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    Cardiac Markers Answer Guide

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    bevorsi
    This document provides cardiac marker test results and questions for several patients. It asks the reader to interpret the results and provide diagnoses. For a 73-year-old man, test results show elevated myoglobin but normal CK-MB and troponin I, suggesting an early presenting acute myocardial infarction. A 57-year-old man admitted with COVID-19 has elevated cardiac enzymes and markers consistent with an acute myocardial infarction complicated by heart failure. A 65-year-old woman with diabetes and elevated NT-proBNP and borderline high-sensitivity troponin likely has heart failure with chronic or minor myocardial injury.

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    Cardiac Markers Answer Guide

    Uploaded by

    bevorsi
    17 views2 pages
    This document provides cardiac marker test results and questions for several patients. It asks the reader to interpret the results and provide diagnoses. For a 73-year-old man, test results show elevated myoglobin but normal CK-MB and troponin I, suggesting an early presenting acute myocardial infarction. A 57-year-old man admitted with COVID-19 has elevated cardiac enzymes and markers consistent with an acute myocardial infarction complicated by heart failure. A 65-year-old woman with diabetes and elevated NT-proBNP and borderline high-sensitivity troponin likely has heart failure with chronic or minor myocardial injury.

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    Original Title

    1. CARDIAC MARKERS ANSWER GUIDE

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    This document provides cardiac marker test results and questions for several patients. It asks the reader to interpret the results and provide diagnoses. For a 73-year-old man, test results show elevated myoglobin but normal CK-MB and troponin I, suggesting an early presenting acute myocardial infarction. A 57-year-old man admitted with COVID-19 has elevated cardiac enzymes and markers consistent with an acute myocardial infarction complicated by heart failure. A 65-year-old woman with diabetes and elevated NT-proBNP and borderline high-sensitivity troponin likely has heart failure with chronic or minor myocardial injury.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    17 views2 pages

    Cardiac Markers Answer Guide

    Uploaded by

    bevorsi
    This document provides cardiac marker test results and questions for several patients. It asks the reader to interpret the results and provide diagnoses. For a 73-year-old man, test results show elevated myoglobin but normal CK-MB and troponin I, suggesting an early presenting acute myocardial infarction. A 57-year-old man admitted with COVID-19 has elevated cardiac enzymes and markers consistent with an acute myocardial infarction complicated by heart failure. A 65-year-old woman with diabetes and elevated NT-proBNP and borderline high-sensitivity troponin likely has heart failure with chronic or minor myocardial injury.

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 2

    Answer guide MBChB IV 2020 CARDIAC

    MARKERS QUIZ: ANSWER ALL THE


    QUESTIONS

    1. A Cardiac Triage screen was done for a 73 year old man in Casualty.
    Results are as shown.
    Test Result Reference range
    CK-MB 2.20 ng/ml 0 – 4.3
    Myoglobin 358ng/ml 0-107
    Troponin I <0.05ng/ml 0 -0.4
    a) Suggest two (2) possible reasons why the doctor ordered for these
    tests. (3 marks)
    Patient may have presented with S/S of AMI
    Patient may have suggestive ECG findings

    b) Describe the findings shown ( 3 marks)


    Elevated myoglobin with normal CK-MB and Troponin I

    c) Provide a likely diagnosis? (2 marks)


    Could be Early presenting AMI

    d) What is your recommendation? (2 marks)


    Repeat cardiac markers after 4-6 hours

    2. The biochemistry results below were obtained for a 57 year old


    hypertensive man who was admitted with a diagnosis of COVID-19. The
    diagnosis of the infection was made by a PCR method.
    Test Result Reference range
    ALT 54 U/L 0- 34
    AST 208 U/L 5 -34
    LDH 582 U/L 120 -250
    Total CK 469 U/L 50 -300
    CK-MB 26 ng/ml 0 – 4.3
    Troponin I 18 ng/ml 0 -0.4
    NT-pro BN 1995 pg/ml <300

    a) Provide two (2) possible reasons why the doctor requested for these
    tests (3 marks)
    Patient may have presented with S/S of heart failure
    Patient may have presented with S/S of AMI

    b) What is the difference between Total CK and CK-MB? (3 marks)


    Total CK is a measure of skeletal, cardiac and brain iso-enzymes of CK
    while CK-MB measures only the cardiac isoenzyme.

    c) Provide a possible explanation for the difference between the ALT and
    AST results. (3 marks)
    ALT is predominantly a hepatic enzyme while AST is found in
    liver as well as muscle, red cells etc. AST elevation in patient
    may be from cardiac muscle.
    d) Provide a possible explanation for the LDH result. (3 marks)
    LDH is also found in muscle and elevation occurs in AMI.
    e) Giving reasons, Provide a possible diagnosis. (3 marks)
    Results are suggestive of AMI in a patient with heart failure.
    Reasons, raised cardiac enzymes, cardiac markers and NT-
    proBNP

    3. The following results were obtained for a 65-year-old female diabetic who
    presented with general weakness/fatigue:
    TEST RESULT REFERENCE RANGE
    NT-pro BNP 4863 pg/ml < 300
    Highly sensitive Troponin I
    (On admission) 58.2 ng/ml >100; OR a Change Between
    Time 0 and Time 2 of > 10ng/ml
    Highly sensitive Troponin I
    (Next day) 60.6 ng/ml >100; OR a Change between
    Time 0 and Time 2 of >10ng/ml

    i) What is highly sensitive troponin I? (3 marks)


    Hs-troponin is new generation of troponin assay able to accurately
    measure extremely low concentrations of cardiac troponin

    ii) What is NT-proBNP used for? (3 marks)


    Is a biomarker of heart failure

    iii) Provide a possible explanation for the troponin results (3 marks)


    Hs-Troponin levels are raised but have not reached the threshold/cut-
    off value for Acute myocardial infarction.

    iv) What is the likely diagnosis? (give reason) (3 marks)


    Heart failure with chronic/minor myocardial injury

    v) Describe two (2) other conditions which may lead to similar results (3
    marks)
    Cardiomyopathy, sepsis, renal failure, stroke, pulmonary
    thromboembolism etc

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