Myocardial infarctio. During a mi there is a increased systemic inflammatory response. Esr is a marker of that very inflamation.
Inflammation. Sedimentation rate is a reflection of inflammation in the body. Inflammation in the heart is part of myocardial infarction. The inflammatory cells local to the inflammation signal back to the liver to increase inflammatory proteins. These proteins result in the increased sedimentation rate.
Yes. The ESR is increased by inflammation and goes up within a few days of a myocardial infarction. It may remain high for a few weeks.
Yes. It raises it.
Depends. The elevation of ck-mb is in direct proportion to the size of the infarction. The highest I personally have ever seen was about 1000 but that is very unsual. Also, ck-mb will rise as a % of the total circulating ck. Normall ck-mb is less than 1.5% of total ck. After infarction, ck-mb will go to anywhere between 2.5-15% of total ck.
Depends on lab. Each lab publishes its own normal range so check with your lab. More importantly though, is not the absolute level. It's the pattern of rising and falling which is indicative of mi. Some normal people always have a markedly elevated CPK and have normal hearts. Muscle disease or even vigorous muscular work can raise the CPK too.
Unique to person. In many occations not painfull at all. Most common symptom is chest pressure, heavyness, oppresion, shortness of breath not "pain", sometimes indigestion like symptoms. "silent" heart attacks are common in patients with diabetes. Still today about 50% of people die on their first heart attack. In many occations thinking" its not my heart", " its reflux", "indigestion", "my hiatal hernia"anything but.
Various. The st segment is a portion of the electrocardiogram. A myocardial infarction can be described as st elevation myocardial infarction or non-st elevation myocardial infarction depending on the appearance of the electrocardiogram. Management of the 2 types of heart attack are somewhat different.
Heart damage. It refers to an elevation in the wave form of an ekg. The leads (areas of the heart we are looking at on the ekg) that is elevated helps us determine what area of the heart is having difficulty.
Multiple methods. Myocardial infarction (mi) is suspected by symptoms usually including chest pain. The conclusive diagnosis is established based on a combination of specific abnormalities of the electrocardiogram (ekg) and presence of certain heart enzymes that leak into the blood during an mi. The most common enzymes are called ck-mb and troponin.
EKG and blood. The diagnosis of acute mi is based on evolutionary changes on the ekg and a characteristic rise and fall of the cardiac troponin enzymes. A scar (or old mi) can be suspected from an abnormal ekg, wall motion abnormality on echo, or a fixed perfusion defect on nuclear testing.
Myocardiainfarction. Arriving to the hospital later rather than earlier can decrease the chance of early intervention to open the artery that saves heart muscle to be effective.
Many. The location is a major factor: left main blockage is most likely to be fatal. Proximal left anterior descending is also often fatal. Patient factors such as on-going tobacco use, uncontrolled hypertension, diabetes, anemia, pre-existing heart or kidney failure and advanced age all raise the risk.
See a doctor. Anyone who has had a heart attack/mi should be under the care of a physician who can evaluate their risks and prescribe the appropriate treatment.
Multiple & varied. Chest pain, radiation to the arm, neck, jaw, sense of impending doom, sweating, feeling of weight on chest, tiredness, shortness of breath, feeling faint or dizzy etc. About a quarter of the mis especially in diabetics may have no recognizable symptoms. Sudden death may be the only symptom in some.