Case 1:

JF is a 42-year old previously healthy farmer who presented with sudden onset central chest pain of one hour duration to the ED. The pain is associated with sweating and radiates to the left arm and jaw. The area of discomfort is about the size of the fist.

Ragavendra R. Baliga, M.D
Assistant Professor
Division of Cardiology
University Of Michigan

 

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Question 6 of 39:

In this patient an elevated rise in cardiac markers is required to confirm the diagnosis of myocardial infarction.

You clicked 'False'

Correct!

According to the World Health Organization (WHO) definition, the diagnosis of MI is based on the presence of at least 2 of the following 3 criteria:

  • a clinical history of ischemic-type of chest discomfort
  • changes obtained serially obtained EKGs and
  • a rise and fall of serum cardiac markers.

Approximately 70% to 80% of patients with acute MI present with ischemic chest discomfort. Also<25% of patients admitted to a hospital with ischemic-type chest discomfort are subsequently diagnosed as having had an acute MI.

Although ST-segment elevation and/or Q waves on the ECG are highly indicative of MI, ~50% of patients with MI do not exhibit ST elevation but display other or non-diagnostic ECG changes.

Thus, for majority of the patients, the laboratory plays an essential role in diagnosing acute MI.

 
 
 
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