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Cardiac Marker

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  • Cardiac Marker

    Medical tests that are often referred to as cardiac markers include:


    cardiac troponin
    (the most sensitive and specific test for myocardial damage)

    creatine kinase
    (CK, also known as phosphocreatine kinase or creatine phosphokinase)

    Aspartate transaminase
    (AST, also called Glutamic Oxaloacetic Transaminase (GOT/SGOT) or aspartate aminotransferase (ASAT))

    lactate dehydrogenase (LDH)

    Myoglobin
    (Mb) has low specificify for myocardial infarction and is used less than the other markers.

    Kinetics of cardiac markers in myocardial infarction with or without reperfusion treatment.

    Cardiac markers are substances released from heart muscle when it is damaged as a result of myocardial infarction.

    Depending on the marker, it can take between 2 to 24 hours for the level to increase in the blood. Additionally, determining the levels of cardiac markers in the laboratory - like many other lab measurements - takes substantial time.
    Cardiac markers are therefore not useful in diagnosing a myocardial infarction in the acute phase. The clinical presentation and results from an ECG are more appropriate in the acute situation.



    Myocardial markers in myocardial infarction

    Ischemia-Modified Albumin (IMA) can be detected via the albumin cobalt binding (ACB) test, a limited available FDA approved assay. Myocardial ischemia alters the N-terminus of albumin reducing the ability of cobalt to bind to albumin.

    IMA measures ischemia in the blood vessels and thus returns results in minutes rather than traditional markers of necrosis that take hours.
    ACB has low specificity therefore generating high number of false positives and must be used in conjunction with typical acute approaches such as ECG and physical exam. Additional studies are required.








    eAbnormal clinical and laboratory findings

    Blood test red blood cells

    (Elevated ESR, Anisocytosis, Poikilocytosis, Reticulocytosis)

    - blood sugar (Abnormal glucose tolerance test, Hyperglycemia) -

    enzymes (Elevated transaminases, Cardiac marker) -

    elevated alpha-fetoprotein - mineral (Iron overload disorder) - pathogens (Bacteremia,

    Viremia)


    Urine test

    Proteinuria (Albuminuria, Microalbuminuria) - Glycosuria - Chyluria - Myoglobinuria - Bilirubinuria - Hemoglobinuria - Ketonuria - Crystalluria
    Other Abnormal basal metabolic rate




    troponin .....> elevated in blood within 3-4 hr's and remain elevated for 10-14 days

    CK ......> elevated after 4-6 hr's return to normal 2-3 days

    CK-MB
    .......> most sensitive after 4 hr's return to normal 2.5 days

    LDH ......> sensitive after 12 hr's return to normal within 10 days

    AST ........> sensitive after 6 hr's return to normal within 4 days
    التعديل الأخير تم بواسطة soma; الساعة 07-11-2007, 01:29 PM.
    ان عشت فعش حرا أومت كالاشجار وقوفا


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  • #2
    شكرا سوما جزاكي الله خير
    sigpic

    قال صلى الله عليه وسلم:
    (ثلاث كفارات وثلاث درجات وثلاث منجيات وثلاث مهلكات فأما الكفارات فإسباغ الوضوء في السبرات وانتظار الصلوات بعد الصلوات ونقل الأقدام إلى الجماعات وأما الدرجات فإطعام الطعام وإفشاء السلام والصلاة بالليل والناس نيام وأما المنجيات فالعدل في الغضب والرضا والقصد في الفقر والغنى وخشية الله في السر والعلانية وأما المهلكات فشح مطاع وهوى متبع وإعجاب المرء بنفسه)

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    • #3
      مرة حلوة المعلومات
      يسلمو..
      Everything is okay at the end. If it's not okay, then it's not the end

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      • #4
        Your subject is very important


        thank you very much



        but I have some questions, can you answer please


        1- types of ck

        2- AST specific for liver function , why we were used it for mycocardic infraction
        أستغفر الله ... أستغفر الله ... أستغفر الله

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        • #5
          hii

          the answer of ur first Question:

          There are three different forms of CK in your body; they are referred to as isoenzymes:


          CK-MM (found in your skeletal muscles and heart),
          CK-MB (found mostly in your heart),
          CK-BB (found mostly in your brain).


          The small amount of CK that is normally in the blood comes mainly from your muscles.
          The CK in your brain almost never gets into the blood.
          ان عشت فعش حرا أومت كالاشجار وقوفا


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          • #6
            the answer 4 ur second Question is:



            Testing for AST is usually used to detect liver damage.

            AST levels are also often compared with

            levels of other liver enzymes, alkaline phosphatase (ALP),
            and alanine aminotransferase (ALT),
            to determine which form of liver disease is present.

            Even though AST is found in heart and other muscles, (so not specific for liver)
            another enzyme, creatine kinase (CK), is present in much higher amounts and is usually used to detect heart or muscle injury.



            enshalla akoon gawbtak
            ان عشت فعش حرا أومت كالاشجار وقوفا


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            • #7
              gzak allah kheir , very butiful subject, thank you

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              • #8
                بسم الله الرحمن الرحيم
                بالنسبه لانزيمات الكبد ليس من الشرط ان تكون خاصه بالكبد فقط
                وانما بعضها خاص بالكبد كالـ GPT& GGT ومنها الذي يتأثر بأي اضطراب يحصل للكبد ولكن خاص لشيء اخر مثل
                GOT:فهو خاص بالقلب وانما يتاثر بمشاكل الكبد تاثر واضح
                وALP:فهو خاص بالعظام وانما يتاثر بمشاكل الكبد.
                وشكرا على الموضوع المهم
                آمل ان اكون قدبلغت الهدف المنشود
                اتهزء بالدعــاء وتزدريه........وماتدري ما صنع الدعــاء
                سهام الليل لاتخطي ولكن.....لها أمد وللأمد انقضـاء

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                • #9
                  Thanks sister Soma in fact the hnformation very important
                  - من جن بالحب فهو عاقل ومن جن بغيره فهو مجنون

                  -إذا أحبك مليون فأنا معهم.. وإذا أحبك واحد فهو أنا ..وإذا لم يحبك أحد فاعلم أنني مت.:sm184:.

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                  • #10
                    i would like to add here there are two types of troponin( T= EDTA blood sample)_and I=( serum or plasma) both cardiac Troponin T and I are presents in the cardiac muscle there is no difference between them you can order only one of them ....they are the best markers of acute myocardial infarction and angina as you mention they rise 3-4 hours and can stay elevated up to 2 weeks , this make the cardiologist to choose it as the only markers beside the ECG ( electric cardiogram) and the role of the other markers is no getting to be less ordered as they are affected by other non cardiac conditions ( some doctors order them to see the severity of the condition ), troponin is enough to be order....thank you soma for your important subject
                    :extra77:

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                    • #11
                      :sm199:very nice subject but so briefly and short ,it need more detail and information cause it interested topic.
                      :
                      رحمك الله ياامي


                      more61:[/I]

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