic
transaminase (SGOT), aspartate
aminotransferase (AST)
 convert amino acids to amino acid residues,
which is vital to energy production
 Increases in AST levels are proportional to
cell damage within the body, making it an
important tool for monitoring the progression
of damage and the healing process.

30. Aspartate aminotransferase
 The degree to which AST is elevated can
also help pinpoint the type of cell damage
that has occurred.
 AST is sometimes used to track heart
attack patients, it is not used as
commonly for this purpose as CK or
troponin.

31. Serum Cholesterol
 Not used to diagnose or monitor a
disease but is used instead to
estimate risk of developing a disease
— specifically heart disease
 High blood cholesterol has been
associated with hardening of the
arteries (atherosclerosis), heart
disease, and a raised risk of death
from heart attacks.

32. Coronary angiography
 Coronary angiography is a procedure
that uses a special dye (contrast
material) and x-rays to see how blood
flows through the arteries in heart.

34. Thank you-