Acute coronary syndrome. Dr LM Murray Chemical Pathology Block SA
|
|
- Myles Stevenson
- 5 years ago
- Views:
Transcription
1 Acute coronary syndrome Dr LM Murray Chemical Pathology Block SA
2 Acute myocardial infarction (MI) MI is still the leading cause of death in many countries It is characterized by severe chest pain, and takes place when there is interrupted blood supply to myocytes and necrosis follows
3 Coronary artery disease Clinical presentation: Angina pectoris: Chest pain: dull or stabbing pain, radiating to the arm or jaw Associated with shortness of breath, diaphoresis, nausea and vomiting Clinical classification of angina: Stable angina: pain occurs only with exertion Unstable angina: pain occurs at rest Myocardial infarction: pain persists without interruption and irreversible myocyte damage has occurred
4 Causes of coronary artery disease Type Atherosclerosis or ischemic heart disease (IHD) Spasm Emboli Congenital Comments Most common. Risk factors: HT, Chol, DM, smoking and family history Most prevalent in Japanese. Mediated by histamine, serotonin, catecholamine and endotheliumderived factors Rare, may occur from vegetations in patients with endocarditis 1-2% of population, mostly asymptomatic
5 Atherosclerosis Affects medium and large vessels Inflammatory process that begins early in life and results in the deposition of lipid, fibrin and calcium in the intimal layers of the arteries; which harden, narrow and eventually occlude the vessel Exact mechanism is unclear
6 Response to injury theory Endothelium is damagedby oxidized lipoprotein, infectious agents, glucose, homocysteine, smoking or HT?? LDL migrates into intima LDL oxidizes produces VCAM-1 and MCP-1 Attracts monocytes into intima Macrophages Macrophages take up oxidezed LDL Foam cells Growth factors and cytokines produced proliferation of smooth muscle cells and secrete collagen cap formation covering lipids This plaques grows and eventually blocks the lumen blood flow leads to ischemia
7 Risk factors for IHD Primary Genetic predisposition HT Smoking Hyperlipidaemia Life style factors Nutrition Fat Antioxidants Salt intake Environmental influence in early life Secondary Age Male sex Lack of exercise Obesity DM Stress Alcohol Ethnicity Socioeconomic factors Homocysteine CRP (C-reactive protein)
8 Acute coronary syndrome Definition:ACS is used when symptoms and signs are indicative of myocardial ischemia Classification: MI with typical ST segment elevation (STEMI) MI without ST segment elevation (NSTEMI) Unstable angina It is vital to be able to diagnose MI early to start thrombolytic treatment and improve patient survival
9 WHO criteria for MI diagnosis Include two of the three criteria: History of chest pain ECG changes Elevated troponin or CK-MB
10 Biochemical diagnosis of acute MI Injured myocardial cells leak enzymes and proteins and these enzymes and proteins (or cardiac biomarkers) are measured to determine if a MI is present
11 Characteristics of cardiac markers Cardiac marker Rise (hour) Peak (hour) Time to return to normal (day) CK CK-MB LD Myoglobin Troponin I Troponin T
12 Time course of cardiac enzymes after acute MI
13 CK-MB Cardiac marker Rise (hour) Peak (hour) Time to return to normal (day) CK CK-MB The pattern of CK-MB release may be influenced by: The size of the infarct Concomitant skeletal muscle injury Composition of myocardium Reperfusion (after thrombolytic therapy or spontaneous)
14 Injury to skeletal muscle may the absolute amount of CKMB but the relative concentration is usually <5 % Measurement of CK-MB mass is more specific for MI than CK-MB activity measurement. Sensitivity of CK-MB: On admission: % 3 hrs: % The sensitivity of CK-MB improves with serial measurements at 0, 3, 6, and 9 hours after presentation
15 Troponins Troponin consists of three proteins T, C and I where it is a regulator complex of muscle Troponin T and I are very cardiac specific
16 Sensitivity of troponin I and T for MI diagnosis 100% by 12 hours after onset of pain Disadvantages of Troponins Troponin T is cleared by the kidneys, thus may be in renal failure Not good at detection of MI in early hours But more sensitive troponin assays are developed which could diagnose MI within 3 hours after chest pain onset.
