Coronary Heart Disease - Blood Test

Blood tests recommended when Coronary Hearth Disease is suspected: 

• CK-MB - Elevated 6-10 hrs. after an infarct. The most sensitive CK parameter is  the index form (CK-MB/total CK). 

Remember that serial levels must be obtained (based on the time of presentation with respect to the time of pain onset) and that a single negative initial CK cannot rule out a myocardial infarction. A negative CK series does not exclude angina.

Troponin T and I - Both are found on the contractile apparatus of the myocardium. They are used frequently to evaluate for ischemia and they remain elevated up to 1 week after an event. Elevated Troponin has been associated with an increased rate of adverse outcomes

• LDH - The use of troponin has eliminated the need for checking LDH in acute coronary syndromes. Troponin remains elevated as long and is much more sensitive.

• Electrolytes Test - Imbalance of electrolytes such as potassium or magnesium can predispose the patient to arrhythmias.

• Renal Profile - Patients with renal disease are more likely to have underlying cardiac pathology. This will be of importance also if the patient goes to the catheterization lab because of the contrast utilized. Thus a blood urea nitrogen (BUN) and a creatinine are of value among this population.

• Chest X-Ray  - A chest X-ray is important to rule out other serious causes of chest pain such as pneumonia, thoracic aneurysm, pneumothorax or possibly pulmonary embolism. If the patient has Congestive Haert Failure [CHF], this is also a poor prognostic indicator.