Incremental value of the leukocyte differential and the rapid creatine kinase-MB isoenzyme for the early diagnosis of myocardial infarction

Article Abstract:

An elevation in the white blood cell count, a decrease in the number of immune cells, along with an elevated rapid creatine kinase-MB enzyme level, may indicate that a heart attack causing death of part of the heart muscle has occurred. A study of 69 heart attack patients who went to an emergency room because of chest pain found that only 39% could be diagnosed by the standard electrocardiographic (ECG) ST-segment elevation. Diagnosis was achieved in the rest of the cases with the combination of white blood cell counts and immune cell counts and increased rapid creatine kinase-MB levels. The combination of measurements may improve the survival of heart attack patients by increasing diagnostic accuracy and providing earlier life-saving treatment. Until now, heart attack patients who did not show an elevated ST-segment on the ECG had a high in-hospital death rate because their diagnosis was missed. The leukocyte differential (change in white blood cell count) is commonly obtained for patients with chest pain, so its use in diagnosing heart attack in such patients may not add time or cost to the diagnosis.

Physiological aspects, Creatine kinase, Leucopenia, Leukopenia

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The heart, part five: coronary artery disease - 1

Article Abstract:

Angina or severe chest pain may indicate the presence of coronary artery disease (CAD) of the heart and should be treated according to severity of discomfort and breathlessness. Up to 148,186 people in the UK died from CAD during 1998, making it the major cause of death. A wide range of investigative procedures are used to assess the presence and severity of CAD, although the stress involved in waiting for results can often cause extra difficulties which should be monitored by nurses.

Care and treatment, Coronary heart disease, Study and teaching, Heart diseases

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Nurse-initiated coronary thrombolysis

Article Abstract:

Methods of diagnosing and treating patients who have suffered an acute myocardial infarction are explained. The early application of thrombolytic agents by coronary care nurses at Forth Valley Acute Hospital, Scotland, is described.

Methods, Usage, Thrombolytic therapy, Fibrinolytic agents, Thrombolytic drugs

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