17 Cardiac marker Rise (hour) Peak (hour) Time to return to normal (day) Troponin I TroponinT Elevated troponin are seen in other conditions indicative of myocardial damage, where it is a poor prognostic sign Sepsis Pulmonary Embolism Hypothyroidism Cardiac failure Pericarditis Myocarditis
18 Increase in troponin after A: Acute Myocardial infarction B: Minor Myocardial infarction C: Myocarditis
19 Myoglobin Cardiac marker Rise (hour) Peak (hour) Time to return to normal (day) Myoglobin Myoglobin is an oxygen-carrying haem protein present in skeletal and cardiac muscle Due to is small size it is released earlier than other proteins from damaged cells Useful biomarker to diagnose early MI A negative result will exclude MI, but a positive result needs to be confirmed
20 Important clinical facts CK-MB and troponins do not start to rise until 3-8 hours after infarction, thus not useful to diagnose early MI A negative myoglobin test in the early hours will exclude MI By 12 hours, troponins are 100 % sensitive thus important in late diagnosis of MI
21 Acute IM presenting within 12 hours are treated with thrombolytic treatment To assess if thrombolytic treatment has been successful we need to look at the increased release of cardiac markers, wash out phenomenon. Myoglobin is the best reperfusion marker Diagnosing myocardial ischemia after cardiac and non-cardiac surgery can be done with troponins as CK and CK-MB are released by injured skeletal tissue A high troponin in patients with unstable angina predicts higher mortality
22 Investigation of patients suspected of heart failure CXR ECG Laboratory: FBC: exclude anaemia UCE: / Potassium, Sodium, renal function Mg: Mg due to long term diuretic use LFT and thyroid function test BNP or NT-pro BNP
23 BNP (Brain naturetic peptide)is released in heart failure due to left ventricular function which leads to cardiac output Both BNP and NT-proBNP (fragment of probnp) are elevated in heart failure. Many laboratories measure NT-proBNP because is more stable in vitro (tube) Thus if BNP or NT-proBNP is negative heart failure can be excluded BNP and NT-proBNP is a prognostic marker in heart failure as well
24 References 1. Swaminathan R (ed). Handbook of Clinical Biochemistry, 2 th Ed World Scientific New Jersey: p Marshall WJ, Bangert SK (eds). Clinical Chemistry, 6 th Ed Mosby Edinburgh: p McPhee SJ, Hammer GD (eds). Pathophysiology of Disease: An Introduction to Clinical Medicine, 6 th Ed McGraw Hill Medical New York: p
Ischemic Heart Disease
Ischemic Heart Disease Dr Rodney Itaki Lecturer Division of Pathology University of Papua New Guinea School of Medicine & Health Sciences Division of Pathology General Consideration Results from partial
More informationObjectives. Identify early signs and symptoms of Acute Coronary Syndrome Initiate proper protocol for ACS patient 10/2013 2
10/2013 1 Objectives Identify early signs and symptoms of Acute Coronary Syndrome Initiate proper protocol for ACS patient 10/2013 2 Purpose of this Education Module: Chest Pain Center Accreditation involves
More informationTYPE II MI. KC ACDIS LOCAL CHAPTER March 8, 2016
TYPE II MI KC ACDIS LOCAL CHAPTER March 8, 2016 TYPE 2 MI DEFINITION: Acute coronary syndrome (ACS) encompasses a continuum of myocardial ischemia and infarction, which can make the diagnostic and coding
More information12 Lead EKG Chapter 4 Worksheet
Match the following using the word bank. 1. A form of arteriosclerosis in which the thickening and hardening of the vessels walls are caused by an accumulation of fatty deposits in the innermost lining
More informationResults of Ischemic Heart Disease
Ischemic Heart Disease: Angina and Myocardial Infarction Ischemic heart disease; syndromes causing an imbalance between myocardial oxygen demand and supply (inadequate myocardial blood flow) related to
More informationAcute Myocardial Infarction. Willis E. Godin D.O., FACC
Acute Myocardial Infarction Willis E. Godin D.O., FACC Acute Myocardial Infarction Definition: Decreased delivery of oxygen and nutrients to the myocardium Myocardial tissue necrosis causing irreparable
More informationDyslipidemia Endothelial dysfunction Free radicals Immunologic
ATHEROSCLEROSIS Hossein Mehrani Professor of Clinical Biochemistry Definition Atherosclerosis: Is a chronic inflammatory process characterized by plaque formation within the vessel wall of arteries and
More informationCoronary Heart Disease. Raja Nursing Instructor RN, DCHN, Post RN. BSc.N
Coronary Heart Disease Raja Nursing Instructor RN, DCHN, Post RN. BSc.N 31/03/2016 Objectives Define coronary heart disease (CHD). Identify the causes and risk factors of CHD Discuss the pathophysiological
More informationLaboratory diagnosis of heart diseases: Cardiometabolic risk AMI Heart failure
Laboratory diagnosis of heart diseases: 2017 Cardiometabolic risk AMI Heart failure 2 Suggested Risk Factors for CVD LDL Oxidation LDL-C Anti-OxLDL OxLDL LDL Oxid. Lag Time Negative LDL HDL-C Paraoxonase
More informationCardiovascular Disorders Lecture 3 Coronar Artery Diseases
Cardiovascular Disorders Lecture 3 Coronar Artery Diseases By Prof. El Sayed Abdel Fattah Eid Lecturer of Internal Medicine Delta University Coronary Heart Diseases It is the leading cause of death in
More informationChest pain affects 20% to 40% of the general population during their lifetime.
