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