Chest pain laboratory findings
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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:
Cardiac Markers
- Troponin I or T are now cardiac marker 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