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Unformatted text preview: e following ► Coronary artery emboli, secondary to cholesterol, air, or the products of sepsis ► Cocaine, amphetamines, and ephedrine ► Arteritis ► Coronary anomalies, including aneurysms of the coronary arteries ► Increased afterload or inotropic effects, which increase the demand on the myocardium Causes continued ► Risk factors for atherosclerotic plaque formation include the following: Age Male gender Smoking Hypercholesterolemia and hypertriglyceridemia, including inherited lipoprotein disorders Diabetes mellitus Poorly controlled hypertension Type A personality Family history Sedentary lifestyle Diagnosis of AMI ( Acute Myocardial Infarction ) Cardiac disease is the #1 cause of death in the United States #1 Symptoms, physical examination , and patient history but there are many causes of chest pain other than AMI #2 EKG … only 50% reliable ­ may be normal even during AMI #3 Laboratory tests (Troponin I , CKMB , Myoglobin , BNP) Cardiac cellular necrosis following ischemic event causes soluble proteins to “leak” into the plasma When coronary arteries are blocked (ischemic event ) cardiac tissue is deprived of oxygen and dies, and dead cardiac tissue cells “spill their guts” into the plasma Lab Studies: Lab Studies: Myoglobin ► ► ► ► ► Soluble heme protein Present in all muscle cells, cardiac and skeletal Plasma myoglobin is elevated in various forms of muscle damage ­ surgery, strenuous exercise, degenerative muscle diseases and physical trauma Myoglobin can also be elevated from decreased renal clearance Relatively low molecular weight , water solubility and high cellular cytoplasm concentrations cause myoglobin to...
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