Cardiac biomarkers in the critically ill
Corey E Ventetuolo1, Mitchell M Levy
1Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, College of Physicians and Surgeons, Columbia University, 622 West 168th Street, PH 8 East, Room 101, New York, NY 10032, USA.
Critical Care Clinics
|March 29, 2011
Summary
Cardiac biomarkers like troponin aid critically ill patients. However, consensus is lacking on their use in noncardiac critical illness, despite their diagnostic and risk assessment potential.
Area of Science:
- Critical care medicine
- Cardiology
- Biomarker research
Background:
- Cardiac biomarkers are vital for diagnosing acute coronary syndromes and heart failure.
- Their utility in critically ill patients with noncardiac conditions is under investigation.
- Current guidelines lack consensus on measuring cardiac biomarkers in noncardiac critical illness.
Purpose of the Study:
- To review the role of cardiac biomarkers in critically ill patients.
- To discuss ideal biomarker characteristics.
- To focus on troponin, natriuretic peptides, and heart-type fatty acid-binding protein in critical illness.
Main Methods:
- Literature review of cardiac biomarkers in critical illness.
- Discussion of ideal biomarker properties.
- Focus on troponin, natriuretic peptides, and heart-type fatty acid-binding protein.
Main Results:
- Cardiac biomarkers can aid diagnosis and risk stratification in critically ill patients.
- Troponin, natriuretic peptides, and heart-type fatty acid-binding protein are key biomarkers in critical illness.
- Further research is needed to establish clear guidelines for their use.
Conclusions:
- Cardiac biomarkers have potential in noncardiac critical illness, but require further study.
- Standardized protocols for biomarker measurement are needed.
- Understanding biomarker roles can improve patient management in critical care settings.
Related Concept Videos
01:20Blood Studies for Cardiovascular System I: Cardiac Biomarkers
Cardiac biomarkers are enzymes, proteins, and hormones released into the blood when cardiac cells are injured. They are powerful tools for triaging.
The essential diagnostic tools for detecting myocardial necrosis and monitoring individuals suspected of having acute coronary syndrome (ACS) include:
Troponins
Troponins, particularly cardiac troponins I and T, are the most precise and sensitive markers of myocardial injury. They are detectable within 4-6 hours of myocardial injury and remain...
The essential diagnostic tools for detecting myocardial necrosis and monitoring individuals suspected of having acute coronary syndrome (ACS) include:
Troponins
Troponins, particularly cardiac troponins I and T, are the most precise and sensitive markers of myocardial injury. They are detectable within 4-6 hours of myocardial injury and remain...
01:19Blood Studies for Cardiovascular System II: CRP, Hcy, and Cardiac Natriuretic Peptide Markers
Cardiac biomarkers are critical in diagnosing, prognosing, and managing cardiovascular diseases. Routine measurement of specific biomarkers such as B-type natriuretic peptide (BNP), C-reactive protein (CRP), and homocysteine (Hcy) is common practice in clinical settings to evaluate heart function and predict cardiovascular events.
These markers indicate stress or strain on the heart muscle:
Natriuretic Peptides (BNP)
Cardiac myocytes produce these hormones in response to ventricular stretching...
These markers indicate stress or strain on the heart muscle:
Natriuretic Peptides (BNP)
Cardiac myocytes produce these hormones in response to ventricular stretching...
01:30Acute Coronary Syndrome III: Diagnostic Studies
Diagnosing acute coronary syndrome or ACS begins with a thorough patient history. Notable symptoms include central, crushing chest pain radiating to the left arm, neck, jaw, or back, along with shortness of breath, sweating (diaphoresis), nausea, vomiting, dizziness, and palpitations.It is crucial to note any history of cardiac illnesses and assess risk factors, including age, gender, smoking, hypertension, diabetes, hyperlipidemia, and a sedentary lifestyle.During physical examination, vital...
01:30Cardiomyopathy II: Dilated Cardiomyopathy
Dilated cardiomyopathy, or DCM, is a progressive myocardial disorder characterized by ventricular chamber dilation and contractile dysfunction.EtiologyVarious factors can cause DCM, including hypertension and heavy alcohol intake, which contribute to the weakening and enlargement of the heart muscle. Viral infections, such as Coxsackievirus B, adenoviruses, and influenza, can lead to DCM by causing inflammation and damage to heart tissue. Certain chemotherapeutic agents, including daunorubicin,...
01:30Dysrhythmias V: Evaluating Dysrhythmias
Dysrhythmias, also known as arrhythmias, are disturbances in the heart's rhythm that range from benign to life-threatening. A thorough evaluation is crucial for appropriate management and involves a comprehensive medical history, physical examination, and various diagnostic tests.Medical HistorySymptoms: Collect detailed information on palpitations, dizziness, syncope, chest pain, and fatigue. Note their onset, frequency, and triggers.Previous Cardiac Issues: Document any history of heart...
01:30Introduction Cardiac Emergencies
Cardiac emergencies are critical situations involving the heart that require immediate medical intervention to prevent severe complications or death. These emergencies often arise from underlying heart conditions that impair the heart's ability to function correctly.Types of Cardiac EmergenciesThe most common types of cardiac emergencies include Acute Coronary Syndrome (ACS), myocardial infarction (MI), cardiac arrest, and heart failure.Acute Coronary Syndrome (ACS)Acute Coronary Syndrome (ACS)...