Question

A 68-year-old man presented to the emergency department with sudden onset of chest pain, left arm pain, dyspnea, and weakness while away from home on a business trip. His prior medical history is not available, but he admits to being a 2-pack/day smoker for longer than 20 years. Cardiac markers were performed at admission and 8 hours postadmission with the following results: 7:30 a.m. (9/26) 4:00 p.m. (9/26) 9.2 5.3 Cardiac markers CK-MB (0-5ng/L) Myoglobin (<70mg/L) CTNT (0-0.1 mg/L) 124 76 <0.1 1.3

picture includes patient's info

questions about data:

do these results indicate a specific diagnosis, if so what is the diagnosis?

what myoglobin, CK-MB, and troponin T results would be excpected if assayed at 4pm on september 27?

can any assumptions be made about the patient's lifestyle/habits that would increase his risk for this condition?

are there any assays that might indicate his risk for further events of this type?

Answer 1

A 68-year-old man presented to the emergency department with sudden onset of chest pain, dyspnea, and weakness.

He is a chronic smoker (2 packs per day from 20 years)

1. Yes, this result indicates a specific diagnosis.

The symptoms and elevated cardiac markers indicate Myocardial Infraction. MI is otherwise known as Heart attack, it is caused when there is restricted or loss of blood supply to the heart muscle which resulted in the death of heart muscles.

2. 4 pm on September 27 Myoglobin, CK-MB, and troponin T results start decreasing because these enzymes releases from damages cardiac muscles which is at the peak level within 24 to 48 hours and starts declining after that.

3. Yes, we can make the assumption that the patient's lifestyle/habits Ex. Smoking increases the risk of MI

Because smoking is the greatest risk factor for cardiovascular diseases, Smoking damages the inner wall of blood vessels and makes it prone to plaque formation which restricts the blood flow.

4. Do further investigation like ECG and Echocardiography to evaluate further risks and plan further treatment accordingly.