Echocardiography uses ultrasound to generate images of cardiac structure and function and assess blood flow dynamics. Common laboratory tests for cardiovascular patients include complete blood count, electrolytes, renal function, liver function, lipid panel, and biomarkers like BNP and troponins. Modern cardiovascular imaging includes echocardiography, nuclear imaging like PET, cardiac magnetic resonance imaging, and computed tomography which provide information on structure, function, blood flow, and tissue characteristics.
Hypertension Emergencies and their managementpptxUzomaBende
This Presentation talks about Hyprtension, the mode of presentation of hypertensive crisis and the effective management of hypertensive crisis to prevent case fatalities.
Bio-Markers of Heart Failure (Dr.LIKHIT T)Likhit T
A brief on bio-markers of Heart failure...First of all, I thank the Authors of all the books from which I picked the points to make this presentation.. This presentation includes classification of bio-markers and explanation according their importance.. Thank you
Introduction to afib, Epidemiology of afib, etiology of afib, Clinical presentation of people with afib, Investigation and management
AF related outcomes and complications and differential Diagnosis
Hyertension in patients on regular hemodialysisEhab Ashoor
Everything about hypertension in patients on regular hemodialysis, including management, Resistant hypertension, Intra-dialytic hypertension and Hypertensive urgencies.
Hypertension Emergencies and their managementpptxUzomaBende
This Presentation talks about Hyprtension, the mode of presentation of hypertensive crisis and the effective management of hypertensive crisis to prevent case fatalities.
Bio-Markers of Heart Failure (Dr.LIKHIT T)Likhit T
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Introduction to afib, Epidemiology of afib, etiology of afib, Clinical presentation of people with afib, Investigation and management
AF related outcomes and complications and differential Diagnosis
Hyertension in patients on regular hemodialysisEhab Ashoor
Everything about hypertension in patients on regular hemodialysis, including management, Resistant hypertension, Intra-dialytic hypertension and Hypertensive urgencies.
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
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Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
1. Common Laboratory & Imaging
studies in CV patients & their
Interpretation
Wossen Teferra, M.D. Cardiology Fellow
2. • The clinical examination remains the basis for the diagnosis of a wide
variety of cardiac disorders
• laboratory tests & Imaging studies are used to supplement the clinical
examination
3. CBC
• Hematocrit/hemoglobin levels aid in the assessment of severe
anemia, which may cause or aggravate heart failure.
• Leukocytosis may signal underlying infection
4. Serum electrolyte
• Hyponatremia (low sodium level): In cases of severe heart failure, sodium
restriction, diuretic therapy and the inability to excrete water, may lead to
hyponatremia.
Dilutional hyponatremia occurs because of a substantial expansion of
extracellular and intravascular fluid volume and a normal or increased level
of total body sodium.
• Hypokalemia (low potassium level): may result incase of prolonged
administration of diuretics may result in hypokalemia.
• Hyperkalemia may occur in patients with severe heart failure who show
marked reductions in glomerular filtration rate (GFR) particularly if they
are receiving potassium-sparing diuretics and/or angiotensin-converting
enzyme inhibitors (ACEIs).
• Calcium and magnesium levels may decrease due to the use of diuretics &
may cause arrhythmia
5. Renal function tests
• Patients with severe heart failure, particularly those on large doses
of diuretics for long periods, may have elevated Blood urea nitrogen
(BUN) and creatinine levels indicative of renal insufficiency owing to
chronic reductions of renal blood flow from reduced cardiac output.
6. Liver function tests
• Congestive hepatomegaly and cardiac cirrhosis are associated with
impaired hepatic function, is characterized by raised values of aspartate
aminotransferase (AST), alanine aminotransferase (ALT), alkaline
phosphatase (ALP) Hyperbilirubinemia secondary to an increase in the
direct and indirectly bilirubin & prolonged prothrombin time (PT).
