A patient was admitted within 60 minutes of experiencing a severe crushing chest pain. An ECG showed ST segment elevation. Results were as follows (reference ranges in parenthesis). Serum Analyte Result Reference Interval Total CK 167 U/L <175 CK-MB activity 8.5 <10 CK-MB to Total CPK ratio 4.8 <5.0 Troponin I 0.2 μg/L <0.1 (<99th percentile) LDH 130 U/L <200 AST 38 U/L 10-40 Myoglobin 143 ng/mL 0-85 Is this most likely a skeletal muscle problem or a cardiac problem? Does the patient meet the criteria for a myocardial infarction (MI)?
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The patient experienced severe crushing chest pain and the ECG showed ST segment elevation, which is indicative of a myocardial infarction (MI). Show more…
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Sri K.
CASE STUDY 26.2 A 59-year-old woman came to the emergency department of a local hospital complaining of pain and a feeling of heaviness in her abdomen for several days. She reported no weakness, chest pain, or left arm pain. She has no chronic health problems except for seasonal allergies and slightly elevated total cholesterol. 8:30 PM, April 11 6:30 AM, April 12 Cardiac Enzymes Total CK (54-186 U/L) 170 106 CK-MB (0-5 ng/mL) 6.3 3.8 % CK-MB (<6%) 3.7 3.6 Myoglobin (<70 ug/L) 52 41 Troponin T (0-0.1 ug/L) 0.8 2.3 Questions: 1. Do the symptoms and personal history of this patient suggest acute MI? 2. Based on the preceding laboratory data, would this diagnosis be acute MI? 3. Why or why not?
Josee P.
CASE STUDY 26.2 A 59-year-old woman came to the emergency department of a local hospital complaining of pain and a feeling of heaviness in her abdomen for several days. She reported no weakness, chest pain, or left arm pain. She has no chronic health problems except for seasonal allergies and slightly elevated total cholesterol. 8:30 PM, April 11 6:30 AM, April 12 Cardiac Enzymes Total CK (54-186 U/L) 170 106 CK-MB (0-5 ng/mL) 6.3 3.8 % CK-MB (<6%) 3.7 3.6 Myoglobin (<70 ng/L) 52 41 Troponin T (0-0.1 pg/L) 0.8 2.3 Questions: 1. Do the symptoms and personal history of this patient suggest acute MI? Based on the preceding laboratory data, would this diagnosis be acute MI? 3. Why or why not?
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