In case study #1, a 45-year old African- American male presents to the emergency room at 4:30 am, 1 hour after waking up with considerable chest pain that is also radiating to his back and right arm. He is also nauseous and short of breath. The patient has had similar incidents in the previous 2-3 months. He is a smoker and has a history of high-blood pressure for which he takes medication. He also takes a daily aspirin. His blood pressure is high upon arrival, 200/40, and O2 saturation is low, 92%, before administration of oxygen. Initial EKG results, though showing some abnormalities, do not show evidence of an active MI. EKG was repeated at 1 hour and showed similar results. Initial blood work including CBC, routine chemistries and cardiac biomarkers were all normal. Because of patient’s history and symptoms, he was admitted to hospital and monitored. His pain was treated with morphine and nitroglycerin. He was also given low-molecular weight heparin. …show more content…
This EKG showed inverted T-waves and also Q-waves. Total CK, CK-MB, and cTnT results were also all now increased. These results were diagnostic for AMI. Patient was taken to the cardiac catheterization lab immediately for angioplasty and placement of stent in an occluded coronary artery.
The testing performed on this patient definitely supports the diagnosis of AMI. Since CM-MB results typically rise within 3-6 hours after the onset of MI symptoms and troponin levels typically rise within 3-4 hours after injury to the heart muscle, this coincides with the patient’s symptom of chest pain awakening him at 3:30 am. Both CK-MB and troponin typically peak at 24 hours after MI. The patient’s symptoms coincide with these results also as blood work drawn approximately 26 hours after onset of symptoms show a decrease from levels drawn at 11 hours after