Myocardial Infarction

MAIN CLINICAL DIAGNOSIS

PERTINENT LABORATORY FINDINGS
• TROPONIN I
• A high troponin and even slight elevations may indicate some
degree of damage to the heart. When a person has significantly
elevated troponin levels and, in particular, a rise and/or fall in the
results from a series of tests done over several hours, then it is
likely that the person has had a heart attack or some other form of
damage to the heart.
• The more damage there is, the greater the concentration in the
blood.
CK-MB (Increased)

• Increased CK-MB can usually be detected in someone with a heart

attack about 3-6 hours after the onset of chest pain. The level of CK-
MB peaks in 12-24 hours and then returns to normal within about 48-
72 hours. If there is a second heart attack or ongoing damage, then
levels may rise again and/or stay elevated longer.
ECG – ST elevation in leads V1 through V6 and
lead I and aVL
• According to the American College of Cardiology/American Heart
Association guidelines for STEMI, there must be “new ST segment
elevation at the J point in at least two contiguous leads of ≥ 2 mm (0.2
mV) in men or 1.5 mm (0.15 mV) in women in leads V2-V3
• And/or of ≥ 1 mm (0.1 mV) in other contiguous chest leads or the
limb leads.” This means 1 millimeter in any two contiguous leads,
except leads V2 or V3, where the elevation must be 2 mm in men or
1.5 mm in women.
BLOOD UREA NITROGEN (Increased)
• Due to a condition that results in decreased blood flow to the kidneys,
such as congestive heart failure, shock, stress, recent heart attack, or
severe burns, to conditions that cause obstruction of urine flow, or
to dehydration.
CREATININE
• Increased creatinine levels
• Reduced blood flow to the kidney due to
shock, dehydration, congestive heart failure, atherosclerosis, or
complications of diabetes