Chest pain affects 20% to 40% of the general population during their lifetime. More than 5% of visits in the emergency department, and up to 40% of admissions are because of chest pain. Chest pain is a
More informationAcute Myocardial Infarction
Acute Myocardial Infarction Hafeza Shaikh, DO, FACC, RPVI Lourdes Cardiology Services Asst.Program Director, Cardiology Fellowship Associate Professor, ROWAN-SOM Acute Myocardial Infarction Definition:
More informationDiagnosis and Management of Acute Myocardial Infarction
Diagnosis and Management of Acute Myocardial Infarction Acute Myocardial Infarction (AMI) occurs as a result of prolonged myocardial ischemia Atherosclerosis leads to endothelial rupture or erosion that
More informationMeasuring Natriuretic Peptides in Acute Coronary Syndromes
Measuring Natriuretic Peptides in Acute Coronary Syndromes Peter A. McCullough, MD, MPH, FACC, FACP, FAHA, FCCP Consultant Cardiologist Chief Academic and Scientific Officer St. John Providence Health
More informationMyocardial Infarction
Myocardial Infarction MI = heart attack Defined as necrosis of heart muscle resulting from ischemia. A very significant cause of death worldwide. of these deaths, 33% -50% die before they can reach the
More information1) Severe, crushing substernal chest pain 2) radiate to the neck, jaw, epigastrium, or left arm. 3- rapid and weak pulse 4- nausea (posterior MI).
1) Severe, crushing substernal chest pain 2) radiate to the neck, jaw, epigastrium, or left arm. 3- rapid and weak pulse 4- nausea (posterior MI). 5- cardiogenic shock (massive MIs >40% of the left ventricle)
More informationIschemic heart disease
Ischemic heart disease Introduction In > 90% of cases: the cause is: reduced coronary blood flow secondary to: obstructive atherosclerotic vascular disease so most of the time it is called: coronary artery
More informationCardiac Pathology & Rehabilitation
Cardiac Pathology & Rehabilitation Which of the following best describes the physical activity performed in my leisure time? A. I perform vigorous physical activity 3X/week for 20 minutes each time B.
More informationBIOCHEMICAL INVESTIGATIONS IN THE DIAGNOSTICS OF CARDIOVASCULAR DISORDERS. As. MARUSHCHAK M.I.
BIOCHEMICAL INVESTIGATIONS IN THE DIAGNOSTICS OF CARDIOVASCULAR DISORDERS As. MARUSHCHAK M.I. Heart attack symptoms Acute MI Measurement of cardiac enzyme levels Measure cardiac enzyme levels at regular
More informationHeart disease remains the leading cause of morbidity and mortality in industrialized nations. It accounts for nearly 40% of all deaths in the United
Heart disease remains the leading cause of morbidity and mortality in industrialized nations. It accounts for nearly 40% of all deaths in the United States, totaling about 750,000 individuals annually
More informationObjectives. Acute Coronary Syndromes; The Nuts and Bolts. Overview. Quick quiz.. How dose the plaque start?
Objectives Acute Coronary Syndromes; The Nuts and Bolts Michael P. Gulseth, Pharm. D., BCPS Pharmacotherapy II Spring 2006 Compare and contrast pathophysiology of unstable angina (UA), non-st segment elevation
More informationBiomarkers of myocardial infarction. Dr. Mamoun Ahram Cardiovascular system, 2013
Biomarkers of myocardial infarction Dr. Mamoun Ahram Cardiovascular system, 2013 References This lecture Hand-outs Acute Myocardial Infarction A rapid development of myocardial necrosis caused by prolonged
More informationIschaemic Heart Disease
Ischaemic Heart Disease Katherine Rothwell Case 1 65 yr old female PMHx : Eczema, is a smoker 20/day Comes to see you complaining of central chest pain Present past few months. Comes on when gardening
More informationLecture 8 Cardiovascular Health Lecture 8 1. Introduction 2. Cardiovascular Health 3. Stroke 4. Contributing Factors
Lecture 8 Cardiovascular Health 1 Lecture 8 1. Introduction 2. Cardiovascular Health 3. Stroke 4. Contributing Factors 1 Human Health: What s Killing Us? Health in America Health is the U.S Average life
More informationAcute coronary syndromes
Acute coronary syndromes 1 Acute coronary syndromes Acute coronary syndromes results primarily from diminished myocardial blood flow secondary to an occlusive or partially occlusive coronary artery thrombus.
