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Cardiac Package - IPD

Heart

13 parameters

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Report in 24Hrs

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At Home

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Fasting Required

Details

IPD Cardiac Tests for confirming attacks

₹5,099₹10,999

54% OFF

Parameters

  • List of Tests
    • LDH Serum
    • Creatinine Phospho Kinase (CPK)
    • Creatinine Kinase - MB (CK-MB)
    • Troponine I
    • Troponine T
    • Lipid Profile
      • Cholestrol
      • HDL
      • LDL
      • LDL/HDL
      • Non HDL
      • VLDL
      • Total Cholestrol
      • Triglycerides

Cardiac Package - IPD

  • Why is it done?
    • This comprehensive cardiac package is designed to evaluate cardiac health and detect myocardial infarction (heart attack), assess cardiac enzyme levels, and evaluate lipid metabolism in hospitalized patients
    • Cardiac enzymes (LDH, CPK, CK-MB, Troponin I, and Troponin T) are measured to detect myocardial injury and differentiate between acute coronary syndrome (ACS) and other conditions causing chest pain
    • Lipid profile components assess cardiovascular risk factors and guide preventive therapy and lifestyle modifications in at-risk patients
    • Indicated for patients presenting with chest pain, dyspnea, palpitations, or syncope suspected of acute coronary events or heart failure
    • Used for post-operative cardiac monitoring and surveillance in high-risk cardiovascular patients
    • Recommended for risk stratification in patients with established coronary artery disease or multiple cardiac risk factors
    • The individual tests work synergistically: cardiac biomarkers detect acute myocardial injury while lipid parameters identify chronic cardiovascular risk
  • Normal Range
    • LDH Serum: 140-280 U/L (or 225-450 U/L depending on lab method) - Normal indicates no significant tissue damage
    • Creatinine Phosphokinase (CPK): 30-200 U/L for males; 30-150 U/L for females - Elevated values suggest muscle or cardiac tissue damage
    • Creatinine Kinase-MB (CK-MB): 0-5 ng/mL or <12 U/L - Normal indicates absence of myocardial infarction
    • Troponin I: <0.04 ng/mL (values vary by assay; high-sensitivity troponin <0.01-0.03 ng/mL) - Normal suggests no acute myocardial necrosis
    • Troponin T: <0.04 ng/mL (high-sensitivity troponin <0.01-0.03 ng/mL) - Normal excludes acute myocardial infarction
    • Total Cholesterol: <200 mg/dL (desirable); 200-239 mg/dL (borderline high); ≥240 mg/dL (high)
    • LDL Cholesterol: <100 mg/dL (optimal); 100-129 mg/dL (near optimal); 130-159 mg/dL (borderline high); 160-189 mg/dL (high); ≥190 mg/dL (very high)
    • HDL Cholesterol: >40 mg/dL (males, desirable); >50 mg/dL (females, desirable); Higher values indicate better cardiovascular protection
    • Triglycerides: <150 mg/dL (normal); 150-199 mg/dL (borderline high); 200-499 mg/dL (high); ≥500 mg/dL (very high)
    • VLDL: <30 mg/dL (calculated as triglycerides/5) - Normal range indicates appropriate lipoprotein metabolism
    • Non-HDL Cholesterol: <130 mg/dL (desirable) - Calculated as Total Cholesterol minus HDL; represents all atherogenic particles
    • LDL/HDL Ratio: <3.5 (desirable ratio for cardiovascular protection) - Lower ratios indicate better cardiovascular health
  • Interpretation
    • LDH Serum Elevation: Increased LDH (especially LDH1 > LDH2 ratio) suggests myocardial infarction, hemolysis, or liver disease; rises 12-24 hours post-MI and peaks at 48-72 hours; remains elevated for 10-14 days making it useful for detecting recent MI
    • CPK Elevation: Elevated CPK indicates muscle injury (cardiac, skeletal, or smooth muscle); rises within 3-12 hours of MI, peaks at 24-48 hours, and normalizes within 3-7 days; also increased in muscular dystrophy, severe exercise, or rhabdomyolysis; requires differentiation of source
    • CK-MB Elevation: Increased CK-MB (>5 ng/mL or >12 U/L) is more cardiac-specific than total CPK; rises 3-12 hours post-MI, peaks at 24-48 hours, normalizes by 48-72 hours; CK-MB/Total CPK ratio >3-5% confirms cardiac origin; useful in early MI detection
    • Troponin I Elevation: Increased Troponin I (>0.04 ng/mL) is highly cardiac-specific and indicates myocardial necrosis; appears 2-4 hours post-MI, peaks at 24-48 hours, remains elevated 7-14 days; superior sensitivity for detecting minor myocardial injury; detects both STEMI and NSTEMI
    • Troponin T Elevation: Increased Troponin T (>0.04 ng/mL) indicates acute myocardial infarction with excellent cardiac specificity; appears 2-4 hours post-MI, peaks 24-48 hours, detectable for up to 14 days; high-sensitivity troponin T enables earlier MI exclusion and detection
    • Elevated Total Cholesterol: Increased risk for atherosclerosis and coronary artery disease; requires lifestyle modification and potential pharmacotherapy; major independent risk factor for MI and stroke
