1. The Cardiovascular System

2. Laboratory Test 1. To assist Diagnosing MI 2. To identify abnormalities 3. To assess inflammation 4. To determine baseline values 5. To Monitor serum level medication 6. To assess effects of medication

3. The Cardiac protiens 1. Creatine Kinase (CK-MB) 2. Myoglobin 3. Troponin T 4. Troponin I

4. 12 Lead Electrocardiogram - An ECG is a surface record of the electrical activity of the heart. -The purpose of which is to determine areas of myocardial ischemia,injury or necrosis, cardiac irregularities and electrolytes balance.

5. ECHOCARDIOGRAPHY - It is a non-invasive cardiac procedure that records and reflects mechanical cardiac activity. - Used to detect valvular/structural anomalies, ventricular wall thickness, decreased or absent wall movement, ventricular ejection fraction, intramural thromboses.

6. Stress Test - A noninvasive test that studies the heart during activity and detects and evaluates CAD. It has 3 ways; Exercise Test, phramacologic Test and Emotional test.

7. - This is the most commonly used type to determine CAD, Chest Pain,drug effects and dysrrhythmias in exercise. Exercise Test

8. Pre-test 1. Consent maybe required 2. Adequate rest 3. Eat a light meal or fast for 4 hours 4. Avoid smoking, alcohol and caffeine.

9. Post Test 1. Instruct to report adverse effect of the Exercise test. 2. Instruct to avoid taking hot shower for 10-12 hours after the test.

10. Pharmacologic Test -Use of Dipyridamole to maximally dilate the coronary artery.

11. Pre-Test 1. Requires 4 hours fasting 2. Avoid alcohol and caffeine POST TEST 1. Reports symptoms of chest pain.

12. Cardiac Catheterization - involves insertion of a catheter into a heart and surrounding vessels. -Determines the structure of and performance of the heart valves and surrounding vessels. -Used to diagnose CAD, Assess coronary artery patency and determine extent of atheroclerosis.

13. Pretest 1. Ensure Consent 2. Assess for allergy to seafoods and Iodine. 3. NPO 4. Document weight and height 5. Baseline V/S, Blood test and document peripheral pulses.

14. Intratest 1. Instruct patient about a fluterry feeling as a catheter is passed through the heart. 2. Infrom the patient that a feeling of warmth and metallic taste may occur as dye is administered.

15. POST TEST 1. Monitor V/S and cardiac Rhythm. 2. Monitor peripheral pulses,color, and warmth and sensation of the extremity distal to insertion site. 3. Maintain sand bag to the insertion site. 4. Monitor for bleeding and Hematoma formation.

16. 5. Maintain bed rest for 6-12 hours 6. Elevate head of bed. 7. Legs should always be straight. 8. Encourage fluid intake to flush out dye. 9. Immobilize the antecubital vein if used. 10. Monitor for Dye allergy.

17. HEMODYNAMIC MONITORING