site last modified: October 4, 2006
Update on Cardiac Biomarkers
At one time, the term "cardiovascular risk" related to the identification of an individual experiencing an acute myocardial infarction (MI), with CK-MB serving as the laboratory's gold standard. In 2000, the European Society of Cardiology (ESC) and the American College of Cardiology (ACC) redefined the criteria for a myocardial infarction to include a typical pattern of increase followed by a gradual decrease in troponin T (cTnT) or I (cTnI) as the preferred biomarker due to its greater specificity and sensitivity relative to CK-MB values (mass assay).
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A 51-Year-Old Man With Acute Dyspnea and Leg Swelling
51-year old man complains of acute onsed of severe dyspnea and right leg swelling. He hit his right leg on a piece of furniture at home, and he then developed erythema, swelling, and pain in this leg. He presented to the emergency department (ED) the following day with hypotension, tachycardia, tachypnea, and altered mental status. His leg was swollen and ecchymotic with a few fluid-filled blisters. He was hemodynamically unstable, and died 36 hours after presentation. Medical history was significant for hypertension, asthma, and stage IIIA squamous cell carcinoma of the lung. He completed chemoradiotherapy 2 years ago, underwent right middle and lower lobectomy with lymphadenectomy 3 months ago, and resumed chemotherapy 1 week prior to presentation.
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