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Cardiac enzymes

Cardiac diagnostic tests

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Cardiac enzymes

  1. 1. Cardiac enzymes Mrs. Srividhya.N
  2. 2. Introduction Cardiac enzymes are markers formed in the blood. The markers are normally present at all times, however they are significantly elevated during a damage to heart muscle.
  3. 3. Definition Cardiac biomarkers are protein molecules released into the bloodstream from damaged heart muscle.
  4. 4. Types of cardiac markers Troponin I and T CK-MB Lactic dehydrogenase (LDH) Myoglobin BNP AST
  5. 5. Troponin It is a contractile protein Types Trop-I : ● Found in cardiac and skeletal muscle ● Rise -3 to 4 hrs ● Peak -24hrs Trop T ● Found only in cardiac muscle ● Rise - 4 to 6 hrs ● Peak -18hrs
  6. 6. CPK /CK-MB Creatinine Phospokinase Highly specific for MI(CKMB) Normal -15-100u/l Rise - 4 -6 hrs Peak 24hrs
  7. 7. Lactic Dehydrogenase (LDH) Types LDH1 and LDH2 Normally LDH2 is greater than LDH1 In MI LDH1 is greater than LDH2 Rise 48 to 72 hrs Normal Value- 100-200U/L
  8. 8. Myoglobin It is a high sensitivity Muscle protein Elevated in all muscle injury Rise 1 -4 hrs Peak 6-12 hrs
  9. 9. BNP Brain type Natriuretic peptide Excellent marker for ventricular function Used especially in case of heart failure Pro BNP Less than 125 pg/mL for patients aged 0-74 years. Less than 450 pg/mL for patients aged 75-99 years.
  10. 10. AST Aspartate transaminase Elevated in MI Normal value - 8-20U/L
  11. 11. Nurses responsibility ● Identify patient properly ● Check the doctor’s order ● Collect sample in sterile technique and sent to lab immediately as it is an emergency test with proper label ● Inform the physician when the reports are ready without delay ● Make the patient comfortable and continuously monitor the patient's hemodynamic status.