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Heart Disease (Expert Forum)
heart blood tests
This forum is for questions and support regarding heart issues such as: Angina, Angioplasty, Arrhythmia, Bypass Surgery, Cardiomyopathy, Coronary Artery Disease, Defibrillator, Heart Attack, Heart Disease, High Blood Pressure, Mitral Valve Prolapse, Pacemaker, PAD, Stenosis, Stress Tests.
heart blood tests
by zk, Oct 15, 2002 12:00AM
A friend had some mild chest pain and could not sleep all night because of it.He did exercise (walking for 60 to 90 min) 5 hours before he went to sleep.In the morning at hospital blood was drawn for cbc & diff tsh and cmp.All the above tests were normal except for urea nitrogen which was 25 with normal limits of 5-23mg/dl. AST was 28 with normal limits of 15-62u/l.That morning after blood was drawn pain stopped and has not since came back.Five days later he had an ekg which was normal.Ten days later he had one more ekg which again was normal.Also ten days later he had electrolytes metabolities which was normal with urea nitrogen of 19 and ck-mb mass of 1.0 with normal limits of 0.0-5.0ng/ml sed rate of 5 (0-15mm/hr),but his crp was abnormal with <0.30 with normal limits of <.8 mg/dl. Would ck-mb mass test ten days later be abnormal if he had heart attack?Usually how long is ck-mb mass abnormally elevated after mild heart attack?Does abnormal crp point in the direction of heart attack?Would an bnp blood test be of any help in this instance?With the above information what are the odds that he had mild heart attack?Thanks
Doctor's Answer
by CCF-M.D.-RCJ, Oct 15, 2002 12:00AM
zk,
Thanks for the questions.
Increases in CK and CK-MB begin four to six hours after the onset of MI, but at least 12 hours is required to detect elevations in all patients who will show high serum CK. Thus, definitive diagnosis for all patients requires 12 hours. Most patients have a typical rising and falling pattern of activity. Peak activity is seen at 18 to 24 hours with a return to baseline levels by 36 to 40 hours.
Elevated abnormal CRP can be elevated with any inflammation, which might include a heart attack, gingivitis, gout, pneumonia, etc.
There is no utility of BNP for diagnosing a heart attack. Elevated BNP values at the time of presentation with a heart attack are associated with a worse prognosis, but the test is not useful for diagnosis.
You have not given me enough information to hazard a guess at the chance your friend had a heart attack. A proper evaluation might include an ECG, echo, nuclear stress test, and possibly cath.
Hope that helps.
Thanks for the questions.
Increases in CK and CK-MB begin four to six hours after the onset of MI, but at least 12 hours is required to detect elevations in all patients who will show high serum CK. Thus, definitive diagnosis for all patients requires 12 hours. Most patients have a typical rising and falling pattern of activity. Peak activity is seen at 18 to 24 hours with a return to baseline levels by 36 to 40 hours.
Elevated abnormal CRP can be elevated with any inflammation, which might include a heart attack, gingivitis, gout, pneumonia, etc.
There is no utility of BNP for diagnosing a heart attack. Elevated BNP values at the time of presentation with a heart attack are associated with a worse prognosis, but the test is not useful for diagnosis.
You have not given me enough information to hazard a guess at the chance your friend had a heart attack. A proper evaluation might include an ECG, echo, nuclear stress test, and possibly cath.
Hope that helps.
