Cardiac Evaluation

Authors
Affiliations

Nate Yomogida, B.S., SPT

Doctor of Physical Therapy

B.S. in Kinesiology

Chloë Kerstein, B.S., SPT

Doctor of Physical Therapy

B.A. in Neuroscience

Dr. Tuttle’s preffered Tests

Subjective

The subjective should be performed initially and you should instruct the patient to alert you if their symptoms change

  • Ask pt about chest pain:
    • Location, radiation
    • Character, quality
    • Frequency
    • Aggravating and alleviating factors
    • Precipitating factors

Physical Exam

Observation

  • Skin: Facial color, skin color, tone, diaphoresis
  • Edema in extremities
  • Respiratory rate, ease of respiration

Palpation

  • Pulses - quality, HR, rhythm
  • Pitting edema

Blood pressure

  • Multiple positions
  • Document

Diagnostic and laboratory measures

Oximetry

ECG

Complete blood count (CBC)

Coagulation profiles

  • Prothrombin time (PT)
    • If someone has a PT of 2.5 = HIGHER risk of bleeding (keep in mind to not bump them into anything or fall)
  • Partial thromboplastin time (PTT)
  • INR: International normalized ratio

    • 3 = bleeding risk

Blood lipids

  • May be falsely elevated after MI for 6 weeks

C-reactive protein (CRP)

C-Reactive Protein (CRP) serum amount is a marker of acute inflammation

Interpertation of CRP Values
Value Risk
<1mg/L Low
1.0 - 3.0 mg/L Average
>3.0 mg/L High

Test validity: High sensitivity CRP (hs-CRP) = predictive of recurrent coronary events

More biochemical markers

Citation

For attribution, please cite this work as: