A patient is admitted with chest pain of approximately 2 hours in duration. The CK level was 8 U/L. Which of the following should be done to adequately assess this patient?
1. rerun the CK level in 48 hours
2. draw blood for a CK-MB in 72 hours
3. rerun the CK level in 28 hours
4. draw blood for a cTnT or cTnI level
4
Rationale: The cardiac marker troponin-T or troponin-I has an onset of 2 to 4 hours. Since the patient has been experiencing chest pain for approximately 2 hours, this test should most likely be drawn to adequately assess the patient. CK levels have 24 to 48 hour duration and it is not a good idea to wait up to 2 days to adequately assess or diagnose the patient. CK-MB levels have 72 hour duration and it also not a good idea to wait up to 3 days to adequately assess or diagnose the patient. CK levels peak at 24 hours so rerunning the test at 28 hours would not provide the correct value for the patient.
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