Cardiovascular Diseases and Heart Evaluation Tests
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Questions and Answers

Which bacteria are commonly associated with endocarditis?

  • Escherichia coli
  • Viridans Streptococci (correct)
  • Corynebacterium diphtheriae
  • Clostridium perfringens
  • What is a common complication of pericarditis?

  • Valvular prolapse
  • Cardiac tamponade (correct)
  • Arrhythmia
  • Pulmonary embolism
  • What is typically used to confirm a diagnosis of myocarditis?

  • Blood cultures
  • Echocardiogram
  • Electrocardiogram (ECG)
  • Cardiac MRI (correct)
  • Which of the following is NOT a cause of congestive heart failure (CHF)?

    <p>Asthma</p> Signup and view all the answers

    What is the primary mechanism that leads to damage in myocarditis?

    <p>Lymphocyte infiltration</p> Signup and view all the answers

    Which of the following diagnostic tests is essential for diagnosing endocarditis?

    <p>Blood cultures from 2 separate sites</p> Signup and view all the answers

    What is a characteristic symptom of congestive heart failure (CHF)?

    <p>Shortness of breath</p> Signup and view all the answers

    Which condition is primarily indicated by inflammation of the endocardium?

    <p>Endocarditis</p> Signup and view all the answers

    What is the primary function of troponins in the context of cardiac biomarkers?

    <p>Proteins involved in muscle contraction</p> Signup and view all the answers

    How long do troponins I remain elevated after myocardial injury?

    <p>7-10 days</p> Signup and view all the answers

    Which cardiac biomarker rises early, generally within 2-3 hours after cardiac muscle damage?

    <p>Myoglobin</p> Signup and view all the answers

    Which cardiac biomarker is known to be the most specific for myocardial injury?

    <p>Troponin I</p> Signup and view all the answers

    What is the primary limitation of myoglobin as a cardiac biomarker?

    <p>It has low specificity for cardiac muscle damage</p> Signup and view all the answers

    Which biomarker is considered a marker of inflammation and indicates the presence of atherosclerotic plaque?

    <p>C-reactive protein</p> Signup and view all the answers

    What is the main characteristic of lactate dehydrogenase as a cardiac biomarker?

    <p>Non-specific and rarely used to diagnose myocardial infarction</p> Signup and view all the answers

    What is a distinguishing feature of creatine kinase MB compared to troponins?

    <p>It can be useful for diagnosing reinfarction</p> Signup and view all the answers

    What is the role of the tricuspid and bicuspid (mitral) valves in the heart?

    <p>They prevent backflow of blood.</p> Signup and view all the answers

    Which component is primarily measured by an electrocardiogram (ECG)?

    <p>Electrical changes in the myocardium.</p> Signup and view all the answers

    What does the QRS complex represent in an ECG?

    <p>Ventricular depolarization.</p> Signup and view all the answers

    How does hypocalcemia affect an ECG reading?

    <p>It lengthens the S-T segment.</p> Signup and view all the answers

    What is the primary purpose of an electrocardiogram (ECG/EKG) in diagnosing myocardial infarction (MI)?

    <p>To record the electrical activity of the heart</p> Signup and view all the answers

    Which of the following is a major risk factor for myocardial infarction (MI)?

    <p>Smoking and family history.</p> Signup and view all the answers

    Which of the following statements about cardiac markers is true?

    <p>Troponins I and T are specific markers for MI diagnosis.</p> Signup and view all the answers

    What is the primary cause of myocardial infarction?

    <p>Blockage of coronary arteries.</p> Signup and view all the answers

    What feature is characteristic of stable angina pectoris?

    <p>Typically triggered by physical exertion and stress</p> Signup and view all the answers

    What happens to the heart during the resting state of cardiac cells?

    <p>Cells remain polarized.</p> Signup and view all the answers

    What is a common consequence of unstable plaques in coronary arteries?

    <p>Formation of clots leading to thrombosis.</p> Signup and view all the answers

    What describes the role of an echocardiogram in myocardial infarction diagnosis?

