Chest pain laboratory findings: Difference between revisions
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==Laboratory Findings== | ==Laboratory Findings== | ||
On the basis of the above, a number of tests may be ordered: | On the basis of the above, a number of tests may be ordered: <ref name="pmid25737484">{{cite journal |vauthors=Mahler SA, Riley RF, Hiestand BC, Russell GB, Hoekstra JW, Lefebvre CW, Nicks BA, Cline DM, Askew KL, Elliott SB, Herrington DM, Burke GL, Miller CD |title=The HEART Pathway randomized trial: identifying emergency department patients with acute chest pain for early discharge |journal=Circ Cardiovasc Qual Outcomes |volume=8 |issue=2 |pages=195–203 |date=March 2015 |pmid=25737484 |pmc=4413911 |doi=10.1161/CIRCOUTCOMES.114.001384 |url=}}</ref><ref name="pmid27353283">{{cite journal |vauthors=Hollander JE |title=Managing Troponin Testing |journal=Ann Emerg Med |volume=68 |issue=6 |pages=690–694 |date=December 2016 |pmid=27353283 |doi=10.1016/j.annemergmed.2016.05.023 |url=}}</ref><ref name="pmid27528647">{{cite journal |vauthors=Hollander JE, Than M, Mueller C |title=State-of-the-Art Evaluation of Emergency Department Patients Presenting With Potential Acute Coronary Syndromes |journal=Circulation |volume=134 |issue=7 |pages=547–64 |date=August 2016 |pmid=27528647 |doi=10.1161/CIRCULATIONAHA.116.021886 |url=}}</ref> | ||
====Cardiac Markers==== | ====Cardiac Markers==== | ||
*[[ | *High sensitivity [[troponin]] I or T are the [[cardiac]] markers of choice and are preferred over [[creatine kinase]]. | ||
*No one marker gives accurate diagnosis so commonly two markers are used for instance | *No one marker gives accurate diagnosis so commonly two markers are used for instance [[troponin I]] or T with [[creatine kinase]] (and CK-MB fraction in many hospitals) | ||
====Blood Tests==== | ====Blood Tests==== | ||
Latest revision as of 23:32, 14 December 2021
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Aisha Adigun, B.Sc., M.D.[2]
Overview
Serial troponins and CK-MB should be ordered. Additional laboratory tests include serum electrolytes, a complete blood count, renal function tests, and liver function tests.
Laboratory Findings
On the basis of the above, a number of tests may be ordered: [1][2][3]
Cardiac Markers
- High sensitivity troponin I or T are the cardiac markers of choice and are preferred over creatine kinase.
- No one marker gives accurate diagnosis so commonly two markers are used for instance troponin I or T with creatine kinase (and CK-MB fraction in many hospitals)
Blood Tests
- D-dimer (when suspicion for pulmonary embolism, aortic dissection)
- Complete blood count may be elevated in infectious causes of chest pain such as pericarditis, pneumonia, mediastinitis.
- BNP and NT-proBNP may help recognize or eliminate heart failure as a cause of chest pain in a presenting patient.
- Arterial blood gas may be done if pulmonary embolism is a differential diagnosis in a patient presenting with chest pain.
- Electrolytes
- Renal function (creatinine)
- Liver function tests
References
- ↑ Mahler SA, Riley RF, Hiestand BC, Russell GB, Hoekstra JW, Lefebvre CW, Nicks BA, Cline DM, Askew KL, Elliott SB, Herrington DM, Burke GL, Miller CD (March 2015). "The HEART Pathway randomized trial: identifying emergency department patients with acute chest pain for early discharge". Circ Cardiovasc Qual Outcomes. 8 (2): 195–203. doi:10.1161/CIRCOUTCOMES.114.001384. PMC 4413911. PMID 25737484.
- ↑ Hollander JE (December 2016). "Managing Troponin Testing". Ann Emerg Med. 68 (6): 690–694. doi:10.1016/j.annemergmed.2016.05.023. PMID 27353283.
- ↑ Hollander JE, Than M, Mueller C (August 2016). "State-of-the-Art Evaluation of Emergency Department Patients Presenting With Potential Acute Coronary Syndromes". Circulation. 134 (7): 547–64. doi:10.1161/CIRCULATIONAHA.116.021886. PMID 27528647.