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Medical Forum / General / General / July 2008What caused my heart attack?
I'm a healthy, active, 75 years old man with NO diabetes and cardiovascular problem and NO any other medical history. After an uneventful leg operation, my leg wound is managed by VAC therapy system, recuperating in the isolated ward and recovering very well. On the fourth day evening after the operation, I found I was in the ICU and told I had a silent hearth attacked. Before the attacked, I was very pale, have rapid pulses, low BP, breathlessness, semiconcious, and was given IV NaCl. Biochemistry done during the heart attack showed these abnormal parameters: Hb=4.2, heamatocrit=14.8, AST=1221, ALT= 631, LDH= 58, CK=1370, CKMB=101, troponin= 11.75 I survive with: initially, complete renal failure (no urine), pulmonary edema, pleural effusion. Thank god, all returned to normal after 3 weeks. However, echocardiography revealed my left heart chambers dilated, mild aortic & mitral valves regurgitation, regional wall motion abnormalities and left ventricular systolic dysfunction. I’m on beta blocker tablets which doc says is good for my heart and I currently feel ok except talking softly, slight breathless on exertion. Can expert enlighten me: What have caused my heart attack? What is the most appropriate treatment for my heart condition? Will my heart function recover to normal? Thanks in advance Cheng On Jul 18, 9:31 pm, kawangku <burongor...@yahoo.com.sg> wrote:CK=1370 << Hemolysis .. Why .. ? Could be a .. few .. reasons. Vol. 33, No. 3, 1993 Original Paper Clinical Spectrum of McArdle Disease: Three Cases with Unusual Expression L. Chiadò-Piat, T. Mongini, C. Doriguzzi, M. Maniscalco, L. Palmucci Paolo Peirolo Center for Neuromuscular Diseases, 2nd Division of Neurology, University of Turin, Italy Address of Corresponding Author Eur Neurol 1993;33:208-211 (DOI: 10.1159/000116938) Abstract Three cases of myophosphorylase deficiency with unusual clinical expression are presented. The 1 st had clinical characteristics suggesting a mild congenital myopathy, and the patient never experienced cramps or myalgias. The 2nd had a slowly progressive myopathy without cramps or myoglobinuria which was detected by chance. The 3rd presented with myoglobinuria and acute renal failure, unrelated to a triggering effort, and with permanent weakness and wasting. In all cases, muscle biopsy demonstrated a vacuolar myopathy with free glycogen increase and absence of myophosphorylase activity, confirmed by biochemical assays. The cases confirm the wide clinical spectrum of McArdle disease. Copyright © 1993 S. Karger AG, Basel -------------------------------------------------------------------------------- Who loves ya. Tom Jesus Was A Vegetarian! http://tinyurl.com/2r2nkh Man Is A Herbivore! http://tinyurl.com/4rq595 DEAD PEOPLE WALKING http://tinyurl.com/zk9fk > I'm a healthy, active, 75 years old man with NO diabetes and > cardiovascular problem and NO any other medical history. [quoted text clipped - 33 lines] > > Cheng On Jul 19, 9:04 am, "ironjust...@aol.com" <ironjust...@aol.com> wrote: On Jul 18, 9:31 pm, kawangku <burongor...@yahoo.com.sg> wrote:CK=1370 Hemolysis ..<< The effect of hemolysis on creatine kinase determination. Arch Pathol Lab Med. 1989 Feb;113(2):184-5.Links Comment in: Arch Pathol Lab Med. 1992 Jan;116(1):7-8. Greenson JK, Farber SJ, Dubin SB. Department of Pathology and Laboratory Medicine, Cedars-Sinai Medical Center, Los Angeles, CA 90048. Hemolysis can cause falsely elevated creatine kinase (CK) values when spectrophotometric methods of measurement are used. This apparent increase in CK is due to the red blood cell enzyme adenylate kinase. In an attempt to reduce this interference, most commercial CK kits employ adenosine monophosphate and/or diadenosine pentaphosphate as adenylate kinase inhibitors. To determine whether hemolyzed specimens should be accepted for testing, we measured the CK values of 26 serum samples, each with six different concentrations of added hemolysate. The results showed that hemolysis had an additive effect on CK, with an average increase in CK of approximately 10 U/L for every 1 g/L of hemoglobin. In most settings, this increase is not clinically significant. In the case of massive hemolysis, the hemoglobin concentration of the serum can be measured to correct the apparent CK value. The exclusion of hemolyzed specimens is unnecessary. PMID: 2916906 [PubMed - indexed for MEDLINE] Who loves ya. Tom Jesus Was A Vegetarian! http://tinyurl.com/2r2nkh Man Is A Herbivore! http://tinyurl.com/4rq595 DEAD PEOPLE WALKING http://tinyurl.com/zk9fk > Why .. ? > [quoted text clipped - 83 lines] > > - Show quoted text - On Jul 20, 12:10 am, "ironjust...@aol.com" <ironjust...@aol.com> wrote: > On Jul 19, 9:04 am, "ironjust...@aol.com" <ironjust...@aol.com> wrote: > On Jul 18, 9:31 pm, kawangku <burongor...@yahoo.com.sg> wrote:CK=1370 [quoted text clipped - 125 lines] > > - Show quoted text - -------------------------------------------------------------------------------------------------------------------------- Obviously I had AMI as from the cardial markers & ECG findings which I found from some of the hospital data. Other than old age and being a male, I have no other risk factors for the AMI ( as I mentioned from start ). My successful operated (for necrotizing faciitis) leg wound was managed by VAC (Vacuum Assisted Closure) therapy system which constantly draining fluid and blood from the dressing which MOST LIKELY the after-care medical staffs neglected the replenishment of fluid and plasma. Just before the heart attack, I was very pale, rapid pulses, low BP, breathlessness, semiconcious, and Heamatocrit=14.8, Hb=4.2 are the solid evidences of Hypovolemia. Fortunately, at the very last minute, a senior medical noticed my signs and symptoms of heart attack and instantly ordered the juniors rushed me to ICU. Therefore, my AMI and renal failure were not due to VAT, coronary plaque and/or occlusion, but hypovolemia and hypoxia, which I hope there are constructive opinions from Internet community. Sadly, I see people talking from God and Hunger to sarcasm. CHENG. On Jul 20, 12:43 am, Kawang <alanperw...@gmail.com> wrote:Sadly, I see people talking from God and Hunger to sarcasm. CHENG << Don't believe it is hemolysis .. ? Fine .. Who loves ya. Tom Jesus Was A Vegetarian! http://tinyurl.com/2r2nkh Man Is A Herbivore! http://tinyurl.com/4rq595 DEAD PEOPLE WALKING http://tinyurl.com/zk9fk |
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