asmi
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by measuring cretinine kinase enzyme(CKMB)
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| aji
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To do a trop-t test....Or a myoglobin assay as my second choice.
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| ELM
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By checking Troponin-1 level and CK-MB level.........that's enough...you don't need anything else according to Dr Goljian.
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| ELM
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| zaki
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well after mi dx of mi depands on sign and symptoms post-mi angina or mi, if not treated previously with pci most recommend pci now,
well trop-i or t is not a good idea because they remain elevated for more then weeks after mi.
ck mb level comming down although remain elevated clinical corellation with last ck mb level is a good choice.
on ekg most of the acute changes are reversing and q waves comming up on day 4 so any acute change of mycocardial injury is plus point in dx of mi in this situation
but patient must go to the cath lab if sign and sypmptoms are present
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| aji
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plz. read the cardiac enzyme kinetics in harrisons ... the choice is trop .test.
thanks
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| mdwannabe
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Trop stays up for up to 7 days...reaches peak though in 2-3 days, if I am not mistaken, so it does seem like a good candidate for monitoring Mi..However, CK-MB peaks at 12-18 hrs, and back to normal at 48 hrs, so reMI seems to be better monitored and reflected by CK-MB.
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| Dot
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Harrison says----- its only myoglobin which can be used in reassesing as its levels fals within 48 hrs and so reinraction wil show its level elevated again
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| mdwannabe
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I am glad that me, Harrison and Dot are on the same page :-)
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| lucky
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its CK MB. levels come down after 48hrs whereas trop. remains elevated for about 10 days.
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| miky
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how do u assess reinfarction in a hospitalized patient who has previous MI 3-4 days back
here's my opinion:
clinically: pain recurrence / worsening, developing of cardiogenic shock, new arrhythmias on ECG. Usually an unexplicable worsening of clinical status.
Lab: increase in CK-MB. Troponin levels remain elevated for 10 days, so they will not indicate a reinfarction.
You usually need to ask an angiography of coronary if not performed.
:roll:
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