    • Elevated LDL Cholesterol: Primary atherogenic lipoprotein; higher levels correlate with increased cardiovascular events; target LDL varies by risk category (lower for higher-risk patients); LDL >130 mg/dL warrants intervention
    • Low HDL Cholesterol: HDL <40 mg/dL (males) or <50 mg/dL (females) is independent cardiovascular risk factor; associated with increased MI and stroke risk; requires lifestyle changes and consideration of medication
    • Elevated Triglycerides: Triglycerides >150 mg/dL increase cardiovascular risk, particularly when combined with low HDL; associated with insulin resistance, obesity, and metabolic syndrome; very high levels (>500 mg/dL) risk for acute pancreatitis
    • Elevated VLDL: Indicates excess very low-density lipoprotein particles; associated with hypertriglyceridemia and increased atherosclerotic risk; reflects high circulating triglycerides
    • Elevated Non-HDL Cholesterol: More comprehensive risk assessment than LDL alone; represents all atherogenic particles; target Non-HDL is typically 30 mg/dL higher than LDL target
    • Elevated LDL/HDL Ratio: Ratio >3.5 indicates unfavorable lipid profile and increased cardiovascular risk; combines harmful and protective lipoproteins for comprehensive risk assessment
    • Factors affecting readings: Timing of sample collection (cardiac biomarkers peak at different times post-MI); hemolysis (falsely elevates enzymes); medication use (statins affect lipids); fasting status (affects triglycerides and lipids); chronic kidney disease (elevates troponins); heart failure; sepsis; and renal infarction
  • Associated Organs
    • Heart (Primary Organ): All tests in this package primarily evaluate cardiac health; LDH, CPK, CK-MB, Troponin I, and T directly indicate myocardial injury; lipid parameters assess risk for coronary atherosclerosis
    • LDH: Produced by heart, liver, red blood cells, kidneys, placenta, and pancreas; cardiac LDH elevation suggests myocardial infarction, myocarditis, or heart failure; also elevated in hemolysis and hepatic disease
    • CPK: Located in cardiac muscle, skeletal muscle, and brain; cardiac-specific elevation indicates myocardial infarction or myocarditis; skeletal muscle elevation may result from trauma, exercise, or muscular dystrophy
    • CK-MB: Cardiac-specific isoenzyme predominantly found in cardiac myocytes; elevation highly specific for myocardial injury; minimal presence in skeletal muscle making it superior for MI diagnosis
    • Troponin I: Regulatory protein in cardiac and skeletal muscle contractility; cardiac troponin I is structurally different from skeletal troponin I, providing excellent cardiac specificity; indicates myocardial necrosis from infarction, myocarditis, or takotsubo cardiomyopathy
    • Troponin T: Structural protein in cardiac and skeletal muscle; cardiac troponin T assays provide cardiac specificity through monoclonal antibody targeting; signals acute myocardial damage from various etiologies
    • Lipid Profile: Reflects lipid metabolism regulated by liver, intestines, and adipose tissue; lipoproteins transport cholesterol and triglycerides; abnormal profiles indicate risk for atherosclerosis affecting coronary, cerebral, and peripheral vessels
    • Liver: Synthesizes most lipoproteins (VLDL, HDL) and regulates cholesterol metabolism; hepatic disease affects lipid levels and enzyme clearance
    • Kidneys: Affected by hyperlipidemia which accelerates glomerulosclerosis; kidney disease affects triglyceride metabolism and troponin clearance
    • Vascular System: Abnormal lipid profiles promote atherosclerotic plaque formation in arteries throughout the body; complications include myocardial infarction, stroke, and peripheral arterial disease
    • Pancreas: Severely elevated triglycerides (>1000 mg/dL) increase risk of acute pancreatitis; lipemic serum may interfere with other laboratory tests
    • Brain: Atherosclerotic disease of cerebral vessels increases stroke risk; abnormal lipid profiles are modifiable risk factors for cerebrovascular events
  • Follow-up Tests
    • If Troponin or CK-MB Elevated: Perform serial troponin measurements (2-3 hour intervals) to establish rise and fall pattern diagnostic of MI; obtain 12-lead ECG to assess ST-segment changes and localize infarction; order echocardiography to assess ventricular function and wall motion abnormalities
    • If Cardiac Biomarkers Elevated: Consider coronary angiography for revascularization assessment, particularly in acute coronary syndrome; order B-type natriuretic peptide (BNP) or NT-proBNP if heart failure suspected
    • If LDH Elevated: Perform LDH isoenzyme fractionation (LDH1-5) to determine tissue source; order liver function tests if hepatic cause suspected; check haptoglobin and indirect bilirubin if hemolysis is concern
