What are the symptoms of abnormal cardiac enzymes?

Dec 04, 2022 Source: Cainiu Health

Dr. Tian Hongbo

Introduction

Abnormal myocardial enzymes are mainly characterized by elevated levels, commonly seen in conditions such as myocardial infarction, viral myocarditis, and cirrhosis. Different underlying diseases produce varying symptoms. Common manifestations include chest pain, fever, nausea, and vomiting; severe cases may lead to arrhythmias, shock, or heart failure, as well as palpitations and shortness of breath. Other symptoms may include abdominal discomfort, fatigue, loss of appetite, nausea, and bloating.

Elevated cardiac enzymes are the main manifestation of abnormal myocardial enzymes, commonly seen in conditions such as myocardial infarction, viral myocarditis, and liver cirrhosis. Different diseases lead to different symptoms.

1. Myocardial infarction: Myocardial infarction is a common acute cardiovascular disease primarily caused by occlusion of blood vessels supplying the heart, resulting in interrupted blood flow and ischemic necrosis of the myocardium. Clinical manifestations mainly include severe and persistent chest pain, fever, nausea, and vomiting. Severe cases may lead to arrhythmias, shock, or heart failure.

2. Viral myocarditis: This condition involves localized or diffuse inflammatory lesions of the myocardium caused by viral infections. The main clinical manifestations include fever, fatigue, chest pain, palpitations, and difficulty breathing. Most patients recover spontaneously, but a small number may progress to dilated cardiomyopathy, leading to serious complications such as heart failure or cardiogenic shock.

3. Liver cirrhosis: Liver cirrhosis represents the pathological stage at which various chronic liver diseases progressively advance, characterized by chronic hepatic inflammation, diffuse fibrosis, and proliferation of intrahepatic and extrahepatic blood vessels. During the compensated phase, there are usually no obvious symptoms; however, during decompensation, symptoms of portal hypertension and impaired liver function may appear, including abdominal discomfort, fatigue, loss of appetite, nausea, abdominal distension, weight loss, and lethargy.

In addition, abnormal cardiac enzymes may also indicate other diseases such as hepatitis, cholecystitis, or cholangitis. Therefore, it is advisable to promptly visit a hospital for comprehensive examinations to determine the exact underlying cause and receive appropriate treatment under medical guidance.

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Can a complete blood count (CBC) show whether cardiac enzymes are elevated?

Under normal circumstances, a routine blood test cannot determine whether cardiac enzymes are elevated. A routine blood test refers to an examination that assesses the status of blood and detects diseases by analyzing the quantity and morphological distribution of blood cells, including red blood cell count, hemoglobin, white blood cells, white blood cell differential count, and platelets. It typically does not include cardiac enzymes, and therefore cannot indicate whether cardiac enzyme levels are high or not.

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What type of tube is used for blood collection to test cardiac enzymes?

Blood collection for cardiac enzymes typically uses a yellow-top tube. Elevated cardiac enzymes primarily indicate acute myocardial infarction, in which myocardial cells suffer from ischemia and hypoxia, leading to the release of large amounts of cardiac enzymes into the bloodstream. An increase in cardiac enzymes suggests that myocardial cell necrosis has occurred. When elevated cardiac enzymes are accompanied by symptoms such as chest tightness, chest pain, or pressure-like pain, acute myocardial necrosis or acute myocardial infarction should be considered.

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Is elevated myocardial enzyme level serious?

Elevated myocardial enzymes can be serious, and the severity should be assessed based on the patient's clinical presentation and overall condition. In mild cases of myocarditis causing elevated myocardial enzymes, levels can return to normal with proper treatment. However, when the elevation is severe, it may impair cardiac function. Patients should prioritize adequate bed rest and consume nutritious foods to support recovery in daily life.

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Normal Values and Clinical Significance of Cardiac Enzyme Tests

The laboratory test report for myocardial enzymes mainly includes lactate dehydrogenase, creatine kinase, and creatine kinase-MB. By comparing these values, it can be determined whether a patient has a disease. In addition to the above common tests, other indicators such as hydroxybutyrate dehydrogenase may also be evaluated. If any of these test results are abnormal, further cardiac ultrasound examination is required to confirm the presence of heart disease.