Cortisol level predicts myocardial infarction in patients with ischaemic chest pain
R J Bain1, V J Poeppinghaus, G M Jones
1Department of Medicine, Countess of Chester Hospital, Cheshire, U.K.
Abstract:
Serum cortisol levels were studied in twenty patients with confirmed myocardial infarction and in twenty patients with severe chest pain admitted to the coronary care unit with suspected myocardial infarction but in whom a diagnosis of angina was subsequently made. Cortisol levels were significantly elevated in patients within five hours of the onset of symptoms in myocardial infarction (857 +/- 74 nmol/l; mean +/- SE) but remained within the normal range for those with angina (340 +/- 55 nmol/l). It is concluded that hypercortisolaemia accompanies myocardial infarction, but not angina, and that the psychological stresses of ischaemic chest pain and admission to the coronary care unit produce little, if any, elevation in serum cortisol levels unless there is significant myocardial necrosis. This observation may be of value to those conducting intervention studies in myocardial infarction since the early elevation of the cortisol levels to above the normal range in patients with ischaemic chest pain is both sensitive (70%) and specific (85%) for myocardial infarction.
More Related Videos
Related Concept Videos
Blood Studies for Cardiovascular System I: Cardiac Biomarkers
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...
Blood Studies for Cardiovascular System II: CRP, Hcy, and Cardiac Natriuretic Peptide Markers
These markers indicate stress or strain on the heart muscle:
Natriuretic Peptides (BNP)
Cardiac myocytes produce these hormones in response to ventricular stretching...
Coronary Artery Disease III: Clinical Manifestations
Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations
Acute Coronary Syndrome III: Diagnostic Studies
Angina III: Clinical Manifestations and Assessment


