Friday, 20 December 2013

Cardiac markers for MI

Things you should know about
Cardiac markers for MI:
1)... Myoglobin first comes and first goes (rises first, disappears first)
2)...LDH is called "lazy enzyme" because it comes late, and goes late (rises after 24 hours and remain till
14 days)
3)...Trop-I has the greatest sensitivity and specificity.
4)...The investigation of choice within first hour of MI is "CKMB"
5)..."CKMB" is useful for confirmation of reinfarction as this enzyme disappears after 72 hours of MI. So, if a patient comes after 72 hours of initial infarction, and you are suspecting a reinfarction, go for "CKMB".
- Myoglobin disappears after 24 to 48 hours.
- CKMB disappears after 72 hours.
- Trop I disappears after 7 - 10 days.
- LDH disappears after 14 days.
Scenerio 1: CKMB of patient is normal. Trop-I is raised. He is 3 - 10 days post MI patient.
Scenerio 2: CKMB and trop - I of patient is normal. LDH is raised. He is 10 - 14 days MI patient.

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