This document discusses acute myocardial infarction (AMI), also known as a heart attack. AMI occurs when blood flow to the heart is blocked, injuring the heart muscle due to lack of oxygen. It is caused by a buildup of cholesterol, fat, and white blood cells in the coronary arteries. AMI can be diagnosed if a patient experiences chest pain for over 20 minutes and has changes on their electrocardiogram (ECG) and increasing and decreasing levels of cardiac biomarkers. Common biomarkers for AMI include creatine kinase, creatine kinase-MB, cardiac troponins, and myoglobin. These biomarkers are detectable in blood and can help determine the extent and timing of the heart injury.

1. IN ACUTE
MYOCARDI
AL
INFRACTIO
N

2. 1. MYOCARDIAL INFRACTION IS THE
MEDICAL TERM FOR AN EVENT
COMMONLY KNOWN AS HEART
ATTACK.
2. IT OCCURS WHEN BLOOD STOPS
FLOWING PROPERLY TO A PART OF
THE HEART AND THE HEART MUSCLE
IS INJURED DUE TO INSUFFICIENT
OXYGEN.
3. THERE IS BLOCKAGE IN CORONARY
ARTERIES DUE TO UNSTABLE BUILDUP
OF WBC , CHOLESTEROL AND FAT
Diagram of a myocardial infarction
(2) of the tip of the anterior wall of
the heart (an apical infarct) after
occlusion (1) of a branch of the left
coronary artery (LCA).

3.  1. SUDDEN CHEST PAIN
 2. SHORTNESS OF THE BREATH
 3.SWEATING
 4.NAUSEA
 5. VOMITING
 6. ABNORMAL HEART BEATS
 ANXIETY

5.  A PATIENT IS DIAGNOSED WITH MI IF 2
OR 3 OF THE FOLLOWING CRITERIA ARE
SATISFIED
 1. CHEST PAIN LASTING FOR MORE THAN
20 MINUTES
 2 . CHANGES IN SERIAL ECG TRACING
 3. RISE AND FALL OF SERUM CARDIAC
BIOMARKERS

6.  ischemia to myocardial muscles (with low O2 supply)
 anaerobic glycolysis
 increased accumulation of Lactate
 decrease in pH
 activate lysosomal enzymes
 disintegration of myocardial proteins
 cell death & necrosis
CLINICALmanifestations BIOMARKERS ECG CHANGES

7.  A BIOMARKER is
measurable and quantifiable
biological parameter which
serve as indices for health-and
physiology-related
assessments such as disease
risk, psychiatric disorder,
environmental exposure and
its effects, disease diagnosis,
metabolic processes,
substance abuse, pregnancy,
cell line development,
epidemiologic studies, etc

8.  1954 SGOT (AST)
 1955 LDH
 1960 CPK
 1972 CPK isoforms by Electrophoresis
 1975 CK - MB by immunoinhibition
 1975 Myoglobin
 1985 CK - MB Mass immunoassay
 1989 Troponin T
 1992 Troponin I
 Recently discover biomarker is Gb3 potentioly
related to survival of heart

9.  Diagnostically has;
1. High sensitivity (detection of MI positive cases)
2. High specificity (absent in non-myocardial injury) Rapidly release at a
detectible concentration
3. Correlate efficiently with the extent of MI
4. Persists in blood for valuable time (long 1/2 life)
 Analytically has;
1. High sensitivity (low detectable limit)
2. High specificity (less interferences)
3. Easy, inexpensive and rapidly tested ( short TAT)

10. Cardiac Enzyme Markers;
CK and LD
Cardiac protein Markers;
Troponins, FA Binding Protein and
Myoglobin
Prognostic & Risk Stratification markers;
hs CRP , MPO & homocysteine

11.  1.MUSELE CREATINE KINASE CATALAYSES THE
TRANSFER OF PHOSPHATE BETWEEN AND ATP
 2. CK IN SERUM IS UNSTABLE AS A RESULT OF
OXYDATION OF SULFHYDRYL GROUP
 3.IT IS RELATAVILY SPECIFIC WHEN SKELETAL
MUSCLE DAMAGE IS NOT PRESENT
 4. THE CKMB ISOFORM OF CK IS EXPRESSED IN
HEART MUSCLE
 5 SINCE IT HAS SHORT DURATION IT CAN NOT BE
USED FOR LATE DIAGNOSIS OF ACUTE MI BUT
CAN BE USED TO SUGGEST INFRACT EXTENTION
IF LEVEL RISE AGAIN