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.
4. Types of cardiac markers
Troponin I and T
CK-MB
Lactic dehydrogenase (LDH)
Myoglobin
BNP
AST
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
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. Myoglobin
It is a high sensitivity Muscle protein
Elevated in all muscle injury
Rise 1 -4 hrs
Peak 6-12 hrs
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.
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.