    <p>It provides insights into heart's pumping ability.</p> Signup and view all the answers

    Which type of myocardial infarction is characterized by ST-segment elevation?

    <p>ST-segment elevation myocardial infarction (STEMI)</p> Signup and view all the answers

    Why might an angiogram be used in the diagnosis of myocardial infarction?

    <p>To detect blockages in the arterial system</p> Signup and view all the answers

    During an angina episode, what typical ECG change may be observed?

    <p>ST-segment depression</p> Signup and view all the answers

    What differentiates unstable angina from stable angina?

    <p>Unstable angina is a medical emergency with chest pain at rest.</p> Signup and view all the answers

    What is the significance of the P wave in an electrocardiogram (ECG)?

    <p>It indicates atrial depolarization.</p> Signup and view all the answers

    Hypokalemia can cause which of the following changes in an electrocardiogram?

    <p>Flattened T wave.</p> Signup and view all the answers

    Which of the following factors is NOT typically included in cardiac risk assessment?

    <p>Duration of exercise routine.</p> Signup and view all the answers

    What is the primary role of natriuretic peptides in cardiac function?

    <p>To control blood pressure and fluid balance.</p> Signup and view all the answers

    Which of the following correctly describes the QRS complex in an electrocardiogram?

    <p>It shows ventricular depolarization.</p> Signup and view all the answers

    What is the consequence of unstable plaques in coronary arteries?

    <p>Increased risk of thrombosis.</p> Signup and view all the answers

    Which of the following best describes myocardial infarction?

    <p>It results in the death of cardiac muscle due to ischemia.</p> Signup and view all the answers

    Which electrolyte imbalance is associated with a prolonged S-T segment on an ECG?

    <p>Hypocalcemia.</p> Signup and view all the answers

    What is a common triggering factor for endocarditis in individuals with pre-existing heart conditions?

    <p>Congenital heart defects</p> Signup and view all the answers

    Which type of inflammation primarily affects the myocardium?

    <p>Myocarditis</p> Signup and view all the answers

    What serious complication can arise from severe myocarditis?

    <p>Myocardial infarction (MI)</p> Signup and view all the answers

    What is a common diagnostic method for pericarditis?

    <p>Echocardiography</p> Signup and view all the answers

    Which condition is characterized by fluid accumulation in the lungs and extremities?

    <p>Congestive heart failure (CHF)</p> Signup and view all the answers

    Which of the following is NOT commonly associated with myocarditis?

    <p>Congenital heart defects</p> Signup and view all the answers

    Which diagnostic test is useful for assessing inflammatory conditions such as myocarditis?

    <p>White blood cell count</p> Signup and view all the answers

    What is a consequence of stasis of blood in the context of congestive heart failure?

    <p>Fluid retention</p> Signup and view all the answers

    What is the primary role of an electrocardiogram (ECG) in the diagnosis of myocardial infarction (MI)?

    <p>Record the electrical activity of the heart</p> Signup and view all the answers

    Which cardiac marker appears in the blood first following a myocardial infarction?

    <p>Myoglobin</p> Signup and view all the answers

    Which of the following statements is true regarding an echocardiogram as a diagnostic tool for myocardial infarction?

    <p>It provides valuable insights but is not the primary diagnostic tool.</p> Signup and view all the answers

    Which type of myocardial infarction is associated with ST-segment elevation?

    <p>ST-segment elevation myocardial infarction (STEMI)</p> Signup and view all the answers

    What is a common misconception about the presence of ECG changes during a myocardial infarction?

    <p>30% of patients may not exhibit ECG changes during an MI.</p> Signup and view all the answers

    What would an angiogram typically be used to identify in the context of coronary artery disease?

    <p>The arterial blockages in the coronary arteries</p> Signup and view all the answers

    Which characteristic symptom is commonly associated with myocardial infarction?

    <p>Severe crushing central chest pain</p> Signup and view all the answers

    In the context of myocardial ischemia, what commonly occurs during unstable angina?

    <p>Chest pain at rest, signaling a medical emergency</p> Signup and view all the answers

    What does an elevation of troponins I or T levels greater than 0.01 ng/mL indicate when accompanied by cardiac symptoms?

