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Healthcare and Lab
Diagnostic Newsletter

สาระข่าวสารความรู้เรื่องสุขภาพ
การตรวจวินิจฉัยโรคทางแล็ป

Cardiac Markers:  
  
Myoglobin Test
Common Questions

 รายละเอียดเรื่องโรคและอาการ
 ของโรคหัวใจขาดเลือด
 Myocardial infarction

Cardiac Markers:  
  
Troponin I/Troponin T
   Test
  

CK-MB Test
 
Also known as: CK MB, CPK  
  MB
  Formally known as: Creatine 
  Kinase–MB



Cardiac Markers:  
  
CK, CPK Test
   Creatinine Kinase
   ครีเอตินีน ไคเนส

Cardiac Markers:  
   
LD, LDH Test
    Lactate Dehydrogenase
    แลคเตส ดีไฮโดรจิเนส


   วิธีทดสอบ/วินิจฉัยทางแล็ป
 
     ( ห้องปฏิบัติการชันสูตร ) 
   
Reference test procedure
 
โรคและกลุ่มอาการที่สนใจ
    และสอบถามรายละเอียดมาก

    - โรคของนักธุรกิจ
    - โรคที่ไม่ติดต่อ
    - โรคของผู้สูงอายุ
    - การดูแลเมื่อเข้าสู่วัยทอง
ิ    - ปัญหาและการเปลี่ยนไต
   อื่นๆอีกมากมาย ที่น่าติดตาม    
  


 

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  Cardiac Markers: Developers enter a new era of progress      
-  Definition

Myoglobin is a protein found in muscle. Myoglobin tests are done to evaluate a person who has symptoms of a heart attack (myocardial infarction) or other muscle damage.

-  Purpose

Myoglobin holds oxygen inside heart and skeletal muscle (muscles that attach to and move bones). It is continually released into the blood in small amounts due to normal turnover of muscle cells. Kidneys discard the myoglobin into urine.

When muscle is damaged, as in a heart attack, larger amounts of myoglobin are released and blood levels rise rapidly. Myoglobin is one of the first tests done to determine if a person with chest pain is having a heart attack, as it may be one of the first blood tests to become abnormal.

Damage or injury to skeletal muscle also causes myoglobin to be released into the blood.

-  Description

Heart attack must be diagnosed quickly. Medications to prevent heart damage are effective only within a limited number of hours. Yet, because of their risk for excessive bleeding, these medications are given only after a diagnosis of heart attack is made.

Myoglobin is one of several cardiac markers used to make the diagnosis. Cardiac markers are substances in blood whose levels rise in the hours following a heart attack. Increased levels help diagnose a heart attack; persistent normal levels rule it out.

Each cardiac marker rises, peaks, and returns to a normal level according to its own timeline, or diagnostic window. Myoglobin is useful because it has the earliest diagnostic window. It is the first marker to rise after chest pain begins. Myoglobin levels rise within two to three hours, and sometimes as early as 30 minutes. They peak after six to nine hours. The levels return to normal within 24-36 hours.

Although a rise in myoglobin supports a diagnosis of heart attack, it is not conclusive. Simultaneous skeletal muscle damage could also cause the increase. Myoglobin rules out, rather than proves, a diagnosis in the following way. If myoglobin levels have not risen after more than five hours, a heart attack in unlikely. Normal levels in the first two to three hours do not rule out an infarction.

The myoglobin test is sometimes repeated every one to two hours to watch for the rise and peak. Results are available within 30 minutes.

Myoglobin in large amounts is toxic to the kidney. When a person has high amounts of myoglobin in the blood, kidney function must be monitored.

-  Preparation

This test requires 5 ml of blood. Collection of the sample takes only a few minutes. A urine myoglobin test requires 1 ml of urine collected into a urine collection cup.

-  Aftercare

Discomfort or bruising may occur at the puncture site or the person may feel dizzy or faint. Pressure to the puncture site until the bleeding stops reduces bruising. Warm packs to the puncture site relieve discomfort.

-  Normal results

Normal results vary based on the laboratory and method used.

-  Abnormal results

Myoglobin levels and levels of other cardiac markers are usually considered before finally confirming a diagnosis of heart attack. A level that has doubled after one to two hours, even if the level is still in the normal range, indicates a significant rise that may be due to heart attack.

Increased levels are also found with skeletal muscle damage or disease, such as an injury, muscular dystrophy , or polymyositis . Myoglobin levels also rise during renal failure because kidneys lose their ability to clear myoglobin from blood.

-  Key Terms

•  Cardiac marker
A substance in the blood that rises following a heart attack.
•  Diagnostic window
A cardiac marker's timeline for rising, peaking, and returning to normal after a heart attack.
•  Myoglobin
A protein that holds oxygen in heart and skeletal muscle. It rises after damage to either of these muscle types.

Common Questions
1. What does heart attack mean?
Heart attack means that some of the muscle in your heart has died. A medical term for this is myocardial infarction. Most commonly, a heart attack starts with a kind of heavy pressure or pain in the chest, often extending into the neck or left arm. You may have trouble catching your breath, or you may feel weak and break into a cold sweat.

A heart attack usually occurs because one of the blood vessels (called coronary arteries) that bring blood to your heart muscle is blocked. This usually happens when a blood clot forms in a blood vessel that is already partially blocked. The partial blockage, which happens gradually over many years, is usually caused by too much fat layered in the wall of the blood vessel (this is often called hardening of the arteries—the medical term for this is atherosclerosis).



2. If I have chest pain, does that mean I am having a heart attack?
Many other problems can cause chest pain, and it is not always possible to tell just from the type of chest pain whether or not you are having a heart attack. Many people have chest pain from straining the muscles in their chest, and chest pain can occur with some lung problems. Chest pain can be a warning sign of hardening of the arteries of the heart (coronary artery disease or CAD).

Chest pain that occurs during exercise, hard work, or at times of stress, lasts for a few minutes and goes away with rest is called angina. If the pain lasts longer than just a few minutes, especially if it occurs when you are resting, seek immediate medical attention.


3. What are the other heart attack tests?
Doctors often use more than one test to determine if a person who has chest pain is having a heart attack. Troponin can pick up damage to heart muscles even when there is no other evidence of a heart attack. Myoglobin and creatine kinase, two other proteins found in the heart and in other muscles, do not usually rise in persons with heart injury unless a heart attack has occurred. Some doctors use the term “mild heart attack” if troponin is high but one or both of the other muscle proteins are not.


4. What if I’m not sure I’m having a heart attack?
If you have prolonged chest pain, especially if it does not go away with rest— or if you have been told you have angina, and the drugs you were prescribed do not ease the pain, seek immediate medical attention. Many people who have had a heart attack die without ever having tried to call an ambulance or get to an emergency room.


5. Is myoglobin useful to evaluate a stroke, too?
A stroke, sometimes called a “brain attack,” occurs when part of the brain dies. Like a heart attack, it usually is due to a blockage of one of the blood vessels that brings blood to the brain. Myoglobin is only found in muscle cells, not in the brain, so it is not helpful in evaluating a person who may have had a stroke.


 

 

 
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