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Cardiac Function Tests: Example: Normal Formula LDH 1 2 0.5 LDH 2 4

This document summarizes cardiac function tests used to detect acute myocardial infarction (AMI). Key tests include creatine phosphokinase (CPK), lactic dehydrogenase (LDH), and serum glutamic oxaloacetate transaminase (SGOT), which are elevated at different time points following AMI. Troponin T and I are also used as they are more specific markers of cardiac damage. The ratio of LDH isoenzymes 1 and 2 is increased in AMI patients compared to normal. B-type natriuretic peptide (BNP) is the definitive test for congestive heart failure diagnosis.

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Ritz Celso
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51 views

Cardiac Function Tests: Example: Normal Formula LDH 1 2 0.5 LDH 2 4

This document summarizes cardiac function tests used to detect acute myocardial infarction (AMI). Key tests include creatine phosphokinase (CPK), lactic dehydrogenase (LDH), and serum glutamic oxaloacetate transaminase (SGOT), which are elevated at different time points following AMI. Troponin T and I are also used as they are more specific markers of cardiac damage. The ratio of LDH isoenzymes 1 and 2 is increased in AMI patients compared to normal. B-type natriuretic peptide (BNP) is the definitive test for congestive heart failure diagnosis.

Uploaded by

Ritz Celso
Copyright
© © All Rights Reserved
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Download as DOCX, PDF, TXT or read online on Scribd
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CARDIAC FUNCTION TESTS In AMI

Example:
Given: LDH 1 = 6.0
Enzymes LDH 2 = 2.0 Normal formula = LDH 1 = 2 = 0.5
Creatinine Phosphokinase (CPK) LDH 2 4
Lactic Dehydrogenase (LDH) LDH 1 is increased when there is myocardial
Serum Glutamic Oxaloacetate Transaminase (SGOT) damage.
Therefore: LDH 1 > LDH 2
Acute Phase Reactants:
Troponin T (TnT) LDH 1 = 6 = 3.0
Troponin I (TnI) LDH 2 2
C reactive protein (CRP)
Therefore LDH 1 LDH 2 ratio is increased in AMI
There are three (3) isoenzymes:
CPK 1 (BB)- increased in brain abnormalities
CPK 2 (MB)- cardio-specific
CPK 3 (MM)- increased in muscular disorders

Creatinine Phosphokinase Other parameters used to detect AMI:


- Is elevated after the first 4-6 hours of AMI Troponin T - (not cardio-specific)
- Peak is at 12 hours post AMI. Troponin I - (cardio-specific)
- Returns back to normal within 24 hours. C reactive protein (CRP)
- Note: serial determination every 3-4 hours must be
done over 12 -16 hour period Troponin T (TnT)
- Elevated after a few hours of chest pain
- Maybe elevated in patients with renal disease
Serum Glutamic Oxaloacetate Transaminase (SGOT)
- Also known as Aspartate Amino transaminase (AST).
Troponin I (TnI)
- Is elevated after the first 12 hours of AMI
- Increased 4-8 hours after onset of chest pain
- Peak is at 24 hours post AMI.
- Peaks at 12-16 hours
- Returns back to normal within 48 hours.
- Remains elevated for 5-9 days
- Values above 1.5 ng/dL is positive for AMI
Lactate Dehydrogenase (LDH) - Cardiospecific
- Is elevated after the first 24 hours of AMI - More specific than CPK-MB
- Peak is at 48 hours post AMI.
- Returns back to normal within 12 days. C reactive protein (CRP)
Diagnosis of Congestive Heart Failure (CHF)
There are five (5) isoenzymes: B- type Natriuretic Peptide (BNP)
LDH 1 - cardio specific - definitive test for CHF
LDH 2 - most numerous - also increased in arrhythmia and stroke
LDH 3 - pulmonary - excellent marker for early heart failure
LDH 4
LDH 5

Normal LDH 1 to LDH 2 ratio: Less than 1

Example: Normal LDH 1 LDH 2 ratio = < 1


Given: LDH 1 = 1.0
LDH 2 = 2.0

Normal formula = LDH 1 = 1 = 0.5


LDH 2 2

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