More informationArteriosclerosis & Atherosclerosis
Arteriosclerosis & Atherosclerosis Arteriosclerosis = hardening of arteries = arterial wall thickening + loss of elasticity 3 types: -Arteriolosclerosis -Monckeberg medial sclerosis -Atherosclerosis Arteriosclerosis,
More informationCurrent Utilities of Cardiac Biomarker Testing at POC. June 24, 2010 Joe Pezzuto, MT (ASCP) Carolyn Kite, RN
Current Utilities of Cardiac Biomarker Testing at POC June 24, 2010 Joe Pezzuto, MT (ASCP) Carolyn Kite, RN 1. Discuss challenges associated with diagnosing Acute Coronary Syndromes (ACS) and Heart Failure
More informationChest pain management. Ruvin Gabriel and Niels van Pelt August 2011
Chest pain management Ruvin Gabriel and Niels van Pelt August 2011 Introduction Initial assessment Case 1 Case 2 and 3 Comparison of various diagnostic techniques Summary 1-2 % of GP consultations are
More informationIn the name of GOD. Animal models of cardiovascular diseases: myocardial infarction & hypertension
In the name of GOD Animal models of cardiovascular diseases: myocardial infarction & hypertension 44 Presentation outline: Cardiovascular diseases Acute myocardial infarction Animal models for myocardial
More informationUPDATE ON THE MANAGEMENTACUTE CORONARY SYNDROME. DR JULES KABAHIZI, Psc (Rwa) Lt Col CHIEF CONSULTANT RMH/KFH 28 JUNE18
UPDATE ON THE MANAGEMENTACUTE CORONARY SYNDROME DR JULES KABAHIZI, Psc (Rwa) Lt Col CHIEF CONSULTANT RMH/KFH 28 JUNE18 INTRODUCTION The clinical entities that comprise acute coronary syndromes (ACS)-ST-segment
More informationClassification of lab tests useful in cardiac disease Biochemical markers in Acute Coronary Syndromes (ACS) Redefinition of Myocardial Infarction (MI)
Biochemical Markers in Cardiac Injury Dr Sami Saeed Assistant Professor/Consultant Chemical Pathologist Foundation University Medical College Fauji Foundation Hospital Rawalpindi Email: drsami@comsats.net.pk
More informationTo estimate the serum level of N-terminal pro-brain natriuretic peptide levels in acute coronary syndrome
Original Research Article To estimate the serum level of N-terminal pro-brain natriuretic peptide levels in acute coronary syndrome Mohamed Yasar Arafath 1, K. Babu Raj 2* 1 First Year Post Graduate, 2
More informationFastTest. You ve read the book now test yourself
FastTest You ve read the book...... now test yourself To ensure you have learned the key points that will improve your patient care, read the authors questions below. The answers will refer you back to
More informationPathophysiology of Cardiovascular System. Dr. Hemn Hassan Othman, PhD
Pathophysiology of Cardiovascular System Dr. Hemn Hassan Othman, PhD hemn.othman@univsul.edu.iq What is the circulatory system? The circulatory system carries blood and dissolved substances to and from
More informationIschaemic heart disease. IInd Chair and Clinic of Cardiology
Ischaemic heart disease IInd Chair and Clinic of Cardiology Definition Syndrome due to chronic insufficient oxygen supply to myocardial cells Nomenclature: ischaemic heart disease (IHD), coronary artery
More informationBiomarkers of Cardiovascular diseases. By Dr. Gouse Mohiddin Shaik
Biomarkers of Cardiovascular diseases By Dr. Gouse Mohiddin Shaik In this section we will discuss Introduction Types of CVD CVD biomarkers Future CVD biomarkers Introduction CVD is the one of the leading
More informationPart 1 Risk Factors and Atherosclerosis. LO1. Define the Different Forms of CVD
Week 3: Cardiovascular Disease Learning Outcomes: 1. Define the difference forms of CVD 2. Describe the various risk factors of CVD 3. Describe atherosclerosis and its stages 4. Describe the role of oxidation,
More informationThe Value of Stress MRI in Evaluation of Myocardial Ischemia
The Value of Stress MRI in Evaluation of Myocardial Ischemia Dr. Saeed Al Sayari, MBBS, EBCR, MBA Department of Radiology and Nuclear Medicine Mafraq Hospital, Abu Dhabi United Arab Emirates Introduction
More informationCardiac Pathology 2: Heart Failure, Ischemic Heart Disease and other assorted stuff. Kris=ne Kra>s, M.D.
