Chest pain laboratory findings

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Aisha Adigun, B.Sc., M.D.[2]

Serial troponins and CK-MB should be ordered. Additional laboratory tests include serum electrolytes, a complete blood count, renal function tests, and liver function tests.

On the basis of the above, a number of tests may be ordered: ^[1][2][3]

• High sensitivity troponin I or T are the cardiac markers of choice and are preferred over creatine kinase.
• No one marker gives accurate diagnosis so commonly two markers are used for instance troponin I or T with creatine kinase (and CK-MB fraction in many hospitals)

• D-dimer (when suspicion for pulmonary embolism, aortic dissection)
• Complete blood count may be elevated in infectious causes of chest pain such as pericarditis, pneumonia, mediastinitis.
• BNP and NT-proBNP may help recognize or eliminate heart failure as a cause of chest pain in a presenting patient.
• Arterial blood gas may be done if pulmonary embolism is a differential diagnosis in a patient presenting with chest pain.
• Electrolytes
• Renal function (creatinine)
• Liver function tests