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Chest pain, headache, vomiting & sweating. Have high BP, ECG normal. Advised tests for troponin, CRP & lipid prfile. Should i get the tests done?

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I HAD MILD CHEST PAIN, SEVERE HEADACHE , VOMITTING 4 TIMES, AND SEVERE SWETTING
YESTERDAY. AT THAT POINT MY BP WAS 148/95 & PULSE 90. AFTER 2 HOURS, I CONSULTED
MY CARDIALOGIST. HE CHECKED MY BP AS 110/80 & ECG IS NORMAL. HOWEVER , HE HAS ADVISED
A) TROPONIN-T, B) CRP C) LIPID PROFLIE.
SHOULD I GET THE TESTS DONE TOMORROW, WHICH WILL BE 2 DAYS AFTER OCCURANCE?
Posted Fri, 22 Jun 2012 in Hypertension and Heart Disease
 
 
Answered by Dr. Anil Grover 47 minutes later
Dear XXXXXXX

Thanks for writing in.

With a background of hypertension, chest pain, sweating and vomiting - a heart attack has to be considered and excluded.

As your cardiologist has found EKG within normal limits, therefore the chances becomes less; but it can be entirely excluded if serum enzymes as advised to you are normal.

Each enzyme after the episode behaves in different manner. For example Creatinine Phosphokinase-MB (CPK MB) falls after one day though elevation of Troponin-T persists. But I would be extra careful and if technically possible get it done today.

C - reactive protein (CRP) and lipid profile are for risk stratification and if elevated some drugs will have to be started; therefore, though one can wait for a day but once you are giving sample for one why not get the other done as well.

A delay in matter of heart that is delayed treatment is more expensive and fraught with incomplete recovery. So with normal EKG I will not press panic button; but would get the test done at the earliest.

Hope this answers your query. If there is follow up question, I will be happy to answer.

Best Wishes

Dr Anil Grover
Cardiologist
Above answer was peer-reviewed by
 
Follow-up: Chest pain, headache, vomiting & sweating. Have high BP, ECG normal. Advised tests for troponin, CRP & lipid prfile. Should i get the tests done? 4 hours later
Dear Doctor,
Thks for your reply.
Today being Sunday, most Labs are closed. So , i wud be getting all tests done
tomorrow morning.
As of now, I feel o.k. except a sensation of weekness.
Sir, do you recommend any other tests also?
 
 
Answered by Dr. Anil Grover 18 minutes later
Dear XXXXXXX

Absolutely no issue; I had said if "technically" possible. Secondly, the diagnostic test that is troponin T is raised for many days after injury.

The other two are screening test and heavens will not fall with one day delay you come to know whether you have another risk factor to take care of or not.

Other tests; Yes, to exclude all risk factors, such as
- Lipid Profile including Lipoprotein - A
- Fasting Blood Sugar

In addition to these, I recommend you the following

1. Your weight should not be more than expected.
2. You ought to do regular exercise.
3. You must see a medical specialist / cardiologist at least once a year. Avoid stress. Take folic acid supplements if you have reduced dietary intake with advancing age.

Thanks again and Good Luck

Dr Anil Grover
Cardiologist
Above answer was peer-reviewed by
 
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