Pericarditis laboratory studies
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Inflammatory markers
- The CBC may show an elevated white count and a serum C-reactive protein may be elevated.
Molecular markers. Acute pericarditis is associated with a modest increase in serum creatine kinase MB (CK-MB)[1][2] and cardiac troponin I (cTnI)[3][4], both of which are also markers for myocardial injury. Therefore, it is imperative to also rule out acute myocardial infarction in the face of these biomarkers. The elevation of these substances is related to inflammation of the myocardium. Also, ST elevation on EKG (see below) is more common in those patients with a cTnI > 1.5 µg/L[4]. Coronary angiography in those patients should indicated normal vascular perfusion. The elevation of these biomarkers are typically transient and should return to normal within a week. Persistence may indicated myopericarditis. As a summary:
- ESR: mild to marked elevation
- CRP: mild to marked elevation
- CK-MB: depends on the extent of myocardial involvement
- LDH: depends on the extent of myocardial involvement
- troponin I: depends on the extent of myocardial involvement
- serum myoglobin: normal (but not always, usually rises with increased ST segment deviation
- gallium-67 scanning: helps ID "inflammatory and leukemic infiltrations"
References
- ↑ Spodick DH (2003). "Acute pericarditis: current concepts and practice". JAMA. 289 (9): 1150–3. doi:10.1001/jama.289.9.1150. PMID 12622586.
- ↑ Karjalainen J, Heikkila J (1986). ""Acute pericarditis": myocardial enzyme release as evidence for myocarditis". Am Heart J. 111 (3): 546–52. doi:10.1016/0002-8703(86)90062-1. PMID 3953365.
- ↑ Bonnefoy E, Godon P, Kirkorian G, Fatemi M, Chevalier P, Touboul P (2000). "Serum cardiac troponin I and ST-segment elevation in patients with acute pericarditis". Eur Heart J. 21 (10): 832–6. doi:10.1053/euhj.1999.1907. PMID 10781355.
- ↑ 4.0 4.1 Imazio M, Demichelis B, Cecchi E, Belli R, Ghisio A, Bobbio M, Trinchero R (2003). "Cardiac troponin I in acute pericarditis". J Am Coll Cardiol. 42 (12): 2144–8. doi:10.1016/j.jacc.2003.02.001. PMID 14680742.