Myocardial Infarction Case Study

809 Words 4 Pages
1. What are Phil’s abnormal test results?

His anion gap was low on both days with 5.0 mmol/L (normal being 10-20 mmol/L); his BUN was high with 53 mg/dL on day 1 and 49 mg/dL on day 2 (normal being 7-24 mg/dL); and his creatinine was high with 2.0 mg/dL on day 1 and 1.8 mg/dL on day 2 (normal being 0.5-1.2 mg/dL).

2. Do the laboratory results rule out a myocardial infarction?

According to Lewandrowski, Chen, and Januzzi (2002), blood testing for cardiac biomarkers plays a vital role in evaluating and diagnosing patients with chest pain and suspected myocardial infarction (MI). The most common clinically relevant cardiac biomarkers include nonspecific markers like lactate dehydrogenase (LD) and total creatine kinase (CK) as well as more specific markers like LD isoenzymes, CK-MB, CK-MB isoforms, myoglobin, and troponin T/troponin I (Lewandrowski, Chen, & Januzzi, 2002). Since CK, CK-MB and troponin I are all within their normal reference ranges and did not significantly increase over the 2 days they were measured, a myocardial infarction can be ruled out.
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What is Phil’s BUN/creatinine ratio? What is a normal BUN/creatinine ratio?

Formula: BUN divided by creatinine = BUN/creatinine ratio
Day 1: 53 mg/dL divided by 2.0 mg/dL = 26.5
Day 2: 49 mg/dL divided by 1.8 mg/dL = 27.2
Average: ((53 mg/dL + 49 mg/dL)/2)
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In congestive heart failure (CHF), digitalis is usually introduced after diuretics and ACE inhibitors to increase the hearts contractility; to decrease its workload; and to improve symptoms as well as morbidity in affected patients (Quinn, 2006). And since Phil C. has normal levels of the medication present in his blood, it can be assumed that he is receiving it to treat congestive heart failure (CHF), which has caused his current

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