Cardiac Pathology 2: Heart Failure, Ischemic Heart Disease and other assorted stuff Kris=ne Kra>s, M.D. Cardiac Pathology Outline Blood Vessels Heart I Heart II Cardiac Pathology Outline Blood Vessels
More informationHeart Disorders. Cardiovascular Disorders (Part B-1) Module 5 -Chapter 8. Overview Heart Disorders Vascular Disorders
Cardiovascular Disorders (Part B-1) Module 5 -Chapter 8 Overview Heart Disorders Vascular Disorders Susie Turner, MD 1/7/13 Heart Disorders Coronary Artery Disease Cardiac Arrhythmias Congestive Heart
More informationNATIONAL INSTITUTE FOR HEALTH AND CLINICAL EXCELLENCE Centre for Clinical Practice
NATIONAL INSTITUTE FOR HEALTH AND CLINICAL EXCELLENCE Centre for Clinical Practice Review consultation document Review of Clinical Guideline (CG95) Chest pain of recent onset: Assessment and diagnosis
More information10/8/2018. Lecture 9. Cardiovascular Health. Lecture Heart 2. Cardiovascular Health 3. Stroke 4. Contributing Factor
Lecture 9 Cardiovascular Health 1 Lecture 9 1. Heart 2. Cardiovascular Health 3. Stroke 4. Contributing Factor 1 The Heart Muscular Pump The Heart Receives blood low pressure then increases the pressure
More informationHealth and Disease of the Cardiovascular system
1 Health and Disease of the Cardiovascular system DR CHRIS MOORE Instructions 2 USE THE ARROWS TO NAVIGATE, OR TAP OUTLINE AT THE TOP TO BRING DOWN A SLIDE MENU Click these where you see them to zoom or
More informationMYOCARDIALINFARCTION. By: Kendra Fischer
MYOCARDIALINFARCTION By: Kendra Fischer Outline Definition Epidemiology Clinical Aspects Treatment Effects of Exercise Exercise Testing Exercise Rx Summary and Conclusions References Break it down MYOCARDIAL
More information1/3/2008. Karen Burke Priscilla LeMone Elaine Mohn-Brown. Medical-Surgical Nursing Care, 2e Karen Burke, Priscilla LeMone, and Elaine Mohn-Brown
Medical-Surgical Nursing Care Second Edition Karen Burke Priscilla LeMone Elaine Mohn-Brown Chapter 26 Caring for Clients with Coronary Heart Disease and Dysrhythmias Coronary Heart Disease (CHD) Leading
More informationChest Pain. Dr Robert Huggett Consultant Cardiologist
Chest Pain Dr Robert Huggett Consultant Cardiologist Outline Diagnosis of cardiac chest pain 2016 NICE update on stable chest pain Assessment of unstable chest pain/acs and MI definition Scope of the
More informationCHAPTER-I MYOCARDIAL INFARCTION
CHAPTER-I MYOCARDIAL INFARCTION Definition A myocardial infarction, more commonly known as MI or acute myocardial infarction (AMI) or heart attack is a condition where there is interruption of blood supply
More informationAcute Coronary Syndrome. Emergency Department Updated Jan. 2017
Acute Coronary Syndrome Emergency Department Updated Jan. 2017 Goals and Objectives To reduce mortality and morbidity for people who have cardiovascular disease, with a focus on those who experience an
More informationHEART AND SOUL STUDY OUTCOME EVENT - MORBIDITY REVIEW FORM
REVIEW DATE REVIEWER'S ID HEART AND SOUL STUDY OUTCOME EVENT - MORBIDITY REVIEW FORM : DISCHARGE DATE: RECORDS FROM: Hospitalization ER Please check all that may apply: Myocardial Infarction Pages 2, 3,
More informationBiomarkers in Acute Cardiac Disease Samir Arnaout, M.D.FESC Associate Professor of Medicine Internal Medicine i & Cardiology American University of Beirut Time course of the appearance of various markers
More informationHeart failure congestive heart failure, or CHF
Heart failure Heart failure (also called congestive heart failure, or CHF) is a frequent end point of many of the conditions In the United States alone, CHF affects nearly 5 million individuals annually,
More informationCardiac Pathophysiology
Cardiac Pathophysiology Evaluation Components Medical history Physical examination Routine laboratory tests Optional tests Medical History Duration and classification of hypertension. Patient history of
More informationLAB 4: THE MUSCLE AND CARDIOVASCULAR SYSTEM THE MUSCLE AND CARDIOVASCULAR SYSTEM
LAB 4: THE MUSCLE AND CARDIOVASCULAR SYSTEM THE MUSCLE AND CARDIOVASCULAR SYSTEM The focus of this week s lab will be pathology of the cardiovascular system. The cardiovascular system is composed of the
More informationHypertension Coronary artery disease
