| Emergency hypertension can result from | | | | moderate risk; one that exceeds 239 mg/dl |
| several disorders, drugs, and procedures. Be | | | | indicates a serious risk of CAD. |
| alert for any of the following in your | | | | |
| patient's history. | | | | High-density lipoprotein (HDL) and LDL |
| | | | cholesterollevels may help predict the risk |
| Cardiovascular Disordersacute left | | | | of CAD more accurately than total cholesterol |
| ventricular failureacute myocardial | | | | levels. An elevated LDL cholesterol level |
| infarctiondissecting aortic aneurysmunstable | | | | indicates an increased risk of CAD, but a |
| angina pectorisworsening of chronic | | | | high HDL cholesterol level indicates a lower |
| hypertension | | | | risk. |
| | | | |
| Neurologic Disorderscerebrovascular | | | | A series of cardiac serum enzyme assays can |
| accidenthead traumahypertensive | | | | confirm an MI. Total creatine kinase (CK) |
| encephalopathyintracranial hemorrhagespinal | | | | levels rise within 6 hours after the start of |
| cord diseasesubarachnoid hemorrhage | | | | an Ml and peak in 12 to 24 hours after |
| | | | cardiac tissue death. When cardiac tissue |
| Renal Disordersacute glomerulonephritisrenal | | | | dies, CK-MB isoenzymes, which are found only |
| parenchymatous diseaserenovascular | | | | in myocardial cells, enter the |
| hypertension | | | | bloodÂÂstream. Measuring their level can |
| | | | help determine the amount of myocardial |
| Other Disorderseclampsianecrotizing | | | | damage. Cardiac troponin levels may be better |
| vasculitispheochromocytomapreeclampsiasclerod | | | | indicators of myocardial damage than CK |
| erma crisisvasculitis | | | | levels . |
| | | | |
| Drugsamphetaminesclonidine (withdrawal | | | | The lactate dehydrogenase (LD) level also can |
| syndrome)cocainelysergic acid | | | | indicate an MI. The blood's LD level rises 24 |
| diethylamidemonoamine oxidase inhibitors | | | | to 48 hours after an MI and peaks in 3 to 6 |
| taken withfoods containing tyramineoral | | | | days. Two of the five isoenzymes that make up |
| contraceptivesphencyclidinesympathomimetic | | | | LD-LD1 and LD2-appear primarily in the heart. |
| drugs | | | | Normally, the LD2 level is higher than the |
| | | | LD1 level. But when a patient has had an MI, |
| Medical and Surgical Procedurescarotid artery | | | | the LD1 level is higher. |
| manipulationcoronary artery bypass surgery | | | | |
| | | | Other blood tests, such as aspartate |
| Diagnostic Tests for Cad | | | | aminotransferase and myoglobin protein |
| | | | levels, also may be used to detect an ML |
| A physician uses certain tests to assess the | | | | However, because these tests are not specific |
| patient's risk of CAD, others to indicate | | | | for MI, they aren't commonly used. With an |
| whether he has CAD, and still others to | | | | MI, the level of serum aspartate |
| determine if he has had an MI-a serious | | | | aminotransferase, formerly called serum |
| complication of CAD. | | | | glutamic-oxaloacetic transaminase, rises. But |
| | | | because serum aspartate aminotransferase |
| Blood Tests | | | | doesn't contain any heart-specific |
| | | | isoenzymes, the results aren't definitive. |
| A physician typically orders a serum lipid | | | | The myoglobin protein level is highly |
| profile to assess the patient's risk of CAD. | | | | sensitive to myocardial injury, but an |
| A total blood cholesterol level below 200 mg | | | | elevated level doesn't confirm an MI because |
| dl indicates a relatively low risk of CAD. A | | | | trauma, inflammation, and ischemia also can |
| level of 200 to 239 mg/dl indicates a | | | | increase the myoglobin protein level. |