• In patients with long-standing heart failure, albumin synthesis may be
impaired, leading to hypoalbuminemia and intensifying the accumulation
of fluid.
• the impairment of hepatic function rapidly resolves by successful
treatment of heart failure.
7. Natriuretic peptides (BNP & NT-proBNP
• B-type natriuretic peptide (BNP) and N-terminal pro-BNP (NT-proBNP),
are released from the failing heart,
• They are relatively sensitive markers for the presence of Heart Failure,
& are useful tools in the diagnosis of patients with Heart Failure especially
in the presence of clinical uncertainity
• the measurement of BNP or NT-proBNP is useful for establishing
prognosis or disease severity in chronic HF
• natriuretic peptide levels increase with age and renal impairment, are
more elevated in women, BNP levels may increase in patients taking
drugs like angiotensin receptor blocker neprilysin inhibitors
• Levels can be falsely low in obese patients.
8. Cardiac Troponins
• Elevated Cardiac troponins I or T are used to diagnose acute coronary
syndrome, may also indicate cardiac ischemia and myocyte damage
related to HF
9. D-dimer
• D-dimer is the degradation product of crosslinked fibrin
• Elevated plasma D-dimer levels indicate that coagulation has been
activated, fibrin clot has formed, and clot degradation by plasmin has
occurred
• There are many causes of elevated D-dimer; identification of the
underlying cause requires correlation with the clinical picture and
other laboratory results
• provide clinical utility in the evaluation of pulmonary embolism.
• Low levels make the diagnosis of pulmonary embolism unlikely
10. PT/INR
• used in the monitoring of patients taking vitamin K
antagonists (warfarin) which are taken for the prevention &
treatment of thrombotic & embolic events.
11. Lab tests done in patients at risk or with estabilished Atherosclerotic
Cardiovascular Disease (ASCVD)
• Fasting blood sugar & HBA1C : to diagnose Diabetes
• Lipid Profile: Total cholesterol, Low density Lipoproteins (LDL), High
Density Lipoprotiens (HDL), Triglycerides are used to diagnose
dyslipedemias
• Urinalysis: Increased albuminuria is recognized as an independent
risk factor for cardiovascular disease; it should be performed in all
patients with diabetes or chronic kidney disease
• CRP: elevated levels are risk factors for atherosclerosis
12. Thyroid Function tests (TSH, T4, T3)
• To diagnose thyroid disorders which may cause cardiac illnesses
• Hyperthyroidism may cause Atrial fibrillation, rate related
cardiomyopathy & pulmonary hypertension
• Hypothyroidism may cause heart blocks resulting in bradycardia
13. • Blood cultures: used to make the diagnosis of Infective endocarditis,
or systemic infection
• Serology for HIV: can be tested to diagnose HIV associated
cardiomyopathy
14. Imaging tests
Chest X-Ray
• A chest x-ray provides useful information about cardiac size and
shape, as well as the state of the pulmonary vasculature, and may
identify noncardiac causes of the patient’s symptoms.
• Although patients with acute HF have evidence of pulmonary
hypertension, interstitial edema, and/or pulmonary edema, the
majority of patients with chronic HF do not.
15. ECG or EKG
• is a graphic representation of electrical activity generated by the
heart.
• The signals, detected by means of metal electrodes attached to the
extremities and chest wall, are amplified and recorded by the
electrocardiograph.
• It is used to detect
arrhythmia
myocardial ischemia & infarctions,
RV/LV hypertrophy,
electrolyte disturbances
acute pericardits
16. Echocardiography
• uses ultrasound to penetrate the body, reflect from relevant
structures, and generate an image.
• hardware and software are optimized for evaluation of cardiac
structure and function.
• can be used to interrogate blood flow within the heart and blood
vessels by using the Doppler principle to ascertain the velocity of
blood flow.
