A patient had been shoveling snow from his driveway and fell after feeling dizzy
ID: 3505565 • Letter: A
Question
A patient had been shoveling snow from his driveway and fell after feeling dizzy. Two days later, he came to the ER complaining that he had injured his left arm and his chest had been "aching" due to the fall. This 52-year-old patient was significantly overweight and a smoker. The following lab results were reported:
Results
Normal Values
CK (total): 157
34 - 145 IU/L
CK-MB: 3.0
< 3.9% of total CK
LD (total): 503
180 - 360 IU/L
LD1/LD2: 1.0
0.5 – 0.8
Troponin: 1.2
0.0 – 0.5 ng/mL
What likely condition do the results indicate (be specific by type)?
Which of the above parameters indicates the condition and why?
What other blood tests might the physician have ordered to rule out alternative diagnoses?
Are there labs that were not included due to the timeline between the patient injury and the arrival at the ER?
Results
Normal Values
CK (total): 157
34 - 145 IU/L
CK-MB: 3.0
< 3.9% of total CK
LD (total): 503
180 - 360 IU/L
LD1/LD2: 1.0
0.5 – 0.8
Troponin: 1.2
0.0 – 0.5 ng/mL
Explanation / Answer
1. From the report, we could say that one of the likely conditions is heart failure.
2. A dracstdincrease in LD(total) or lactate dehydrogenase suggests that the print could have a heart failure. Apart from this he has pain in his chest and is overweight
3. One of the alternatives could be muscle damage. To rule this out, the doctor may recommend adolase test in blood which has increased levels in case of muscle damage.
4. Yes there could be because heart failure is a serious condition and the doctor might suggest directly going for remedies.
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