cardiac enzymes

[ohmeowzer RN, RN]

on a saunders question .. it asks which is the first cardiac enzyme to rise ? trop or ckmb? i had 2 questions with each a different answer. i'm confused .. thank you

[Dani07]

that would be ck-mb :)

[LIDIYA]

According to NCSBN : CK-MB rises within 2 hrs of Acute MI, and stays elevated for a few days. Troponin rises within a few hrs of MI too, but stays elevated for a few weeks.

I’ve read somewhere that CK-MB is a definitive for Dx of acute MI b/c it’s specifically shows damage to cardiac muscle. CK-MM - damage to skeletal muscle.

Hope this helps

[JoniL&DRN]

OK I could be wrong here (as is often the case) but I think Troponin is the gold standard marker for cardiac cell death, elevating late but staying elevated longer. CK-MB also an indicator but can be an indicator of another muscle injury, elevating sooner but can be elevated for other reasons.

I'm pretty sure that Troponin was drilled in my atrophying brain.

[suzanne4, RN]

CK rises first; but can be because of several different factors, including long bone injury, rhabdo, etc., and is not strictly heart related. You also can see it when someone is in a car accident and the airbags have inflated, as they have hit their chest. Not necessarily related to myocardial infarction in the strictest sense.

Serum Troponin levels rise about 8 hours after injury, so if your patient has a rise in it, it means that injury was about one shift before you will see the rise. But they do not remain elevated for weeks in even an acute MI in normal situations. If they are, then that usually means sustained cardiac damage. Usually they will be back to baseline within a couple of days at the latest.

Hope that this helps.

[ALEXIS VALIENTE]

OK I could be wrong here (as is often the case) but I think Troponin is the gold standard marker for cardiac cell death, elevating late but staying elevated longer. CK-MB also an indicator but can be an indicator of another muscle injury, elevating sooner but can be elevated for other reasons.

I'm pretty sure that Troponin was drilled in my atrophying brain.

I agree!!!!

[pagandeva2000, LPN]

I agree!!!!

I read and was always told that troponin was the 'gold standard' as well.

[Laur143]

Troponin is the definitive lab for an acute MI. Although CK-MB does indicate there may be cardiac damage, it may also mean that the muscle is injured(and the myoglobin in elevated.) CK-MB rises first, but doesnt stay elevated long. Troponin is elevated for a greater period of time. hope that helps

[nurse_plush]

#1 to rise is myoglobin

#2 Troponin (i think it's the 'T-I' that is cardiac specific)

#3 CPK MB

#4 SGOT/AST

#5 Lactic Dehydrogenase

-

hope that helps.

[MLabraT]

SGOT/AST is more liver specific but shows little relevance to the heart.

AST: Test Sample | Aspartate aminotransferase

LDH ( LDH: Test Sample | Lactate Dehydrogenase ) was used as the cardiac marker to Dx MI. It has been replaced by troponin T and I. Myoglobin can rise because of the heart or skeletal muscels. Troponin T and I are the choice tests. "Cardiac-specific troponins I and T (cTnI and cTnT) are troponins that are found only in the heart." Troponins: Test Sample