Myocardial Infraction Case Study

To determine if the patient’s chest pain is related to injury, you would look for ST-segment elevation. Myocardial injury represents a worsening stage of ischemia. If ST-segment elevation is greater than or equal to 1mm above the isoelectric line, it is significant and treatment needs to be prompt and effective to try to restore oxygen to the myocardium, and to avoid or limit infarction. The absence of serum cardiac markers confirms that infarction has not

Mr Brown is a 76 year old male, which presented to the emergency department via ambulance with thoracic back pain, which commenced two days prior to the presentation. The triage assessment stated the patient is alert, orientated, distressed, chest clear and equal, neurovascular intact with equal strength in all extremities and good strong regular pulses. The nil injury stated patient said he ‘just woke up with it’. The patient’s observation displayed a temperature of 36.9°C, blood pressure of 169/105, pulse rate of 99 beats per minute, respiratory rate of 20 breaths per minute, Glasgow coma score of 15, and a blood glucose level of 5.4. Mr Brown’s has a past medical history of atrial fibrillation, asthma, emphysema, hypertension, chronic back pain, lumbar fusion (L1), total

The decision either to perform or not to perform a cardiac catheterization in a patient who also has acute renal failure can be a difficult decision to reach. Diagnostic blood and urine tests can prove to be beneficial in helping the provider make such a tough decision. The contrast used in the cardiac catheterization can harm the function of the kidneys, and it can push the patient from acute to chronic renal failure, which can influence quality of life as well as morbidity and mortality. When a patient has chest pain, the nurse practitioner should perform a thorough assessment to ensure the angina is cardiac-related and not from another source, such as pleuritic chest pain or muscular chest pain (Grossman & Porth, 2014). Once it is confirmed by one’s assessment that the chest pain is cardiac-related, then one should look at serum diagnostic results, such as the cardiac enzymes.

Cardiac Troponins are specific to the cardiac myocyte and have central role in diagnosing ACS. They are found to be specific and sensitive, in addition they also provide prognostic information which adds to their utility in managing and diagnosing of CAD. Constant change in levels of Cardiac Troponins is required to define ACS. CKD patients with advanced disease have misfortune of having both a dramatically high rate of cardiac mortality paired with decreased ability to detect, it due to elevated Cardiac Troponin levels.[6]. mortality in dialysis patients from cardiovascular disease is substantially higher than the general population as depicted in Figure1.

While CK alone is not a specific marker to the heart muscle; CK-MB a subset isoenzyme of CK is a specific cardiac marker during an AMI. Serum levels greater than 5% is an indication of an MI. Troponin is another specific and sensitive cardiac marker that is not usually found in the blood. When the myocardium is injured, the necrotic tissue releases troponin into the blood, even the smallest injury to the myocardium will show traces of troponin elevation in the blood. Traces of troponin will remain in the blood for 10-14 days and can help to diagnose an MI when levels of CK are not present or when the diagnosis has been delayed(Lemone2015). Another cardiac marker that is found during an MI is myoglobin and it is the first one to appear but it is also the first one to

Chest pain is a very common symptom, and around 20% to 40% of the general population will experience chest pain in their lives(149). In the UK, up to 2 % of visits to a general practitioner are due to new onset chest pain (150). Approximately 5% of visits to the emergency department are due to a complaint of chest pain, and up to 40% of emergency hospital admissions are the result of chest pain(149, 151). Approximately 52,000 new cases of angina per year are diagnosed in men and 43,000 in women. The incidence of angina increases with age(123).