Hypertension Coronary artery disease 1 Problem Magnitude Hypertension( HTN) is the most common primary diagnosis. Worldwide prevalence estimates for HTN may be as much as 1 billion. Arterial hypertension
More informationIschemic Heart Diseases. Dr. Nabila Hamdi MD, PhD
Ischemic Heart Diseases Dr. Nabila Hamdi MD, PhD ILOs Compare and contrast the different types of angina regarding their pathogenesis, clinical manifestations and evolution. Discuss myocardial infarct,
More informationINFLAMM-O-WARS ACTIVITY 4B. Clumps and Bumps: A Look at Atherosclerosis. Student Activity Page 4B. Introduction. Background A LOOK AT ATHEROSCLEROSIS
Clumps and Bumps: A Look at Atherosclerosis Student Activity Page 4B Introduction Chances are that every one in your class knows somebody who has had a heart attack, but how many really understand what
More informationBIOCHEMICAL EXAMINATION OF ACUTE MYOCARDIAL INFARCTION. Written by Lenka Fialová, translated by Jan Pláteník
BIOCHEMICAL EXAMINATION OF ACUTE MYOCARDIAL INFARCTION 1 Structure of heart muscle Written by Lenka Fialová, translated by Jan Pláteník Heart muscle (myocardium) is a particular form of striated muscle,
More informationCho et al., 2009 Journal of Cardiology (2009), 54:
Endothelial Dysfunction, Increased Carotid Artery Intima-media Thickness and Pulse Wave Velocity, and Increased Level of Inflammatory Markers are Associated with Variant Angina Cho et al., 2009 Journal
More informationPATIENTS AND METHODS:
BACKGROUND: Rheumatoid arthritis (RA) is a chronic systemic inflammatory disease characterized by erosive synovitis that involves peripheral joints and implicates an important influence in the quality
More informationCardiovascular Diseases and Diabetes
Cardiovascular Diseases and Diabetes LEARNING OBJECTIVES Ø Identify the components of the cardiovascular system and the various types of cardiovascular disease Ø Discuss ways of promoting cardiovascular
More informationThe focus of this week s lab will be pathology of the cardiovascular system.
LAB 3: THE MUSCLE AND CARDIOVASCULAR SYSTEM The focus of this week s lab will be pathology of the cardiovascular system. The cases we will cover are: A. Atherosclerosis Refer to virtual slide p_8, should
More informationThe 10 th International & 15 th National Congress on Quality Improvement in Clinical Laboratories
The 10 th International & 15 th National Congress on Quality Improvement in Clinical Laboratories Cardiac biomarkers in atherosclerosis Najma Asadi MD-APCP Ross and Colleagues in 1973: Response to Injury
More informationEDUCATIONAL COMMENTARY CARDIAC FUNCTION: BIOCHEMICAL MARKERS UPDATE
EDUCATIONAL COMMENTARY CARDIAC FUNCTION: BIOCHEMICAL MARKERS UPDATE Educational commentary is provided through our affiliation with the American Society for Clinical Pathology (ASCP). To obtain FREE CME/CMLE
More informationSupplementary Table 1. Details of the components of the primary composite endpoint
Supplementary Table 1. Details of the components of the primary composite endpoint 1. Death The cause of death will be defined by the underlying cause, not the immediate mode of death. Death will be classified
More informationMWLCEMS SYSTEM Continuing Education Packet Management of the Acute MI Patient
MWLCEMS SYSTEM Continuing Education Packet Management of the Acute MI Patient In this CE we will discuss the patient presenting with an acute ST-Elevation Myocardial Infarction (STEMI) Definition: Myocardial
More informationPharmacology. Drugs affecting the Cardiovascular system (Antianginal Drugs)
Lecture 7 (year3) Dr Noor Al-Hasani Pharmacology University of Baghdad College of dentistry Drugs affecting the Cardiovascular system (Antianginal Drugs) Atherosclerotic disease of the coronary arteries,
More informationIschemic heart disease (IHD) Dr: Salah Ahmed
Ischemic heart disease (IHD) Dr: Salah Ahmed The coronaries: 1- Left anterior descending coronary artery: - supplies anterior portion of LV, anterior 2/3 of IVS - accounts for 40-50% of coronary artery
More informationATHEROSCLEROSIS زيد ثامر جابر. Zaid. Th. Jaber
ATHEROSCLEROSIS زيد ثامر جابر Zaid. Th. Jaber Objectives 1- Review the normal histological features of blood vessels walls. 2-define the atherosclerosis. 3- display the risk factors of atherosclerosis.
