A 52-year-old patient presents to the emergency department with reports of substernal chest pain. A history is taken; serum creatine kinase (CK) and lactate dehydrogenase (LDH) isoenzymes and serum lipid studies are ordered, as is a 12-lead ECG
Which of the following results is most significant in diagnosing an MI during the first 12 hours of chest pain? a. ECG—inverted T waves c. Serum enzymes—elevated CK-MB
b. Serum enzymes—elevated LDH4 d. Patient history—substernal chest pain
C
The creatine kinase (CK) muscle/brain (MB) biomarker (CK-MB) is released as a result of myocardial damage, and serum levels rise 4 to 8 hours after myocardial infarction (MI), peak at 15 to 24 hours, and remain elevated for 2 to 3 days. Serial samples are drawn routinely at 6- or 8-hour intervals, and three samples are usually sufficient to support or rule out the diagnosis of MI.
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