    • If CPK Elevated: Differentiate with CK-MB and myoglobin; order electrolytes if rhabdomyolysis suspected; check muscle enzymes (aldolase) for muscular dystrophy
    • If Total Cholesterol >200 mg/dL: Recheck fasting lipid panel to confirm; order advanced lipid testing (lipoprotein(a), apolipoprotein B); perform metabolic syndrome screening with glucose and blood pressure assessment
    • If LDL Cholesterol Elevated: Consider statin therapy; monitor LDL response to treatment at 4-12 weeks; repeat lipid panel annually for non-pharmacotherapy patients
    • If HDL Cholesterol Low: Assess lifestyle factors (exercise, diet, smoking); order metabolic assessment for insulin resistance; consider niacin or fibrates if triglycerides also elevated
    • If Triglycerides >200 mg/dL: Order fasting blood glucose and insulin to screen for insulin resistance; check thyroid function (TSH); assess medication use (oral contraceptives, beta-blockers, corticosteroids)
    • If Triglycerides >500 mg/dL: Order serum amylase and lipase to exclude acute pancreatitis; obtain abdominal ultrasound; consider fibrate therapy; repeat lipid panel within 4 weeks of treatment initiation
    • Cardiac Imaging: Stress testing or nuclear imaging for ischemia assessment in patients with positive biomarkers but no acute findings; coronary CT angiography as alternative to invasive catheterization in appropriate patients
    • Comprehensive Metabolic Panel: Assess glucose, renal function, and electrolytes to identify comorbidities affecting cardiovascular risk; monitor during lipid-lowering therapy
    • Inflammatory Markers: High-sensitivity C-reactive protein (hs-CRP) to assess cardiovascular inflammation in intermediate-risk patients; elevated levels indicate increased MI risk
    • Thrombotic Assessment: Prothrombin time (PT/INR) and activated partial thromboplastin time (aPTT) if anticoagulation indicated; D-dimer if pulmonary embolism suspected
    • Monitoring Schedule: Acute MI - repeat troponins every 2-3 hours for 12 hours; stable CAD - lipid panel every 4-12 weeks when initiating therapy, then annually; post-MI - repeat lipids at 4-6 weeks and 3 months to optimize therapy
  • Fasting Required?
    • YES - Fasting of 8-12 hours is required for this cardiac package, specifically for accurate lipid profile measurement
    • Fasting Duration: Ideal fast of 9-12 hours overnight; minimum 8 hours acceptable; longer fasts (>14 hours) not necessary and may affect glucose metabolism
    • Rationale for Fasting: Triglycerides are significantly affected by recent food intake; fasting ensures accurate assessment of true baseline lipid levels; LDL and HDL calculations require precise triglyceride measurements
    • In Acute Setting: For acute coronary syndrome presentations, lipid panel and cardiac biomarkers should be drawn immediately without waiting for fasting status; non-fasting triglycerides and lipids can be measured but should be repeated in fasting state for proper interpretation
    • Permitted During Fasting: Water only is permitted; no food, beverages, or supplements; black coffee or tea without additives may be allowed but verify with laboratory
    • Medications: Continue all regularly scheduled cardiac medications including beta-blockers, ACE inhibitors, and aspirin; do not discontinue medications before testing without physician guidance
    • Avoid Medications Affecting Lipids: Withhold lipid-lowering medications (statins, fibrates, niacin) 12 hours before testing if baseline lipid assessment needed; if patient taking statin, document medication name, dose, and duration on requisition
    • Dietary Restrictions: Avoid high-fat foods for 24 hours before testing; avoid excessive alcohol consumption (24-48 hours prior) as it affects lipid and enzyme levels
    • Physical Activity: Avoid strenuous exercise 24 hours before testing as it elevates CPK and may affect lipid metabolism; moderate daily activities are acceptable
    • Stress Management: Minimize emotional stress before testing; stress elevates cortisol which affects lipid profiles and glucose metabolism
    • Timing of Draw: Early morning collection (7-9 AM) preferred; consistent timing facilitates valid comparisons with previous results; samples should be processed within 2 hours of collection
    • Patient Communication: Advise patients in advance of testing requirements; provide written fasting instructions; confirm compliance when patient arrives for testing
    • Documentation: Note fasting status on laboratory requisition (fasting vs. non-fasting); document time of last food intake; record any deviations from standard preparation
    • Exceptions for IPD (Inpatient): Hospitalized patients may have modified fasting requirements; clear liquids 2 hours prior acceptable if patient requires medications; acute care protocols may supersede fasting requirements

How our test process works!

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