ALU 301: Chapter 6: An Underwriter's Guide to Cardiac Diagnostic Testing with Complete Solutions.

Heart "Clicks" - ANSWER-Most often associated with Mitral Valve Prolapse test. Bayes' Theorem - ANSWER-"Conditional probability" - a ration method to minimize the diagnostic uncertainty (i.e. false positives and false negatives) surrounding cardiac testing. The results of one cardiac test can be used to improve the accuracy of the tests that follow. Benefits of Bayes' Theorem - ANSWER-It provides a much more rational approach allowing the risk assessment to start with some simple parameters such as age, sex, and the results of routine underwriting, and to use those results to help understand the risk when more powerful cardiac testing has also been performed. Most basic cardiac diagnostic workup - ANSWER-The history and physical taken by a physician. Most valuable element of the physical exam? - ANSWER-Auscultation with the stethoscope. By listening for the timing and intensity of heart sounds, the physician can detect the various murmurs associated with heart disease. Heart murmurs - ANSWER-Diagnosed with a stethoscope and can be systolic, diastolic or continuous. Murmur grades - ANSWER-Grade 1: Barely audible with utmost concentration Grade 2: Soft, but easily heard Grade 3: Loud without thrill Grade 4: Loud with thrill Grade 5: Loud, heard with barely any contact between stethoscope and chest wall Grade 6: Loud, heard with stethoscope off the chest wall Pericardial friction rub - ANSWER-A superficial, high-pitched, or scratchy sound that is diagnostic of pericarditis. Gallop rhythms - ANSWER-Soft, low-pitched sounds that can be normal if found in young, health individuals, but are at times indicative of serious hypertensive disease, cardiac dysfunction, or early heart failure. Troponins - ANSWER-Troponin I and T are integral part of the contractile apparatus of heart and normally only present in trace quantities. When increased, troponins are the most sensitive and specific biomarkers for myocardial damage and can be elevated when other biomarkers are not. Creatine Phosphokinase (CPK) - ANSWER-Usually elevated at the time of acute MI