    <p>Myocardial injury</p> Signup and view all the answers

    How long can troponin T remain elevated after a myocardial injury?

    <p>7-10 days</p> Signup and view all the answers

    Which cardiac biomarker is associated with inflammation but lacks specificity?

    <p>C-reactive protein (CRP)</p> Signup and view all the answers

    What is a key characteristic of myoglobin as a cardiac biomarker?

    <p>Its elevation indicates damage proportional to the muscle affected.</p> Signup and view all the answers

    Which enzyme is predominantly found in the myocardium and can indicate myocardial infarction when elevated?

    <p>Creatine kinase MB</p> Signup and view all the answers

    What is the primary function of troponins in myocardial cells?

    <p>Facilitating skeletal muscle contractions</p> Signup and view all the answers

    Which cardiac biomarker rises early, typically within 2-3 hours after muscle damage but is not specific to cardiac tissue?

    <p>Myoglobin</p> Signup and view all the answers

    What is the typical rise time of creatine kinase MB levels after a myocardial infarction?

    <p>Within 3-4 hours</p> Signup and view all the answers

    Study Notes

    Cardiovascular Diseases and Evaluation Tests

    • This presentation covers various cardiovascular diseases and the tests used to evaluate them.

    Heart Structure

    • The heart has four chambers: two atria and two ventricles.
    • Tricuspid and mitral (bicuspid) valves regulate blood flow.
    • Veins carry blood to the heart.
    • Arteries carry blood away from the heart.

    Heart Blood Flow

    • Blood flows through the heart in a specific pathway, involving the atria and ventricles.
    • Coronary arteries supply blood to the heart muscle itself.
    • Specific coronary arteries are named, like the left coronary artery and its branches (circumflex, left anterior descending, obtuse marginal arteries) and right coronary artery and its branches (acute marginal artery).

    Electrocardiogram (ECG/EKG)

    • An ECG records electrical changes in the myocardium (heart muscle) during a cardiac cycle.
    • These changes are detectable on the body's surface, using electrodes placed on the skin.
    • The ECG instrument measures small electrical changes and shows deflections (electrical impulses) in the heart.
    • The time between deflections represents phases in the cardiac cycle.
    • The baseline is the time between heartbeats.

    Electrocardiogram (Detailed)

    • Heart cells remain polarized between cardiac cycles – their resting state.
    • A triggered impulse causes atrial cells to depolarize, first shown as a P wave.
    • Depolarization of ventricular cells is shown as a large QRS complex.
    • Repolarization of ventricular cells is associated with a T wave.

    Impact of Electrolytes on ECG

    • Potassium imbalances (hypokalemia and hyperkalemia) affect the ECG.
    • Calcium imbalances (hypocalcemia and hypercalcemia) also affect the ECG, specifically the S-T segment.

    Cardiac Risk Assessment

    • Risk factors (age, sex, blood pressure, smoking, and family history) influence cardiac risk.
    • Lipid profiles (cholesterol, LDL-C, HDL-C, triglycerides) are assessed.
    • Fasting blood glucose (or hemoglobin A1c) levels are crucial.
    • Natriuretic peptides indicate heart function and fluid balance.
    • Troponin levels help diagnose myocardial infarction (MI).

    Myocardial Infarction (MI)

    • Also known as a heart attack.
    • Occurs due to necrosis from ischemia, characterized by blockage in coronary arteries.
    • Symptoms include chest pain, shortness of breath, dizziness, and nausea.
    • A primary cause is coronary artery blockage.

    Pathology of MI

    • Atherosclerosis (inflammatory process) is a common cause of MI.
    • Progressive narrowing of arterial lumen reduces coronary perfusion, causing chest pain.
    • Unstable plaques can rupture, causing clot formation (thrombosis).
    • Sudden occlusion of the artery results in myocardial infarction.