More informationBLOOD PRESSURE. Unit 3: Transportation and Respiration
BLOOD PRESSURE Unit 3: Transportation and Respiration Blood Pressure The force of your blood pushing on the walls of your arteries. How is Blood Pressure Measured? Measured at an artery in the arm and
More informationObserve the effects of atherosclerosis on the coronary artery lumen
Clumps and Bumps: A Look at Atherosclerosis Activity 4B Activity Description This activity features actual photomicrographs of coronary artery disease in young people aged 18 24 years. Students will observe
More informationChest pain and troponins on the acute take. J N Townend Queen Elizabeth Hospital Birmingham
Chest pain and troponins on the acute take J N Townend Queen Elizabeth Hospital Birmingham 3 rd Universal Definition of Myocardial Infarction Type 1: Spontaneous MI related to atherosclerotic plaque rupture
More informationATHEROSCLEROSIS. Secondary changes are found in other coats of the vessel wall.
ATHEROSCLEROSIS Atherosclerosis Atherosclerosis is a disease process affecting the intima of the aorta and large and medium arteries, taking the form of focal thickening or plaques of fibrous tissue and
More informationUnit 1: Human Systems. The Circulatory System
Unit 1: Human Systems The Circulatory System nourish all cells with oxygen, glucose, amino acids and other nutrients and carry away carbon dioxide, urea and other wastes Purposes Transport chemical messengers
More informationECG in coronary artery disease. By Sura Boonrat Central Chest Institute
ECG in coronary artery disease By Sura Boonrat Central Chest Institute EKG P wave = Atrium activation PR interval QRS = Ventricle activation T wave= repolarization J-point EKG QT interval Abnormal repolarization
More informationElectrocardiography. Hilal Al Saffar College of Medicine,Baghdad University
Electrocardiography Hilal Al Saffar College of Medicine,Baghdad University Which of the following is True 1. PR interval, represent the time taken for the impulse to travel from SA node to AV nose. 2.
More informationAIMS: CHEST PAIN. Causes of chest pain. Causes of chest pain: Cardiac causes: Acute coronary syndromes pericarditis thoracic aortic dissection
CHEST PAIN Dr Susan Hertzberg Emergency Department Prince of Wales Hospital AIMS: To identify causes of chest pain in patients presenting to the ED. To identify and risk stratify patients presenting with
More informationPrehospital and Hospital Care of Acute Coronary Syndrome
Ischemic Heart Diseases Prehospital and Hospital Care of Acute Coronary Syndrome JMAJ 46(8): 339 346, 2003 Katsuo KANMATSUSE* and Ikuyoshi WATANABE** * Professor, Second Internal Medicine, Nihon University,
More informationHeart Disease. Signs and Symptoms
Heart Disease The term "heart disease" refers to several types of heart conditions. The most common type is coronary artery disease, which can cause heart attack, angina, heart failure, and arrhythmias.
More informationLnformation Coverage Guidance
Lnformation Coverage Guidance Coverage Indications, Limitations, and/or Medical Necessity Abstract: B-type natriuretic peptide (BNP) is a cardiac neurohormone produced mainly in the left ventricle. It
More informationTROPONIN POSITIVE 2/20/2015 WHAT DOES IT MEAN? When should a troponin level be obtained?
TROPONIN POSITIVE WHAT DOES IT MEAN? Frequently Asked Questions Regarding the Use of Troponin in the Clinical Setting What does an elevated troponin level mean? Elevated troponin is a sensitive and specific
More informationThe Universal Definition of Myocardial Infarction 3 rd revision, 2012
The Universal Definition of Myocardial Infarction 3 rd revision, 2012 Joseph S. Alpert, MD Professor of Medicine, University of Arizona College of Medicine, Tucson, AZ; Editor-in-Chief, American Journal
More informationYOUR INFORMATION. Ischemic Heart Disease
YOUR INFORMATION Ischemic Heart Disease ISCHEMIC HEART DISEASE Your diagnosis You have been given a diagnosis of heart failure, which usually means your heart is working inefficiently. This inefficiency
More informationAcute Coronary Syndrome
ACUTE CORONOARY SYNDROME, ANGINA & ACUTE MYOCARDIAL INFARCTION Administrative Consultant Service 3/17 Acute Coronary Syndrome Acute Coronary Syndrome has evolved as a useful operational term to refer to
More informationPractitioner Education Course
2015 Practitioner Education Course ST Elevation Myocardial Infarction 2 Pathology Concept of vulnerable plaque Mild Atheroma Diagnosis IVUS OCT 3 Diagnosis This is based on : Clinical History ECG Changes.
