Acute Coronary Syndrome & Cardiac Biomarkers

A patient presented with a complaint of central chest pain, no ST elevation with elevated cardiac biomarkers, what is the possible diagnosis?

• STEMI

• NSTEMI

• UA

• None of the above, he is healthy!

Which of the following is true about cardiac troponin?

• Troponins have a high clinical sensitivity and near absolute specificity for myocardial necrosis.

• It peaks at 6 hours.

• It is not useful for the detection of reinfarction.

• It remains elevated for less than 24 hours.

Which of the following is false about CK-MB?

• CK-MB is a more sensitive and specific test for myocardial damage than total CK

• The plasma mass measurement method of CK-MB is the best alternatives.

• Remains the gold standard cardiac biomarker.

• A 20% or more increase in the value of CK-MB between 2 samples 3-6 hours apart support the diagnosis of reinfarction.

Which of the following is true about myoglobin?

• This appears slowly after myocardial necrosis but has not achieved widespread use in cardiac practice.

• Myoglobin can only be found in muscle tissue and would be present in the bloodstream if there is damaged muscle tissue.

• Rises in the first 30 minutes and slowly excreted from the kidneys.

• Since it has no specificity, positive values are important rather than negative values.

Which of the following is false about LDH?

• Expressed in many organs including skeletal muscle, kidney, liver, heart, and lungs.

• Increases within 6-12 hours from onset of chest pain.

• Peaks over 5-7 days.

• Returns to normal within 8-14 days

Which of the following is true about AST?

• A different group with ALT.

• In cardiac and skeletal muscle, ALT is 20 times more than AST.

• Declining over 2-3 days if no further cardiac damage.

• AST is a specific and sensitive marker for the diagnosis of MI.