Ventricular tachycardia laboratory findings: Difference between revisions
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Serial [[cardiac enzymes]], [[serum electrolytes]] as well as [[calcium]], [[magnesium]] and [[phosphate]] levels, should be obtained. A toxicology screen should also be obtained to assess for illicit drugs as the cause of the VT, as well as levels of medications that may have caused the VT. | Serial [[cardiac enzymes]], [[serum electrolytes]] as well as [[calcium]], [[magnesium]] and [[phosphate]] levels, should be obtained. A toxicology screen should also be obtained to assess for illicit drugs as the cause of the VT, as well as levels of medications that may have caused the VT. | ||
==Laboratory Findings== | ==Laboratory Findings== | ||
* Elevated levels of [[natriuretic peptides—B-type]] (BNP) or N-terminal pro-[[BNP]] are associated with increased risk of [[sudden cardiac death]] and [[ventricular tachycardia]], particularly in high risk [[ischemic heart disease]] and [[heart failure]] [[patients]]. | * Elevated levels of [[natriuretic peptides—B-type]] (BNP) or N-terminal pro-[[BNP]] are associated with increased risk of [[sudden cardiac death]] and [[ventricular tachycardia]], particularly in high risk [[ischemic heart disease]] and [[heart failure]] [[patients]].<ref name="AhmadFiuzat2014">{{cite journal|last1=Ahmad|first1=Tariq|last2=Fiuzat|first2=Mona|last3=Neely|first3=Benjamin|last4=Neely|first4=Megan L.|last5=Pencina|first5=Michael J.|last6=Kraus|first6=William E.|last7=Zannad|first7=Faiez|last8=Whellan|first8=David J.|last9=Donahue|first9=Mark P.|last10=Piña|first10=Ileana L.|last11=Adams|first11=Kirkwood F.|last12=Kitzman|first12=Dalane W.|last13=O'Connor|first13=Christopher M.|last14=Felker|first14=G. Michael|title=Biomarkers of Myocardial Stress and Fibrosis as Predictors of Mode of Death in Patients With Chronic Heart Failure|journal=JACC: Heart Failure|volume=2|issue=3|year=2014|pages=260–268|issn=22131779|doi=10.1016/j.jchf.2013.12.004}}</ref> | ||
* Ionized [[calcium]] levels along with [[magnesium]] and [[phosphate]] levels should be obtained.<ref name="pmid3337132">{{cite journal |vauthors=Tchou P, Young P, Mahmud R, Denker S, Jazayeri M, Akhtar M |title=Useful clinical criteria for the diagnosis of ventricular tachycardia |journal=Am. J. Med. |volume=84 |issue=1 |pages=53–6 |date=January 1988 |pmid=3337132 |doi=10.1016/0002-9343(88)90008-3 |url=}}</ref><ref name="pmid4709549">{{cite journal |vauthors=Lown B, Temte JV, Arter WJ |title=Cardiac arrhythmias. 6. Ventricular tachyarrhythmias. Clinical aspects |journal=Circulation |volume=47 |issue=6 |pages=1364–81 |date=June 1973 |pmid=4709549 |doi=10.1161/01.cir.47.6.1364 |url=}}</ref> | * Ionized [[calcium]] levels along with [[magnesium]] and [[phosphate]] levels should be obtained.<ref name="pmid3337132">{{cite journal |vauthors=Tchou P, Young P, Mahmud R, Denker S, Jazayeri M, Akhtar M |title=Useful clinical criteria for the diagnosis of ventricular tachycardia |journal=Am. J. Med. |volume=84 |issue=1 |pages=53–6 |date=January 1988 |pmid=3337132 |doi=10.1016/0002-9343(88)90008-3 |url=}}</ref><ref name="pmid4709549">{{cite journal |vauthors=Lown B, Temte JV, Arter WJ |title=Cardiac arrhythmias. 6. Ventricular tachyarrhythmias. Clinical aspects |journal=Circulation |volume=47 |issue=6 |pages=1364–81 |date=June 1973 |pmid=4709549 |doi=10.1161/01.cir.47.6.1364 |url=}}</ref> | ||
Revision as of 04:17, 17 May 2021
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Ventricular tachycardia Microchapters |
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Differentiating Ventricular Tachycardia from other Disorders |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Serial cardiac enzymes, serum electrolytes as well as calcium, magnesium and phosphate levels, should be obtained. A toxicology screen should also be obtained to assess for illicit drugs as the cause of the VT, as well as levels of medications that may have caused the VT.
Laboratory Findings
- Elevated levels of natriuretic peptides—B-type (BNP) or N-terminal pro-BNP are associated with increased risk of sudden cardiac death and ventricular tachycardia, particularly in high risk ischemic heart disease and heart failure patients.[1]
- Hypocalcemia, hypokalemia, and hypomagnesemia make patients vulnerable to monomorphic VT or torsade de pointes.
- Diuretic usage can lead to hypokalemia which can provoke ventricular tachycardia.
- Cardiac troponin I and cardiac troponin T levels along with CK-MB and LDH can help access myocardial ischemia or infarction.
- Digoxin and tricyclic antidepressant blood levels should be ordered.
- Sometimes recreational drugs like cocaine, can result in ventricular tachycardia so a toxicology screen should also be obtained.
| Laboratory Pearls for Ventricular Tachycardia | |
|---|---|
| Electrolytes | Hypokalemia and hypomagnesemia frequently associated with torsades de pointes |
| Troponin I | Elevated in myocardial infarction |
| Creatine-kinase MB | Elevated in myocardial infarction |
References
- ↑ Ahmad, Tariq; Fiuzat, Mona; Neely, Benjamin; Neely, Megan L.; Pencina, Michael J.; Kraus, William E.; Zannad, Faiez; Whellan, David J.; Donahue, Mark P.; Piña, Ileana L.; Adams, Kirkwood F.; Kitzman, Dalane W.; O'Connor, Christopher M.; Felker, G. Michael (2014). "Biomarkers of Myocardial Stress and Fibrosis as Predictors of Mode of Death in Patients With Chronic Heart Failure". JACC: Heart Failure. 2 (3): 260–268. doi:10.1016/j.jchf.2013.12.004. ISSN 2213-1779.
- ↑ Tchou P, Young P, Mahmud R, Denker S, Jazayeri M, Akhtar M (January 1988). "Useful clinical criteria for the diagnosis of ventricular tachycardia". Am. J. Med. 84 (1): 53–6. doi:10.1016/0002-9343(88)90008-3. PMID 3337132.
- ↑ Lown B, Temte JV, Arter WJ (June 1973). "Cardiac arrhythmias. 6. Ventricular tachyarrhythmias. Clinical aspects". Circulation. 47 (6): 1364–81. doi:10.1161/01.cir.47.6.1364. PMID 4709549.