17. Renal Function Monitoring
• Serum electrolyte and renal function tests are recommended for serial
monitoring in HF, both in the acute and chronic settings,
because worsening renal function is associated with a poor prognosis. 2
• The frequency of renal function monitoring depends on the clinical status
of the patient.1
• 4
• Serum electrolytes and renal function tests are also recommended in
patients on angiotensin-converting enzyme inhibitors, angiotensin II
receptor blockers, and diuretics.4
• 5
18. • Measurement of BNP or NT-proBNP is useful for establishing disease
severity and prognosis in chronic HF 2
• 3
• and for prognosis in the acute setting. 2
• 3
• Cardiac troponins may add additional prognostic value. 3
19. • Cardiac-specific troponin T (cTnT) and cardiac-specific troponin I (cTnI)
have amino-acid sequences different from those of the skeletal
muscle forms of these proteins.
• These differences permitted the development of quantitative assays
for cTnT and cTnI with highly specific monoclonal antibodies. cTnT and
cTnI may increase after STEMI to levels many times higher than the
upper reference limit (the highest value seen in 99% of a reference
population not suffering from MI), the measurement of cTnT or cTnI is
of considerable diagnostic usefulness, and they are now the preferred
biochemical markers for MI (Fig. 269-3).
• With improvements in the assays for the cardiac-specific troponins, it
is now possible to detect concentrations
20. • <1 ng/L in patients without ischemic-type chest discomfort.
• The cardiac troponins are particularly valuable when there is clinical
suspicion of either skeletal muscle injury or a small MI that may be
below the detection limit for creatine phosphokinase (CK) and its MB
isoenzyme (CK-MB) measurements, and they are, therefore, of
particular value in distinguishing UA from NSTEMI. In practical terms,
the high-sensitivity troponin assays are of less immediate value in
patients with STEMI. Contemporary urgent reperfusion strategies
necessitate making a decision (based largely on a combination of
clinical and ECG findings) before the results of blood tests have
returned from the laboratory.
• Levels of cTnI and cTnT may remain elevated for 7–10 days after
STEMI.
21. • CK rises within 4–8 h and generally returns to normal by 48–72 h (Fig. 269-
3). An important drawback of total CK measurement is its lack of specificity
for STEMI, as CK may be elevated with skeletal muscle disease or trauma,
including intramuscular injection.
• The MB isoenzyme of CK has the advantage over total CK that it is not
present in significant concentrations in extracardiac tissue and, therefore,
is considerably more specific. However, cardiac surgery, myocarditis, and
electrical cardioversion often result in elevated serum levels of the MB
isoenzyme. A ratio (relative index) of CK-MB mass to CK activity ≥2.5
suggests but is not diagnostic of a myocardial rather than a skeletal muscle
source for the CK-MB elevation.
• Many hospitals are using cTnT or cTnI rather than CK-MB as the routine
serum cardiac marker for diagnosis of STEMI, although any of these
analytes remains clinically acceptable. It is not cost-effective to measure
both a cardiac-specific troponin and CK-MB at all time points in every
patient.
22. Biomarkers
• Circulating levels of natriuretic peptides are useful and important adjunctive
tools in the diagnosis of patients with HF.
• Both B-type natriuretic peptide (BNP) and N-terminal pro-BNP (NT-proBNP),
which are released from the failing heart, are relatively sensitive markers for the
presence of HF with depressed EF; they also are elevated in HF patients with a
preserved EF, albeit to a lesser degree.
• In ambulatory patients with dyspnea, the measurement of BNP or NT-proBNP is
useful to support clinical decision-making regarding the diagnosis of HF, especially
in the setting of clinical uncertainty.
• Moreover, the measurement of BNP or NT-proBNP is useful for establishing
prognosis or disease severity in chronic HF and can be useful to achieve optimal
dosing of medical therapy in select clinically euvolemic patients.
• However, it is important to recognize that natriuretic peptide levels increase with
age and renal impairment, are more elevated in women, and can be elevated in
right HF from any cause. BNP levels may increase in patients taking ARNIs.
