A patient reports chest pain, nausea, and vomiting off and on for the last 4 days, which the patient interpreted as the flu. Which laboratory tests will provide information about acute cardiac damage for this patient?
1. Troponin I and T
2. Red blood cells
3. CPK-MB
4. Homocysteine and platelets
1
Rationale 1: The levels of troponin T begin to rise within 3–6 hours after myocardial injury and remain elevated 14–21 days. Levels of troponin I begin to increase 3–5 hours after myocardial ischemia, peak at 14–18 hours, and remain elevated for 5–7 days.
Rationale 2: Red blood cells are unaffected by acute cardiac damage.
Rationale 3: The CPK-MB rises within 3–6 hours after the MI, peaks within 12–24 hours, and returns to normal 3–4 days following the infarction. This patient would likely have normal values 4 days after the onset of symptoms.
Rationale 4: Homocysteine does not change and platelets are unaffected by acute cardiac damage.
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