Makindo Medical Notes"One small step for man, one large step for makindo" |
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Related Subjects: |Atherosclerosis |Ischaemic heart disease |Assessing Chest Pain |ACS - General |ACS - STEMI |ACS - NSTEMI |ACS - GRACE Score |ACS - ECG Changes |ACS -Cardiac Troponins |ACS - Post MI arrhythmias |ACS: Right Ventricular Infarction
Troponins begin to be released within minutes of myocardial damage. Take a troponin at time 0 and at 6-12 hours.
Other causes of elevated Troponin |
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Cardiac Biomarkers | |
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Creatinine Phosphokinase (CK) | Rises in 4-8 hrs. Peaks Day 1 at 16h and normalises at 3 days. Isoenzyme CKMB is myocardial specific |
Myoglobin | Rises in 4 hrs. Peaks < 12hrs and normalises at 24 hrs |
Troponin | Rises in 3-12 hrs. Peaks at 24h and normalises at 10 days. There are new highly sensitive forms and troponin I/T has replaced all others. Can be elevated in non-primary cardiac conditions - elderly, sepsis, CKD, AKI. Despite this they are the biomarker of choice in the assessment of ACS. |
Lactate Dehydrogenase (LDH) | Rises in 12 hrs. Peaks at 48h and normalises at 14 days. Nonspecific marker of tissue damage. |