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Lecture 12

Cardiac Markers

Historically the clinical diagnosis of an acute MI requires two of what three findings Chest pain, Characteristic EKG changes, and increased serum enzymes
Diseases affecting cardiac muscle cause an increase in what CK enzymes CK MM and MB (MI, Trauma to the heart)
Disorders affecting the skeletal muscle cause an increase in what CK enzymes CK MM (Dystrophies, trauma, Hypothyroid, stroke, psychoisis)
Diseases affecting smooth muscle cause and increase in what CK enzymes Increased CKBB (labor and delivery, Intestinal infarct, shock)
How long after the onset of symptoms (of MI) do CK and CKMB become abnormal 8 hours (peak within 36 hours)
when do CK enzymes return to normal after a MI within 2-3 days
what is the most sensitive and specific marker for a MI Cardiac troponin I and T
When do cardiac troponins increase after symptoms of an MI about 8 hours after symptoms
how long do troponins remain increased after a MI 7-10 days (continued release not delayed clearance)
When do CK markers prove more useful than troponins when you need to detect re-infarct in the acute >3 <10 day period following a MI
How specific are troponins for coronary artery etiologies of myocardial infarction they are not specific for coronary artery etiologies of myocardial disease they are increased in cardiac conditions that are associated with myocardial injury such as heart failure and cardiomyopathies
when are natriuretic peptides A and B increased in serum in chronic heart failure secondary to enhanced atrial and ventricular synthesis
where are B-type natriuretic peptides found in the brain and ventricles of the heart (released in response to ventricular overload)
where are c-type natriuretic peptides found in the brain and CNS released in response to endothelial stress
When is BNP used in diagnosis of heart failure in ED patients, Monitoring therapy of heart failure, prognosis in acute coronary syndromes
Where is CRP produced in the liver
when is CRP increased with inflammation (used as a nonspecific test for infection)
How can CRP be used to assess risk of MI atherosclerosis increases CRP
Created by: UVAPATH3