Picture this scenario: You start feeling pain in the middle of your chest and it is radiating down your right or left arm (yes, either one!), and off you go to the emergency room where the doctor tells you about the test results and tries to explain what it means when your cardiac enzymes are elevated…”
And, even as you shake your head “yes” you’re thinking
I’ve seen that expression on your face before, so let’s get into a little information about what it means for you when your cardiac enzymes are elevated.
Severe stress on the heart can damage its muscle. When that happens, your heart releases certain enzymes — a kind of protein — into your blood.
After a heart attack, the level of these enzymes can get pretty high. They’re called “biomarkers” because they tell doctors when someone’s heart is damaged or stressed.
Measuring the levels of these biomarkers is used to help diagnose conditions associated with the heart not getting enough blood flow to it.
- They can often be detected in body fluids such as blood or urine.
A cardiac enzyme test is also performed after a heart attack to asses whether the heart is damaged, as well as the extent of the damage.
The tests can also be used to help find a person’s risk of having these conditions or to help watch and manage a confirmed diagnosis of heart disease.
The cardiac enzymes that doctors measure to decide if someone is having (or has recently had) a heart attack are named Troponin T and Troponin I.
These are the most specific enzymes related to heart attacks, so both troponin types are commonly checked.
When your cardiac enzymes are elevated it indicates that the heart muscle may be injured or may not be getting enough oxygen, such as with a heart attack.
Doctors may also check the levels of creatine phosphokinase (CPK) an enzyme found mainly in the heart, brain, and skeletal muscle.
- When the CPK levels are raised, it’s a clear sign of heart muscle damage
Be aware, however, that the tests may come back “normal” if they’re performed too soon after an injury to the heart, so they’re typically repeated after several hours.
Other causes of elevated cardiac enzymes include the following:
➡ Tachycardia, where the heart beats faster than normal
➡ Pulmonary embolism, a blockage of an artery in the lungs
➡ Kidney Disease
➡ Weakening of the heart muscle
➡ Injury or trauma to the heart muscle (such as from a car accident)
➡ Prolonged exercise (too much, too hard, for too long)
➡ Swelling of the heart muscle (Myocarditis). Click this link to Read about Myocarditis Here.
➡ Open heart surgery
Medication is often prescribed following a cardiac enzyme test to prevent future heart attacks or treat heart damage.
A doctor will likely order other tests as well as a cardiac enzyme test, because other factors may be the cause of high levels.
Other blood tests
- Electrocardiogram (called an EKG or ECG)
- Chest X-ray
- Stress test
- Heart CT scan
If a doctor determines that a heart attack caused the higher cardiac enzymes levels, the patient will need treatment in the hospital with medications or surgery to restore blood flow to the heart.
Doctors may also prescribe the following medications for a patient who has had a heart attack:
- Drugs that dissolve blood clots (known as a thrombolytic)
- Blood thinners, such as heparin
- Antiplatelet agents to keep blood clots from getting bigger
- ACE inhibitors
- Pain medications
A doctor may also recommend surgery, such as stent placement or a coronary artery bypass (CABG) after a heart attack, in addition to treatment with medications.
Always consider heart attacks as a medical emergency.
When your cardiac enzymes are elevated, you must follow all the doctor’s instructions for the best outcomes.
- Those who receive faster treatment will generally have better outcomes than those who wait. The outlook can vary, based on the cause of the higher enzyme levels.
Lastly, always make sure your physician thoroughly explains each medication prescribed as well as any instructions before and after surgery, if applicable, or alternative treatments if no surgery is performed.
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