Cardiac Markers in the Early Diagnosis and Management of Patients with Acute Coronary Syndrome
Journal Title: Sultan Qaboos University Medical Journal - Year 2009, Vol 9, Issue 3
Abstract
Chest pain is a non-specifc complaint and is the most frequent reason for patients seeking urgent medical attention. A small group of these patients will have acute coronary syndromes (ACS). Te current diagnostic and triage systems based on clinical history and electrocardiograms are insufcient. Tey may result in some of these patients being misdiagnosed and being admitted to the wrong units or receiving inappropriate care, treatment and investigations. In some patients, the diagnosis is delayed resulting in the late administration (or no administration) of essential early treatment. A few patients with ACS may be inadvertently discharged from the emergency department leading to serious health and legal implications. Tese systems also result in the unnecessary admission of a substantial number of patients without ACS. Te triage and management of patients with chest pain can be considerably improved by implementation of serial cardiac markers testing that can identify ACS in the very early stages of presentation. Tis review article will discuss the currently available markers of myocardial damage such as creatine kinase (CK), creatine kinase muscle and brain (CK-MB) (mass and activity), CK-MB isoforms, heart-type fatty acid-binding protein, myoglobin, cardiac troponin T, and cardiac troponin I.
Authors and Affiliations
Hafdh A Al-Hadi| Cardiology Unit, Department of Medicine, Sultan Qaboos University Hospital, Muscat, Sultanate of Oman, Keith A Fox| Te University of Edinburgh, Cardiovascular Research Unit. Te Royal Infrmary of Edinburgh, Scotland
Keywords
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