Question

ABCcDdEe AaBbccdee No Spacing AaBbCcDc AaBbCcDdEk AaBb Heading 1 Heading 2 Title AaBb CcDdEe Subtitle Normal Case 4: A 64 year-old man complained of chest pain and fainting two days before admission. He had several prior admissions for severe chest pain, which was relieved by nitroglycerin. On the day of admission he was nauseated and felt numbness in the left arm. He was admitted to coronary care unit, and his serial enzyme studies are shown below. Lab Data: Day 2 7 0 Episode 16 0 268 7 22 Day3 19 O 858 Day1 13 0 348 9 32 Total CK % CK-2 Total LD % LD-1 % LD-2 % LD-3 % LD-4 % LD-5 AST 470 6 6 13 14 25 12 8 10 Reference 50 U/L 0% 200 U/L 25% 35% 20% 10% 10% 50 U/L 50 U/L 100 U/L 1.20 mg/dL 46 64 19 15 142 223 108 1.12 9 11 61 617 1047 134 1.04 ALT 310 490 119 .98 130 105 ALP Total Bili 0.86 1. Explain what you think is wrong with this patient: a. The complains of chest pain, numbness in the left arm suggests that this patient could possibly be having a myocardial infraction, also the elevated total LD, AST 2. What other tests would you run on this patient? 1009

Answer 1

1, LD is Lactate dehydrogenase enzyme found in cells throughout the body. High-level LD indicates there is tissue damage. when the patient is with chest pain LD level increase due to dell destruction, it peak after 24 hours for two to three days and turns in to normal in 10 to 14 days.
AST is Aspartate aminotransferase. This enzyme can be found in the liver, RBC, heart, and muscles. when it injured there will be a high AST level. Very high Ast level due to liver disease called hepatitis. it will be elevated for 1-2 months. AST increase due to the breakup of RBC and it will be high after a heart attack and muscle injury. due to decreased cardiac output and impaired perfusion, there is hepatic dysfunction.
serum concentration of cytoplasmic enzymes like CK, CK-MB, LDH increase due to myocardial cell damage. can identify the peak levels within 72 hours.
2, Patient need EKG to measure the heart electrical activity. Check the Troponin level to know the protein level in the serum that causes heart damage. stress test to see the heart response during activity. angiogram for identifies the block in the artery.