1. Serial Cardiac Enzyme Study - Lab Values
CK is only slightly elevated on admission. The time course of CK
elevation is consistent with that expected for infarct-related
release of CK. CK-MB rises and falls in parallel with CK, as does CK
index, with a peak at 24 hours. Could you still have made the
diagnosis of acute MI based on laboratory data if the patient had
waited 24 to 48 hours before coming to medical attention?
Answer
When would a negative CK profile not be helpful in ruling out acute
MI?
Answer
What additional test would be of value in the assessment of a patient
with a suspected acute MI and a negative CK profile?
Answer
In this case, total CK and CK-MB appear to peak at the same time. In
most cases, CK-MB peaks about 6 hours prior to total CK and returns
to normal levels about 12 - 24 hours prior to Total CK. Which test is
more sensitive for myocardial injury, CK or CK-MB?
Answer
Which test is more specific for myocardial injury?
Answer
Serial troponin levels are recorded on the right side of the chart.
Elevated levels of cardiac troponin, particularly cardiac troponin I,
are highly specific markers of myocardial injury. Note that troponin
levels rise in parallel with CK-MB and reach a maximum at the same
time that CK-MB and CK index peak. In contrast, however, troponin
levels remain persistently elevated after CK-MB and CK index have
returned to normal.
