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 7 of 39:

As this patient presented within the first two or three hours of symptom onset, the most appropriate serum cardiac markers for the early diagnosis of MI are myoglobin and CK-MB subforms.

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Myoglobin, a low molecular weight heme protein found in cardiac and skeletal muscle, is not cardiac specific but is released more rapidly from infarcted myocardium then CK-MB and may be detected as early 2 hours after MI.

CK-MB exists in only one form in myocardial tissue but in different isoforms (or subforms) in plasma. An absolute level of CK-MB2>1 U/L or a ratio of CK-MB2 to CK-MB1 of 1.5 has improved sensitivity and specificity for diagnosis of MI within first 6 hours compared with conventional assays for CK-MB.

 
 
 
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