    Cardiac Biomarkers

    • Useful for detecting myocardial cell death.
    • Troponins, proteins involved in muscle contraction, rise within hours of cardiac injury and remain elevated for days.
    • Troponin I is often used as a more specific marker than Troponin T.
    • Myoglobin is another cardiac biomarker that rises early but is not as specific.
    • Creatine kinase MB (CK-MB) is also used but is less specific than troponins.
    • Lactate dehydrogenase (LDH) rises later. The highly sensitive troponin assays are available earlier to detect a cardiac event and troponins I or T reference is < 0.01 ng/mL.
    • C-reactive protein (CRP) measures inflammation, which may be connected with atherosclerosis and increased risk of MI.

    MI Diagnosis - Other Tools

    • Electrocardiogram (ECG) records the heart's electrical activity and is useful to diagnose MI (ST-segment elevation or Q-waves).
    • Echocardiogram is an ultrasound technique used to assess heart function.
    • Angiogram detects arterial blockages using contrast dye and x-rays.

    MI Diagnosis

    • History (symptoms) informs the diagnosis.
    • ECG changes (ST-segment elevation, Q waves) can indicate MI.
    • Blood markers (troponins, CK-MB, myoglobin) help diagnose MI and quantify muscle damage.
    • Each marker (troponin, CK-MB, myoglobin, etc.) appears in the blood at a different time from onset of MI, so a comprehensive assessment is key for diagnosis.
    • A patient may not show specific ECG changes (30%).

    Angina Pectoris

    • Stable angina is chest pain due to reduced coronary blood flow, often triggered by physical activity or stress.
    • Symptoms may subside with rest or medication.
    • Unstable angina presents with similar symptoms but may occur at rest and is a medical emergency.
    • ECG changes associated with angina typically show ST-segment depression.

    Acute Coronary Syndrome (ACS)

    • ACS encompasses conditions where myocardial ischemia is possible (lack of blood flow to the heart).
    • ST-segment elevation myocardial infarction (STEMI) is a severe type of ACS, often indicating a complete blockage.
    • Non-ST-segment elevation myocardial infarction (NSTEMI) is a less severe type of ACS.
    • Unstable angina is also a possibility.

    Endocarditis

    • Infection of the inner lining of the heart chambers and valves (endocardium).
    • Commonly caused by bacteria (streptococci, staphylococcus aureus, enterococcus).
    • Diagnosis involves clinical evaluation, blood cultures, CRP, and echocardiography to confirm the infection.

    Myocarditis

    • Inflammation of the heart muscle (myocardium).
    • Often associated with viral infections, drugs, and autoimmune diseases.
    • Can lead to heart damage and possibly MI or stroke.

    Pericarditis

    • Inflammation of the pericardium (the outer lining of the heart).
    • Common causes include infection, trauma, cancer, and medications.
    • Complications can include cardiac tamponade (fluid buildup compressing the heart).

    Diagnosis of Endocarditis, Myocarditis and Pericarditis

    • Blood cultures, white blood cell count, troponin and myoglobin levels, antibody titers, and imaging techniques (like echocardiograms and cardiac MRIs) to potentially aid in diagnosis.

    Congestive Heart Failure (CHF)

    • Progressive disease where the heart loses its ability to efficiently pump blood.
    • Causes include hypertension, heart valve disease, and cardiomyopathies. Ultimately, blood can not be effectively pumped to tissues.
    • Stasis (stagnation) in blood vessels and fluid accumulation in the body (lungs, extremities) lead symptoms like shortness of breath, fatigue, and swelling (edema).

    Congestive Heart Failure (CHF) - Diagnosis

    • Diagnosis involves symptoms evaluation, echocardiography (a detailed study of heart's electrical activity), chest X-ray for fluid status, ECG for electrical activity, and biochemical tests of blood pressure measurements, electrolytes (Na and K), natriuretic peptide (BNP) levels, and kidney function (BUN, creatinine).

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    Description

    This quiz explores various cardiovascular diseases alongside the evaluation tests used to diagnose them. Key topics include heart structure, blood flow pathways, and the role of electrocardiograms in assessing heart health. Test your knowledge on the anatomy and functions of the heart, along with the tools for monitoring cardiovascular health.

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