Ventricular tachycardia laboratory findings
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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
Common laboratory findings predicting sudden cardiac arrest and ventricular tachycardia include:
- Elevated level of Natriuretic peptides—B-type (BNP) or N-terminal pro-BNP as the marker of myocardial stress and fibrosis in heart failure disease[1]
- Highly sensitive troponin T indicating cardiomyocyte injury[2]
- Electrolytes abnormality such as hypokalemia, hypomagnesemia relation QT prolongation and torsades de pointes[3]
- Tricyclic antidepressant poisoning associated with QT prolongation
- Cocaine toxicology screening
- 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
- ↑ 1.0 1.1 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.
- ↑ Hussein, Ayman A.; Gottdiener, John S.; Bartz, Traci M.; Sotoodehnia, Nona; deFilippi, Christopher; Dickfeld, Timm; Deo, Rajat; Siscovick, David; Stein, Phyllis K.; Lloyd-Jones, Donald (2013). "Cardiomyocyte Injury Assessed by a Highly Sensitive Troponin Assay and Sudden Cardiac Death in the Community". Journal of the American College of Cardiology. 62 (22): 2112–2120. doi:10.1016/j.jacc.2013.07.049. ISSN 0735-1097.
- ↑ Laslett, David B.; Cooper, Joshua M.; Greenberg, Richard M.; Yesenosky, George A.; Basil, Anuj; Gangireddy, Chethan; Whitman, Isaac R. (2020). "Electrolyte Abnormalities in Patients Presenting With Ventricular Arrhythmia (from the LYTE-VT Study)". The American Journal of Cardiology. 129: 36–41. doi:10.1016/j.amjcard.2020.04.051. ISSN 0002-9149.
- ↑ Menduiña, Manuel J.; Candel, José M.; Alaminos, Pilar; Gómez, Francisco J.; Vilchez, José (2005). "Bidirectional Ventricular Tachycardia Due to Digitalis Poisoning". Revista Española de Cardiología (English Edition). 58 (8): 991–993. doi:10.1016/S1885-5857(06)60385-X. ISSN 1885-5857.
- ↑ 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.