More informationChapter 18. Diet and Health
Chapter 18 Diet and Health Risk Factors and Chronic Diseases Interrelationships among Chronic Diseases Chronic Disease Heart Disease and Stroke Hypertension Cancer Diabetes The Formation of Plaques in
More informationCardiovascular Concerns in Intermediate Care
Cardiovascular Concerns in Intermediate Care GINA ST. JEAN RN, MSN, CCRN-CSC CLINICAL NURSE EDUCATOR HEART AND & CRITICAL AND INTERMEDIATE CARE Objectives: Identify how to do a thorough assessment of the
More informationChest Pain Accreditation ACS Education
Chest Pain Accreditation ACS Education Objectives Recognize the Typical and Atypical Signs and Symptoms of ACS Recognize Gender and Age Differences of ACS Recognize the Risk Factors of ACS Understand Early
More informationCLINICAL OUTCOME Vs SURROGATE MARKER
CLINICAL OUTCOME Vs SURROGATE MARKER Statin Real Experience Dr. Mostafa Sherif Senior Medical Manager Pfizer Egypt & Sudan Objective Difference between Clinical outcome and surrogate marker Proper Clinical
More informationPyruvate + NADH + H + ==== Lactate + NAD +
1 UNIVERSITY OF PAPUA NEW GUINEA SCHOOL OF MEDICINE AND HEALTH SCIENCES DIVISION OF BASIC MEDICAL SCIENCES DISCIPLINE OF BIOCHEMISTRY AND MOLECULAR BIOLOGY PBL SEMINAR ANAEROBIC METABOLISM - An Overview
More informationClinical Policy: Cardiac Biomarker Testing for Acute Myocardial Infarction Reference Number: CP.MP.156
Clinical Policy: Reference Number: CP.MP.156 Effective Date: 12/17 Last Review Date: 12/17 See Important Reminder at the end of this policy for important regulatory and legal information. Description The
More informationHypertension The normal radial artery blood pressures in adults are: Systolic arterial pressure: 100 to 140 mmhg. Diastolic arterial pressure: 60 to
Hypertension The normal radial artery blood pressures in adults are: Systolic arterial pressure: 100 to 140 mmhg. Diastolic arterial pressure: 60 to 90 mmhg. These pressures are called Normal blood pressure
More informationWe are IntechOpen, the world s leading publisher of Open Access books Built by scientists, for scientists. International authors and editors
We are IntechOpen, the world s leading publisher of Open Access books Built by scientists, for scientists 3,900 116,000 120M Open access books available International authors and editors Downloads Our
More informationContinuing Medical Education Post-Test
Continuing Medical Education Post-Test Based on the information presented in this monograph, please choose one correct response for each of the following questions or statements. Record your answers on
More informationNormal blood vessels A= artery V= vein
Normal blood vessels A= artery V= vein Artery (A) versus vein (V) ARTERIOSCLEROSIS Arteriosclerosis ="hardening of the arteries" arterial wall thickening and loss of elasticity. Three patterns are recognized,
More informationΒΙΟΔΕΙΚΤΕΣ ΣΤΗΝ ΚΑΡΔΙΑΚΗ ΑΝΕΠΑΡΚΕΙΑ. ΔΗΜΗΤΡΙΟΣ ΤΟΥΣΟΥΛΗΣ Καθηγητής Καρδιολογίας
ΕΘΝΙΚΟ ΚΑΙ ΚΑΠΟΔΙΣΤΡΙΑΚΟ ΠΑΝΕΠΙΣΤΗΜΙΟ ΑΘΗΝΩΝ ΙΑΤΡΙΚΗ ΣΧΟΛΗ Ά ΚΑΡΔΙΟΛΟΓΙΚΗ ΚΛΙΝΙΚΗ Διευθυντής: Καθηγητής Δημήτριος Τούσουλης ΒΙΟΔΕΙΚΤΕΣ ΣΤΗΝ ΚΑΡΔΙΑΚΗ ΑΝΕΠΑΡΚΕΙΑ ΔΗΜΗΤΡΙΟΣ ΤΟΥΣΟΥΛΗΣ Καθηγητής Καρδιολογίας
More informationCirculation and Cardiac Emergencies. Emergency Medical Response
Circulation and Cardiac Emergencies Lesson 19: The Circulatory System and Cardiac Emergencies You Are the Emergency Medical Responder You are called to the home of a 50-year-old man whose wife called 9-1-1
More informationWHI Form Report of Cardiovascular Outcome Ver (For items 1-11, each question specifies mark one or mark all that apply.
WHI Form - Report of Cardiovascular Outcome Ver. 6. COMMENTS To be completed by Physician Adjudicator Date Completed: - - (M/D/Y) Adjudicator Code: OMB# 095-044 Exp: 4/06 -Affix label here- Clinical Center/ID:
More informationStructure and organization of blood vessels
The cardiovascular system Structure of the heart The cardiac cycle Structure and organization of blood vessels What is the cardiovascular system? The heart is a double pump heart arteries arterioles veins
More informationMyocardial infarction
CHAPTER-I CARDIOVASCULAR SYSTEM Myocardial infarction SUB: PHARMACOTHERAPEUTICS-I CODE:T0820006 Dr. Venugopal Pharm.D Assistant Professor Department of Pharm.D Kriahna Teja Pharmacy College,Tirupati. Definition
More information