It binds to tropomyosin, interlocking them to form a troponin-tropomyosin complex, helping it to position on actin, while the rest of the complex modulates muscular contraction [13]. Four human cardiac TnT (cTnT) isoforms were determined. In the fetal heart, TnT1 is the mainly expressed one, TnT4 in the failing adult heart, while TnT3 is the dominant form in the adult heart [14]. The cTnT is rapidly released from injured cardiac muscles and the presence of measurable amounts of circulating cTnT can indicate cardiac damage. Therefore, serologically, cTnT is a proven diagnostic and risk biomarker in acute coronary syndromes [15]. On the other hand, histologically, cTnT is sensitive at detecting acute myocardial infarction as the infracted fibers show a low staining affinity to it [15,

Please see admission H and P for further details. Briefly, ___[NAME] is a very pleasant 52-year-old female with a history of CVA with right hemiparesis, hyperlipidemia, hypertension, hypothyroidism. She presents to the emergency room with complaints of chest pain for 2 days. She reports the pain is mostly in the left anterior chest wall radiating to her left shoulder. It has been intermittent now with associated palpitations. She was admitted for further evaluation workup.

Chest pain syndrome, rule out myocardial infarction. She was admitted to telemetry, where 3 sets of cardiac enzymes and troponins were measured, and she was given supplemental oxygen, nitrates and Coreg were started. After 3 sets of cardiac enzymes were documented to be negative, the patient was discharged and she was instructed to call my office for scheduling of an outpatient stress myocardial perfusion scan, to evaluate for obstructive

Creatine kinase and troponin are both contractile proteins found within the muscles in the body. If the doctors are finding those proteins in the bloodstream, it means that the muscles normally containing these proteins has been damaged or have died depending on the severity of the heart attack.

I was doing an admission on a female patient in her late 40s. She came to the hospital with complaints of chest pain. While doing the admission and physical assessment, I noticed everything was within defined limits. No abnormal heart sounds, lungs were clear, and the electrocardiography (EKG) was normal sinus rhythm. I looked over all her labs and those too were normal. I noticed this patient was here a month ago for chest pain and had a cardiac work up done. All tests were negative.

4 In stress echocardiography (SE), cardiologists use ultrasound imaging for this purpose. Due to its accessibility and cost efficiency, SE represents a common type of noninvasive diagnostic tool for the detection of myocardial ischaemia.3 SE is widely used, has a moderate to high degree of sensitivity and moderate to high specificity in correctly identifying CAD, but it is cumbersome and adds substantial costs to the patient’s care. It is also fraught with false positive and false negative results that typically require even more testing.3

The heart is a complex organ and it is vital for other organs and the entire body that it functions properly. A myocardial infarction (heart attack) can display different symptoms when people are seeking medical attention; therefore, physicians run laboratory tests to determine and rule out diagnoses. The Troponin T laboratory test is specific to the protein molecules of the cardiac and skeletal muscles. Troponin are protein molecules that can be elevated within a few hours of a heart attack and can remain elevated for up to two weeks. A series of troponin tests are preformed over several hours and a rise or fall in the results indicates a heart attack. The Troponin T test can also be used for the management of acute coronary heart disease

While Myocardial infarction is the most frequent cause of death among men and women in most nations throughout the world, a difference exists in the spectrum of clinical presentation between the sexes. Symptoms of Myocardial infarction in men are as follows – crushing chest pain, stomach discomfort, rapid heartbeat, shortness of breath, dizziness, and diaphoresis (often accompanied by nausea and light-headedness). Women, on the other hand, tend to experience atypical, vague symptoms which can delay recognition and treatment. The classic crushing or stabbing chest pain is not the usual presentation in women as it is with men. The clinical manifestations of a heart attack in women are as follows: fatigue, dizziness, fainting, paroxysmal dyspnea, lightheadedness, heartburn, upper abdominal or epigastric pain, nausea, vomiting, pain in the upper body (arm, neck, upper back, jaw, throat, teeth).

Increase in cardiac troponin levels in the presence of EKG findings is far more definitive. ????? However, troponin may be increased in patients with other cardiac conditions such as End stage renal disease, congestive heart failure, and rheumatic dieaseses can provide false negatives. (16). Thus the importance of patient history in order to avoid misdiagnosis. Once a diagnosis is obtained there are options in