While a 67-year-old female is shopping for groceries, she faints and falls. She is driven home by a friend. When home, she realizes that she is bleeding from her mouth and is slightly disoriented. She appears injured from the fall, but she does not remember tripping or falling. The woman is taken to a local emergency department. The examining physician determines that there was a loss of consciousness. To determine the reason, he orders head CT and ECG and the following laboratory tests: CBC, PT, aPTT, CK, LDH, AST, and troponin T and troponin I. All tests are within normal limits. The woman is sutured for the mouth injuries and admitted to a 24-hour observation unit.
Questions:
1. What possible diagnoses is the physician considering?
2. What tests would be elevated at 6, 12, and 24 hours if this patient had an AMI?
3. What laboratory tests would be useful with this patient?