• Levels can be falsely low in obese patients. Other biomarkers, such as soluble ST-
2 and galectin-3, are newer biomarkers that can be used for determining the
prognosis of HF patients
23. • The clinical examination remains the basis for the diagnosis of a wide variety of
disorders.
• The clinical examination may then be supplemented by five types of laboratory
tests:
(1) ECG
(2) noninvasive imaging examinations ( Chest X-ray, Echocardiogram, radionuclide
imaging, computed tomographic imaging, positron emission tomography, and
magnetic resonance imaging)
(3) blood tests to assess risk (e.g., lipid determinations, C-reactive protein) or
cardiac function (e.g., brain natriuretic peptide [BNP] [Chap. 252]),
(4) occasionally specialized invasive examinations (i.e., cardiac catheterization and
coronary arteriography
(5) genetic tests to identify monogenic cardiac diseases (e.g., hypertrophic
cardiomyopathy [Chap. 254], Marfan’s syndrome [Chap. 406], and abnormalities of
cardiac ion channels that lead to prolongation of the QT interval and an increase in
the risk of sudden death [Chap. 241]).
24. • Echocardiography uses high-frequency sound waves (ultrasound) to
penetrate the body, reflect from relevant structures, and generate an
image.
• hardware and software are optimized for evaluation of cardiac
structure and function.
• provide information about cardiac structure and function,
• can be used to interrogate blood flow within the heart and blood
vessels by using the Doppler principle to ascertain the velocity of
blood flow.
25. RADIONUCLIDE IMAGING
• Radionuclide imaging techniques are commonly used for the evaluation of
patients with known or suspected coronary artery disease (CAD),
including for initial diagnosis and risk stratification as well as the
assessment of myocardial viability.
• These techniques use small amounts of radiopharmaceuticals (Table 236-
1), which are injected intravenously and trapped in the heart and/or
vascular cells.
• Radioactivity within the heart and vasculature decays by emitting gamma
rays.
• The interaction between these gamma rays and the detectors in specialized
scanners (single-photon emission computed tomography [SPECT] and PET)
creates a scintillation event or light output, which can be captured by
digital recording equipment to form an image of the heart and vasculature.
26.
27. Cardiac magnetic resonance (CMR) imaging
• is based on imaging of protons in hydrogen, which is an advantage, given
the abundance of water in the human body. When the body is placed
inside a MRI scanner, protons in different tissues, such as in simple fluid or
complex macromolecules such as fat or protein, interact with the magnetic
field at their unique frequencies. A set of orthogonal gradient coils in the
scanner is designed to locate protons spatially so that radiofrequency (RF)
pulses of energy can be delivered to select imaging planes of interests.
Once the RF pulses stop, the energy absorbed will be released, collected by
the phased-array receiver coils placed on the patient’s body surface,
digitally recorded in a data matrix known as the K-space, then
reconstructed into a magnetic resonance image. The large arrays of
software methods of delivering RF pulses are known as pulse sequences
which aim at extraction of different types of cardiac structural or
physiologic information
28. CARDIAC COMPUTED TOMOGRAPHY
• CT acquires images by passing a thin x-ray beam through the body at
many angles to generate cross-sectional images.
• The x-ray transmission measurements are collected by a detector
array and digitized into pixels that form an image.
• The grayscale information in individual pixels is determined by the
attenuation of the x-ray beam along its path by tissues of different
densities, referenced to the value for water
• Cardiac CT produces tomographic images of the heart and
surrounding structures.
29. • Routine Laboratory Testing Patients with new-onset HF and those
with chronic HF and acute decompensation should have a complete
blood count, a panel of electrolytes, blood urea nitrogen, serum
creatinine, hepatic enzymes, and a urinalysis. Selected patients
should have assessment for diabetes mellitus (fasting serum glucose
or oral glucose tolerance test), dyslipidemia (fasting lipid panel), and
thyroid abnormalities (thyroid-stimulating hormone level).
