ST elevation myocardial infarction cardiac markers: Difference between revisions

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{{Infobox_Disease |
#redirect:[[ST elevation myocardial infarction diagnostic criteria#Biomarkers in the Diagnosis of MI]]
  Name          = Myocardial infarction|
  Image          = |
  Caption        = |
  DiseasesDB    = 8664 |
  ICD10          = {{ICD10|I|21||i|20}}-{{ICD10|I|22||i|20}} |
  ICD9          = {{ICD9|410}} |
  ICDO          = |
  OMIM          = |
  MedlinePlus    = 000195 |
  eMedicineSubj  = med |
  eMedicineTopic = 1567 |
  eMedicine_mult = {{eMedicine2|emerg|327}} {{eMedicine2|ped|2520}} |
  MeshID        = |
}}
{{SI}}
{{WikiDoc Cardiology Network Infobox}}
{{CMG}}
 
'''Associate Editor-In-Chief:''' {{CZ}}
 
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===Cardiac markers===
{{main|Cardiac marker}}
 
Cardiac markers or cardiac enzymes are proteins from cardiac tissue found in the blood. These proteins are released into the bloodstream when damage to the heart occurs, as in the case of a myocardial infarction. Until the 1980s, the enzymes [[Aspartate transaminase|SGOT]] and [[lactate dehydrogenase|LDH]] were used to assess cardiac injury. Then it was found that disproportional elevation of the ''MB'' subtype of the enzyme [[creatine kinase]] (CK) was very specific for myocardial injury. Current guidelines are generally in favor of [[troponin]] sub-units I or T, which are very specific for the heart muscle and are thought to rise before permanent injury develops.<ref>{{cite journal | author = Eisenman A | title = Troponin assays for the diagnosis of myocardial infarction and acute coronary syndrome: where do we stand? | journal = Expert Rev Cardiovasc Ther | volume = 4 | issue = 4 | pages = 509-14 | year = 2006 | id = PMID 16918269}}</ref> Elevated troponins in the setting of chest pain may accurately predict a high likelihood of a myocardial infarction in the near future.<ref>{{cite journal | author = Aviles RJ, Askari AT, Lindahl B, Wallentin L, Jia G, Ohman EM, Mahaffey KW, Newby LK, Califf RM, Simoons ML, Topol EJ, Berger P, Lauer MS | title = [[Troponin]] T levels in patients with acute coronary syndromes, with or without renal dysfunction. | journal = N Engl J Med | volume = 346 | issue = 26 | pages = 2047-52 | year = 2002 | id = PMID 12087140}}. [http://www.cmaj.ca/cgi/content/full/167/6/671 Summary for laymen]</ref>
 
The diagnosis of myocardial infarction requires two out of three components (history, ECG, and enzymes).  When damage to the heart occurs, levels of cardiac markers rise over time, which is why [[blood test]]s for them are taken over a 24 hour period. Because these enzyme levels are not elevated immediately following a heart attack, patients presenting with chest pain are generally treated with the assumption that a myocardial infarction has occurred and then evaluated for a more precise diagnosis.<ref name="Braunwald-2002">{{cite journal | author=Braunwald E, Antman EM, Beasley JW, Califf RM, Cheitlin MD, Hochman JS, Jones RH, Kereiakes D, Kupersmith J, Levin TN, Pepine CJ, Schaeffer JW, Smith EE III, Steward DE, Théroux P. | title=ACC/AHA 2002 guideline update for the management of patients with unstable angina and non–ST-segment elevation myocardial infarction: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee on the Management of Patients With Unstable Angina). | journal=J Am Coll Cardiol | year=2002 | volume=40 | pages=1366-74 | id=PMID 12383588 | format=PDF | url=http://www.acc.org/qualityandscience/clinical/guidelines/unstable/incorporated/UA_incorporated.pdf}}</ref>
 
 
==References==
{{reflist|2}}
 
==External links==
* [http://www.themdtv.org The MD TV: Comments on Hot Topics, State of the Art Presentations in Cardiovascular Medicine, Expert Reviews on Cardiovascular Research]
* [http://www.clinicaltrialresults.org Clinical Trial Results: An up to dated resource of Cardiovascular Research]
* [http://hp2010.nhlbihin.net/atpiii/calculator.asp?usertype=pub Risk Assessment Tool for Estimating Your 10-year Risk of Having a Heart Attack] - based on information of the [[Framingham Heart Study]], from the United States [[National Heart, Lung and Blood Institute]]
* [http://www.nlm.nih.gov/medlineplus/heartattack.html Heart Attack] - overview of resources from [[MedlinePlus]].
* [http://ww2.heartandstroke.ca/Page.asp?PageID=1975&ArticleID=5288 Heart Attack Warning Signals] from the Heart and Stroke Foundation of Canada
* [http://www.regionalpci-stemi.org/index.html Regional PCI for STEMI Resource Center] - Evidence based online resource center for the development of regional PCI networks for acute STEMI
* [http://www.stemisystems.org/ STEMI Systems] - Articles, profiles, and reviews of the latest publications involved in STEMI care. Quarterly newsletter.
* [http://d2b.acc.org/ American College of Cardiology (ACC) Door to Balloon (D2B) Initiative.]
* [http://www.americanheart.org/heartattack American Heart Association's Heart Attack web site] - Information and resources for preventing, recognizing and treating heart attack.
 
{{Electrocardiography}}
{{Circulatory system pathology}}
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[[Category:Cardiology]]
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Latest revision as of 18:54, 10 August 2012