The nurse has received the laboratory results for a patient who developed chest pain 4 hours ago and may be having a myocardial infarction. The most important laboratory result to review will be
a. myoglobin.
b. low-density lipoprotein (LDL) cholesterol.
c. troponins T and I.
d. creatine kinase-MB (CK-MB).
ANS: C
Cardiac troponins start to elevate 4 to 6 hours after myocardial injury and are highly specific to myocardium. They are the preferred diagnostic marker for myocardial infarction. Myoglobin rises in response to myocardial injury within 30 to 60 minutes. It is rapidly cleared from the body, thus limiting its use in the diagnosis of myocardial infarction. LDL cholesterol is useful in assessing cardiovascular risk but is not helpful in determining whether a patient is having an acute myocar-dial infarction. Creatine kinase (CK-MB) is specific to myocardial injury and infarction and in-creases 4 to 6 hours after the infarction occurs. It is often trended with troponin levels.
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