10 Cardiac Markers That Could Indicate a Heart Attack

10 Cardiac Markers That Could help you avert a Heart Attack

Introduction

A heart attack can happen in any person at any time, and it’s critical to know the signs and symptoms so that you can seek medical help as soon as possible- and what better way than to get yourself tested for Cardiac Markers.

Recently, I developed chest pain early one Sunday morning while I was sipping my coffee and reading an article on my tablet.

The pain was of a crushing type just behind the breastbone- the sternum- radiating to the back, that temporarily unsettled me.

As a practicing physician I knew what that pain meant. So, I decided to get myself investigated impromptu.

I went to a nearby hospital and got an ECG done and as suggested by my pathologist friend-Dr. Suresh Tekchandani, MD [Pathology], Pathology InCharge Vinamra Swaraj Hospital, Vashi, Navi Mumbai- to get my high sensitivity troponin I levels [a cardiac marker test] done.

Fortunately for me, both the tests were normal. Well, that was a close call. The pain was probably due to esophagitis, a condition caused by acid reflux from the stomach or cervical spondylitis due to bending posture while reading.

My motto has always been-Prevention is Better Than Cure. And this article will help do just that!

Earlier I had written an article on Heart Attack. You can go through it here-

While there is no foolproof way to prevent a heart attack, recognizing risk factors and learning your personal risk of developing coronary artery disease (CAD) can help you take steps to reduce your risk.

A heart attack happens when the blood supply to your heart becomes blocked due to plaque buildup in your coronary arteries.

If not discovered in time, this lack of blood flow triggers some serious side effects like intense chest pain, nausea or vomiting, feeling very unwell and possibly even fainting.

This article will introduce you to 10 cardiac marker tests that could indicate a potential heart attack or impending danger of one. Your doctor may advise you to do one or more of these tests if he/she is suspecting a heart attack.

What are cardiac markers?

Cardiac markers are proteins and enzymes in the blood that provide insight into heart health. Elevated cardiac markers are a sign of some type of damage in the body, such as heart disease, infection, or inflammation.

A healthy heart produces proteins known as cardiac markers (such as troponin, creatine kinase, and natriuretic peptides) that circulate in the blood stream.

These proteins help doctors diagnose and monitor certain heart diseases.

Elevated levels of cardiac markers are frequently seen in patients with unstable angina, recent heart attack, myocardial infarction or in those with ongoing heart disease.

Useful Resource-

Cleveland Clinic on Cardiac Enzymes

Elevated troponin

Troponin is a protein in your body that measures heart muscle injury. When you have a heart attack, your heart muscle starts to break down.

If your troponin level is elevated, it means your heart muscle is damaged. Troponin is often used as a marker for potential heart attack.

It’s a useful marker because it can be measured in the blood even before other symptoms appear. This test is often recommended for people who have chest pain and are admitted to the emergency room.

Elevated creatine kinase (CK)

Creatine kinase is an enzyme that is produced in your muscles. This cardiac marker becomes elevated when your muscle tissue is injured.

CK is also known as a muscle enzyme, and it’s used to assess the severity of muscle injury. If the level of creatine kinase in your blood is high, it may mean that you have a heart attack, muscle injury, or some other type of injury to your muscles.

CK can be measured using a blood test, but it’s less accurate than a cardiac marker test.

Elevated natriuretic peptide

Natriuretic peptides are cardiac markers that are released by your heart and circulate in your blood. The natriuretic peptide test is used to diagnose various heart diseases, including heart failure.

The three natriuretic peptide tests are –

• B-type natriuretic peptide (BNP),
• N-terminal pro-B-type natriuretic peptide (NT-proBNP), and
• cardio-specific natriuretic peptide (cNP).

NT-proBNP is the most common natriuretic peptide used to assess heart failure and diagnose heart disease. NT-proBNP is also used to monitor people who have had heart failure or a heart attack.

The normal range for all the above tests are-

• BNP: 0 – 100 pg/ml
• NT-proBNP: 0 – 300 pg/ml
• Cardio-specific natriuretic peptide: 0 – 0.2 ng/ml

Elevated B-Type Natriuretic Peptide (BNP)

The BNP test is a cardiac marker for heart failure. It’s often used to diagnose and monitor people with heart failure.

B-type natriuretic peptide (BNP) is a cardiac marker for heart failure. It’s also used to diagnose and monitor people with heart failure.

Because BNP can be falsely positive in people with high blood pressure, it’s important to tell your doctor if you have high blood pressure.

BNP is also used to predict whether a person who has had a heart attack will have a future heart attack.
Elevated Cardiac enzymes

The three most commonly used cardiac enzymes are

• creatine phosphokinase (CPK),
• aspartate transaminase (AST), and
• creatine kinase (CK).

CPK is present in your muscles, while AST is found in your liver, heart and other organs. CK is found in your heart, brain and other muscles.

CPK-MB, AST and CK are also known as cardiac markers, which are proteins produced by your body when your muscles or heart are injured.

Other markers are LDH and ALT.

When these cardiac markers are found in higher-than-normal levels in your blood, it means that your muscles or heart have been injured.

Normal ranges of all cardiac markers

Finally, to summarize, let’s remember the normal values of all the cardiac markers-

• Cardiac Troponin I [Trop I] – 0.04 ng/ml
• Cardiac Troponin T [Trop T] – 0.01 ng/ml
• B-type natriuretic peptide – less than100 pg/ml
• NT-proBNP: 0 – 300 pg/ml
• Cardio-specific natriuretic peptide: 0 – 0.2 ng/ml

Cardiac Enzymes normal range–

• Creatine Kinase (CK-MB): 5 to 25 IU/L
• Creatinine Phosphokinase (CPK): 10 to 120 mcg/L
• Lactic Dehydrogenase (LDH):313 to 618 IU/L
• Alanine Transaminase (ALT): 4 to 36 IU/L
• Aspartate Transaminase (AST): 8 to 33 IU/L

Useful Resource-

NIH

Conclusion

Heart attacks can be frightening, but it’s important to know the signs and symptoms so that you can seek medical help as soon as possible.

By knowing your personal risk of developing coronary artery disease (CAD) and having these cardiac markers checked on a regular basis, you can take steps to reduce your risk and improve your heart health.

Remember, it’s never too early or too late to take care of your heart.

My next article will be on FAQ on Coronary Bypass Surgery that will help you decide whether you would like to go in for it or get an Angioplasty done instead.

Final Words

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Adios.