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We provide our users the most up-to-date and accurate information on the treatment and prevention of cardio pathologies in accordance with current American and European clinical guidelines.
The information provided on this website is for educational purposes only and should not be considered medical advice. Always consult a licensed physician for diagnosis and treatment.
Cardiac Enzymes: Their Role in Diagnosing Heart Conditions
Introduction
Cardiac enzymes are proteins released into the bloodstream when the heart muscle is damaged. They play a crucial role in diagnosing conditions like heart attacks (myocardial infarctions) and other cardiac disorders. Understanding how they work can help patients comprehend their diagnostic value and clinical significance.
Key Cardiac Enzymes
1. Troponins (Troponin I and Troponin T)
- These are the most specific markers of heart muscle damage.
- Even a very small increase in troponin levels can indicate cardiac injury.
- Troponin levels start rising within 3–4 hours after myocardial injury, peak at 12–24 hours, and can remain elevated for up to 2 weeks.
2. Creatine Kinase-MB (CK-MB)
- A less specific but still useful enzyme.
- Levels start rising within 3–6 hours, peak at 12–24 hours, and return to normal within 2–3 days.
- Useful in detecting recurrent heart attacks.
3. Myoglobin
- A very early marker, appearing in the blood within 1–2 hours.
- Not specific to cardiac muscle; can also increase due to muscle injuries.
4. Lactate Dehydrogenase (LDH)
- Not commonly used today due to its low specificity for heart conditions.
How Cardiac Enzymes Are Used in Diagnosis
Doctors typically perform serial enzyme measurements over time to assess trends rather than relying on a single test. This is especially important in diagnosing heart attacks where timely intervention can be lifesaving.
Other Conditions That May Elevate Cardiac Enzymes
Apart from heart attacks, cardiac enzymes may be elevated in:
- Myocarditis (inflammation of the heart muscle)
- Heart failure
- Severe hypertension
- Sepsis and shock (due to reduced oxygen supply to the heart)
Conclusion
Cardiac enzyme tests are a fundamental tool in cardiology. Elevated levels, especially of troponins, warrant immediate medical attention as they may indicate a critical event such as a heart attack. If you ever experience symptoms like chest pain, shortness of breath, and dizziness, seek emergency medical care immediately.
Source recommendations
1. American College of Cardiology/American Heart Association (ACC/AHA) Guidelines for the Management of Patients With ST-Elevation Myocardial Infarction
- https://pubmed.ncbi.nlm.nih.gov/15289388/
- https://professional.heart.org/en/science-news/2021-acc-aha-scai-guideline-for-coronary-artery-revascularization
- https://www.ahajournals.org/doi/10.1161/cir.0b013e3182742cf6
- https://www.sciencedirect.com/science/article/pii/S073510972106157X
- https://www.ahajournals.org/doi/10.1161/01.cir.0000134791.68010.fa
2. European Society of Cardiology (ESC) Guidelines for the Management of Acute Coronary Syndromes
- https://www.escardio.org/Guidelines/Clinical-Practice-Guidelines/Acute-Coronary-Syndromes-ACS-Guidelines
- https://pubmed.ncbi.nlm.nih.gov/37622654/
- https://academic.oup.com/eurheartj/article/44/38/3720/7243210
- https://pubmed.ncbi.nlm.nih.gov/32860058/
- https://academic.oup.com/eurheartj/article/42/14/1289/5898842
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If you or your loved ones experience any of these symptoms, you should consult a doctor in time. Remember that self-medication can be dangerous, and timely diagnosis will preserve the quality and life expectancy.
The heart is an organ that does not know how to "keep silent" if something goes wrong. Chest pain, shortness of breath, swelling, dizziness, and rhythm disturbances are the symptoms that require our attention. The best prevention of heart disease is careful attention to your health, regular checkups with a doctor, and a healthy lifestyle. Take care of your heart, and it will serve you for many years!
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