| Emergency hypertension can result from several | | | | cholesterollevels may help predict the risk of CAD |
| disorders, drugs, and procedures. Be alert for any of | | | | more accurately than total cholesterol levels. An |
| the following in your patient's history. | | | | elevated LDL cholesterol level indicates an increased |
| Cardiovascular Disordersacute left ventricular | | | | risk of CAD, but a high HDL cholesterol level indicates |
| failureacute myocardial infarctiondissecting aortic | | | | a lower risk. |
| aneurysmunstable angina pectorisworsening of chronic | | | | A series of cardiac serum enzyme assays can |
| hypertension | | | | confirm an MI. Total creatine kinase (CK) levels rise |
| Neurologic Disorderscerebrovascular accidenthead | | | | within 6 hours after the start of an Ml and peak in 12 |
| traumahypertensive encephalopathyintracranial | | | | to 24 hours after cardiac tissue death. When cardiac |
| hemorrhagespinal cord diseasesubarachnoid | | | | tissue dies, CK-MB isoenzymes, which are found only |
| hemorrhage | | | | in myocardial cells, enter the bloodÂÂstream. |
| Renal Disordersacute glomerulonephritisrenal | | | | Measuring their level can help determine the amount |
| parenchymatous diseaserenovascular hypertension | | | | of myocardial damage. Cardiac troponin levels may be |
| Other Disorderseclampsianecrotizing | | | | better indicators of myocardial damage than CK |
| vasculitispheochromocytomapreeclampsiascleroderma | | | | levels . |
| crisisvasculitis | | | | The lactate dehydrogenase (LD) level also can |
| Drugsamphetaminesclonidine (withdrawal | | | | indicate an MI. The blood's LD level rises 24 to 48 |
| syndrome)cocainelysergic acid diethylamidemonoamine | | | | hours after an MI and peaks in 3 to 6 days. Two of |
| oxidase inhibitors taken withfoods containing | | | | the five isoenzymes that make up LD-LD1 and |
| tyramineoral | | | | LD2-appear primarily in the heart. Normally, the LD2 |
| contraceptivesphencyclidinesympathomimetic drugs | | | | level is higher than the LD1 level. But when a patient |
| Medical and Surgical Procedurescarotid artery | | | | has had an MI, the LD1 level is higher. |
| manipulationcoronary artery bypass surgery | | | | Other blood tests, such as aspartate |
| Diagnostic Tests for Cad | | | | aminotransferase and myoglobin protein levels, also |
| A physician uses certain tests to assess the patient's | | | | may be used to detect an ML However, because |
| risk of CAD, others to indicate whether he has CAD, | | | | these tests are not specific for MI, they aren't |
| and still others to determine if he has had an MI-a | | | | commonly used. With an MI, the level of serum |
| serious complication of CAD. | | | | aspartate aminotransferase, formerly called serum |
| Blood Tests | | | | glutamic-oxaloacetic transaminase, rises. But because |
| A physician typically orders a serum lipid profile to | | | | serum aspartate aminotransferase doesn't contain |
| assess the patient's risk of CAD. A total blood | | | | any heart-specific isoenzymes, the results aren't |
| cholesterol level below 200 mg/dl indicates a relatively | | | | definitive. The myoglobin protein level is highly |
| low risk of CAD. A level of 200 to 239 mg/dl | | | | sensitive to myocardial injury, but an elevated level |
| indicates a moderate risk; one that exceeds 239 mg | | | | doesn't confirm an MI because trauma, inflammation, |
| dl indicates a serious risk of CAD. | | | | and ischemia also can increase the myoglobin protein |
| High-density lipoprotein (HDL) and LDL | | | | level. |