30. Modern cardiovascular imaging consists of
• echocardiography (cardiac ultrasound),
• nuclear scintigraphy including positron emission tomography (PET)
imaging,
• magnetic resonance imaging (MRI), and
• computed tomography (CT)
31. lipid panel or lipid profile
• , measures the fats in the blood.
• The measurements can help determine the risk of having a heart
attack or other heart disease. The test typically includes
measurements of:
• Total cholesterol. This is the amount of the blood's cholesterol
content. A high level can increase the risk of heart disease.
• Ideally, the total cholesterol level should be below 200 milligrams per
deciliter (mg/dL) or 5.2 millimoles per liter (mmol/L).
32. Low-density lipoprotein (LDL) cholesterol.
• Excess LDL cholesterol in the blood causes plaque to buildup in the arteries, which
reduces blood flow.
• These plaque deposits may rupture and lead to major heart and blood vessel problems.
• The LDL cholesterol level should be less than 130 mg/dL.
• Desirable levels are < 70 mg/dL : especially if you have diabetes or a history of heart
attack, a heart stent, heart bypass surgery, or other heart or vascular condition.
High-density lipoprotein (HDL) cholesterol.
• Men should aim for an HDL cholesterol level over 40 mg/dL (1.0 mmol/L). Women should
aim for an HDL over 50 mg/dL (1.3 mmol/L).
Triglycerides. Triglycerides are another type of fat in the blood. High triglyceride levels
usually mean you regularly eat more calories than you burn. High levels can increase the
risk of heart disease.
• The recommended triglyceride level is less than 150 mg/dL (1.7 mmol/L).
Non-HDL cholesterol. Non-high density lipoprotein cholesterol (non-HDL-C) is the
difference between total cholesterol and HDL cholesterol. Non-HDL-C includes cholesterol
in lipoprotein particles that are involved in hardening of the arteries. Non-HDL-C fraction
may be a better marker of risk than total cholesterol or LDL cholesterol.
33. • Routine Laboratory Testing Patients with new-onset HF and those
with chronic HF and acute decompensation should have a complete
blood count, a panel of electrolytes, blood urea nitrogen, serum
creatinine, hepatic enzymes, and a urinalysis.
• Selected patients should have assessment for diabetes mellitus
(fasting serum glucose or oral glucose tolerance test), dyslipidemia
(fasting lipid panel), and thyroid abnormalities (thyroid-stimulating
hormone level).
34. • The urine should be examined for evidence of diabetes mellitus and renal
disease (including microalbuminuria) since these conditions accelerate
atherosclerosis.
• measurements of lipids (cholesterol—total, LDL, HDL—and triglycerides),
• glucose (hemoglobin A1C),
• creatinine,
• hematocrit,
• thyroid function
• Evidence exists that an elevated level of high-sensitivity C-reactive protein
(CRP) (specifically, between 0 and 3 mg/dL) is an independent risk factor
for IHD and may be useful in therapeutic decision-making about the
initiation of hypolipidemic treatment. The major benefit of high-sensitivity
CRP is in reclassifying the risk of IHD in patients in the “intermediate” risk
category on the basis of traditional risk factors.
35. ECG or EKG
• is a graphic representation of electrical activity generated by the
heart.
• The signals, detected by means of metal electrodes attached to the
extremities and chest wall, are amplified and recorded by the
electrocardiograph.
• It is used to detect arrhythmias and myocardial ischemia, it may
reveal findings related to life-threatening metabolic disturbances or
to increased susceptibility to sudden cardiac arrest
• A routine 12-lead ECG is used to assess cardiac rhythm and determine
the presence of LV hypertrophy or a prior MI (presence or absence of
Q-waves) as well as to determine QRS width to ascertain whether the
patient may benefit from resynchronization therapy (see below). A
normal ECG virtually excludes LV systolic dysfunction.