Cardiac Enzymes: Labs, Tests and Treatments For The Cardiovascular System
Cardiac Enzymes: Labs, Tests and Treatments For The Cardiovascular System
Cardiac Enzymes: Labs, Tests and Treatments For The Cardiovascular System
Labs
Cardiac Enzymes
Creatine Kinase
Normal Values
Male
25 - 90 U/L
Female
10 - 70 U/L
CK is an enzyme found in striated muscle as well as a number of tissues such as kidney, lung, gastrointestinal tract
and brain, thus limiting its potential as a specific marker of cardiac damage. CK begins to rise in 3-8 hours, peaks at
24 hours and returns to normal after 72-96 hours.
CK-MB
Table Head
Adult
0 - 3 ng/mL
Elevation in the MB isoenzyme form of creatine kinase can be indicative of a myocardial infarction. The enzyme
is released into the blood stream as a result of cardiocyte cell membrane damage.CK-MB begins to rise 4-6 hours
after the onset of symptoms, peaks at 24 hours and returns to normal after 48-72 hours. It is useful for the detection
of re-infarction.
Troponin
Normal Values
Adult
0 - 0.4 ng/mL
Troponin is the most specific marker for cardiac muscle damage. Troponin can be detected 2-4 hours after injury
and will remain elevated for up to 2 weeks.
Homocysteine
Normal Values
Adult
5 - 15 mmol/L
Lipid Profile
Total Cholesterol
Normal Values
Adult
High-Density Lipoprotein
Normal Values
Adult
30 - 80 mg/dL
HDL levels <40 mg/dL are associated with an increased risk of CAD.
HDL is increased in:
50 - 190 mg/dL
Triglycerides
Normal Values
Adult
DM, pancreatitis, nephrotic syndrome, alcoholism and medications such as OCPs and Beta Blockers
Tests
Angiogram
Invasive imaging procedure using contrast dye to visualize blood vessels. In a cardiac
catheterization contrast dye is used to evaluate the coronary arteries to assess for degree of
atherosclerosis.
Arterial (N = 100-140/70-90 mm Hg) and pulmonary (N = 15-30/3-12 mm Hg) pressures can
also be determined.
Non-surgical procedure often performed during cardiac catheterization for the treatment of
coronary artery disease. Occluded coronary arteries are opened using a flexible catheter and balloon.
Stents may be placed at this time.
Treatments
Coronary Artery Bypass Grafting (CABG)
Surgical procedure for the treatment of coronary artery disease. Grafted arteries or veins
(commonly left internal thoracic artery or great saphenous vein) bypass the occluded
coronary arteries. CABG is used in the treatment of multi-vessel disease and in patients
with diabetes.
Pacemaker
Pacemakers are electronic devices placed into people hearts in order to help them maintain
a normal heart rate and rhythm.
A biventricular pacemaker can have up to three leads. The leads are placed through the left
subclavian vein and into the superior vena cava. One lead terminates in the right atrium,
one in the right ventricle and the third is placed into the coronary sinus which is in the
atrioventricular groove on the posterior aspect of the heart and advanced in to the lateral
venous tributary to pace the left ventricle.