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Cardiac Function

QuestionAnswer
Myoglobin, creatine kinase (CK) and lactate dehydrogenase (LD), AST =Markers of cardiac injury Damage to the myocardium results in the release of these proteins into the circulation!
History of chest pain (clinical symptoms) Abnormal electrocardiogram (ECG) Rise and fall of cardiac markers in serum Diagnosis of MI
Necrosis (death) of an area of the heart muscle produces a Q wave on ECG
STEMI (ST elevation MI): severe! Coronary artery completely blocked by clot. Traditional AMI! Cardiac necrosis, DEATH NSTEMI (non-ST elevation MI): artery only partially blocked, less severe, tracings also seen in unstable angina
Biomarkers released into circulation from damaged myocytes: AST , LD and its isoenzymes Then CK and one of its fractions CK-MB
CK-MB: in AMI rises w/in 4-6h, peaks 12-24h, normal 2-3 days
Cardiac Proteins Myoglobin Cardiac troponins troponin T (cTnT) troponin I (cTnI) Cardiac myosin light chains CK isoforms
Myoglobin: Rises: w/in 2-4h, Peaks: 6-12h, Normal : 24-36h nonspec marker -Known as an EARLY marker! If normal after 8h, patient did NOT have an MI -used to RULE-OUT MI (↑helps to rule-in MI)
cTnI/cTnT: Rises: w/in 4-6h, Peaks: 24h, Normal : 3-7d (up to 14d) Used to RULE-IN AMI cTnI/T are SPECIFIC Markers
Cardiac Troponins Used in identification of unstable angina No AMI but persistent small increase helps to rule-in UA
BNP stimulates Na+ and water loss through kidneys (to relieve ventricular wall stretch and expanded fluid volume associated with CHF) Increases renal flow and GFR Discovered to be a marker for CHF!
Created by: mastergogo