Module 2: Cardiac Markers

Question 1

Criteria used to diagnose AMI

Answer 1

2 of the following must be present:

1. Clinical presentation of ischemic type chest pain lasting more than 20min.
2. Changes in serial ECG tracings
3. Rise of serum cardiac markers over serial draws

Question 2

3 possible treatment options for AMI

Answer 2

Thrombolytic agents
Anticoagulants
Angioplasty

Question 3

How can myoglobin be used as a negative predictor of AMI?

Answer 3

After an AMI, myoglobin increases. If myoglobin levels are normal 2-4 hours after chest pain, it is likely that the pain was not due to an AMI

Question 4

Myoglobin levels after AMI

Answer 4

First elevated in 1-3hrs, peaks at 6-8hrs, returns to normal within 24hrs

Question 5

Myoglobin reference range

Answer 5

30-90ug/L

Question 6

CK-MB levels after AMI

Answer 6

First elevated in 4-6hrs, peaks at 12-24hrs, returns to normal within 2-3 days

Question 7

Troponin levels after AMI

Answer 7

First elevated in 4-6hrs, peaks at 12-18hrs, returns to normal within 5-14 days

Question 8

Disadvantage of using Troponin as a cardiac marker

Answer 8

Not as useful for identifying reinfarction (as elevated levels persist for up to 2 weeks after AMI)

Question 9

Advantages of using myoglobin as a cardiac marker

Answer 9

Early indicator (increased within 1-3hrs after AMI), can be used to detect reperfusion or reinfarction, can be used as a negative predictor of AMI

Question 10

Disadvantage of using myoglobin as a cardiac marker

Answer 10

Not specific for cardiac muscle