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Myocardial Infarction: Difference between revisions
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→Cardiac Markers
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== Cardiac Markers == | == Cardiac Markers == | ||
Cardiac markers are essential in order to confirm the diagnosis of MI, indicated by elevated Creatine Kinase isoenzyme MB (CK MB) and/or (high-sensitive) troponins. Troponins are more specific and sensitive than CK MB. The cardiac troponin concentration begins to rise around 4 hours after the onset of myocardial cell damage. <Cite>REFNAME12</Cite> | Cardiac markers are essential in order to confirm the diagnosis of MI, indicated by elevated Creatine Kinase isoenzyme MB (CK MB) and/or (high-sensitive) troponins. Troponins are more specific and sensitive than CK MB. The cardiac troponin concentration begins to rise around 4 hours after the onset of myocardial cell damage. <Cite>REFNAME12</Cite> | ||
With high-sensitive troponins, myocardial cell damage can be detected even earlier. | With high-sensitive troponins, myocardial cell damage can be detected even earlier. | ||
It can take 4-6 hours before the CK MB concentration is elevated. Serial measurements are advised in order to estimate infarct size and increase the sensitivity of the (older) assays. <Cite>REFNAME13</Cite> | It can take 4-6 hours before the CK MB concentration is elevated. Serial measurements are advised in order to estimate infarct size and increase the sensitivity of the (older) assays. <Cite>REFNAME13</Cite> | ||
A pitfall concerning mildly elevated cardiac markers can be patients with renal failure or pulmonary embolism. <Cite>REFNAME14</Cite> Although cardiac markers are helpful for confirming the diagnosis, reperfusion should not always wait till the cardiac markers are known if the ECG or symptoms are evident. | |||
A pitfall concerning mildly elevated cardiac markers can be patients with renal failure or pulmonary embolism. <Cite>REFNAME14</Cite> Although cardiac markers are helpful for confirming the diagnosis, reperfusion should not always wait till the cardiac markers are known if the ECG or symptoms are evident. | |||
== Treatment == | == Treatment == | ||