Serum cardiac troponin-1 and ST segment elevation in patients with acute pericarditis

This study was designed to assess myocardial lesion in idiopathic acute pericarditis. The troponine-I a sensitive and specific marker of myocardial injury was used to assess myocardial lesion in a idiopathic acute pericarditis. ST segment elevation in acute pericarditis also reflects associated superficial myocardial injury. The relationship of tropinine-I and ST segment elevation in idiopathic acute pericarditis was also established. Out of 60 patients selected cardiac troponine-I was detected in 30 patients and was beyond the 1.5 ng/ml threshold in 12 ST-segment elevation was observed in 93% of the patients with cardiac troponin-I levels more than 1.5 ng/ml. So pericardial associated minor myocardial injury may be picked up by troponine-I which is likely to be mixed by ST segment elevation to troponine-I is more specific and sensitive marker for detection of pericardial associated myocardial injury than ST segment elevation. The patients who have tropinine-I threshold more than 1.5 ng/ml were likely to have more recent infarction

Role of cardiac markers in evaluation of suspected myocardial infarction

Current cardiac marker for evaluation of suspected myocardial infarction include CK-MB, myoglobin, CK-MB isoforms and troponins, recommended use for each marker vary according to its cardiac specificity, sensitivity, ease of measurements, turn around time for test results and diagnostic and prognostic uses. CK-MB is an effective marker for reinfarction because it return to normal level within 48 hours after the initial episode. Myoglobin is less specific and sensitive and its pattern of response to infarction is widely variable. CK-MB isoform are good indicator of early stage infarction but technical problems can affect the precision of test result. Because troponin levels remain elevated after onset of chest pain they are good marker for late stage infarction. No single panel consisting of CK-MB and troponin assays is recommended

Recognition of acute right ventricular infarction by right precordial leads

Fifty consecutive patients admitted to NICVD Karachi were screened for presence of ECG criteria of right ventricular infarction. As right ventricular infarction is a fairly frequent occurrence [6 of 50 i.e. 12%] in our population, the recording of lead V3-4R should be an intrinsic part of ECG recording of all patients suspected of acute myocardial infarction