Leeuwenhoek had stolen and peeped into the fantastic sub-visible world of little things, creatures that had lived, had bred, had battled, had died, completely hidden from and unknown to all men from the beginning of time. Beasts these were of a kind that ravaged and annihilated whole races of men ten million times larger than they were themselves. Beings these were, more terrible than fire-spitting dragons or hydra-headed monsters. They were silent assassins that murdered babies in warm cradles and kings in sheltered places. It was this invisible, insignificant, but implacable-and sometimes friendly- world Leeuwenhoek had looked into for the first time of all men of all countries. ~Microbe Hunters

Tuesday, 23 April 2013

Troponin

A bit of a late post, but I just finished 2 back-to-back finals. 2 more and I am done year 3!!
Troponin is a cellular protein released from heart cells when you have a heart attack, aka Myocardial Infarction, MI.

Historically, myocardial infarctions have been diagnosed by fulfilling 2 of the 3 following criteria:

  • History of chest pain
  • Abnormal electrocardiogram (ECG)
  • Rise and fall of cardiac markers
Since the diagnosis was based on the fact that 2 of the 3 conditions had to be met, there were some people who were not properly diagnosed with having had an MI. We know now that some people do not have chest pain when experiencing a heart attack, nor may they have an abnormal ECG. The only indication some people have are characteristic cardiac marker fluctuations. 

The protein cardiac markers the lab tests for and monitors over a 24 hour period are troponin, CK-MB, and myoglobin. The first marker that is elevated is myoglobin. Since myoglobin is released from all muscle cells of the body when they die, it is nonspecific, but it helps to "rule out" or "fail to rule out" an MI. That means, the "chest pain" someone may be experiencing may be due to eating 10 kg of Gramma’s chilli causing acid reflux, or a potential heart attack. The next marker to be tested for is troponin which begins to rise after 2-8 hours after the onset of an MI and stays elevated for 5-10 days after. It is considered a "late marker" so it will still be positive if the patient doesn't come to the ER immediately, but can still receive effective treatment. And the final one is CK-MB and it's rise-fall pattern is in the middle of the 2 other enzymes so using the measurement of CK-MB and either of the other proteins, health care professionals can determine approximately the time someone has a heart attack.
Isn't this the CUTEST LITTLE HEART?!?!
It is the heart of the fetal pig my little sister dissected.

Darn good and sure of it,

adot

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