A 51yearold overweight white man visits his family physician

A 51-year-old, overweight white man visits his family physician with a symptom of “indigestion” of 5 days’ duration. He has also had bouts of sweating, malaise, and headache. His blood pressure is 140/105 mm Hg; his family history includes a father with diabetes who died at age 62 of AMI secondary to diabetes mellitus. An electrocardiogram revealed changes from one performed 6 months earlier. The results of the patient’s blood work are as follows:

CK 129 U/L (30–60)

CK-MB 4% (<6%)

LD 280 U/L (100–225)

LD Isoenzymes LD-1 > LD-2

AST 35 U/L (5–30)

Questions 1. Can a diagnosis of AMI be ruled out in this patient?

2. What further cardiac markers should be run on this patient?

3. Should this patient be admitted to the hospital?

Solution

1: No, diagnosis of AMI can not be ruled out due to family history of death of a father of AMI secondary to diabetes. The results also show deviation of ECG and damage to cardiac tissue.