Child's chest pain

Don’t think that only adults have heart problems. Sometimes when children have chest pain, it should also be taken seriously. If a child complains of chest pain, you should pay attention to whether it is caused by malnutrition. Nowadays, children are more picky about food and are still in the developmental stage. If their nutritional supplements are not comprehensive, it is easy to cause myocardial damage. Therefore, when a child complains of chest pain, parents should take the child for examination in time for early treatment.

Myocardial damage, water, soil and nutritional factors. According to investigations, this disease has obvious regional characteristics. The soil, water and food in the affected areas lack certain trace elements needed by the human body, such as selenium, molybdenum, magnesium, etc. or related nutrients, which interfere with myocardial metabolism, cause myocardial damage and thus the disease.

Early markers

Refers to markers whose blood levels increase within 6 hours after myocardial injury. Currently known early markers for diagnosing acute coronary syndrome (ACS) mostly appear in the early stages of the pathological process (before myocardial necrosis). The use of early markers can help with early diagnosis and, in turn, early treatment.

C-reactive protein (CRP) CRP increases abnormally in the early stage of myocardial operation and has a short window period. It has good clinical value in the early stage of myocardial injury and prognosis estimation. With the application of high-sensitive CRP (hs-CRP) detection method, its clinical application value has received increasing attention in recent years.

Myoglobin (Mb) Although Mb has low myocardial specificity, it can be rapidly released from the necrotic myocardium after myocardial infarction and has a high sensitivity. Mb has a short blood half-life, so it helps to observe whether reinfarction occurs during the course of AMI and whether the infarction expands. Mb is also a sensitive and accurate indicator for evaluating reperfusion during thrombolytic therapy of AMI.

Identify markers

A biochemical marker that appears in the blood 6 to 9 hours after the onset of myocardial injury and persists for several days, and has a high sensitivity and specificity for myocardial injury.

Creatine kinase isoenzyme (CK-MB) There are many methods for CK-MB analysis. The common method to measure its activity (u/L) is immunosuppression analysis. The CK-MB mass analysis method is to measure its protein concentration (μg/L), which avoids interference (such as giant CK) that may be encountered in activity determination. It has high sensitivity (minimum detection limit <1μg) and accuracy, short measurement time (the fastest only takes 7 minutes), is suitable for automatic analysis, and has been widely recognized.

Cardiac troponin (cTn) cTn has two isoforms: cTnI and cTnT. Because of its high sensitivity, strong specificity, and long duration after onset, cTn is currently a better definite marker for diagnosing myocardial injury.

cTn detection: cTn abnormalities can be detected in peripheral blood 6 to 8 hours after myocardial injury, and the increase can last for 7 to 10 days (cTnI) or 10 to 14 days (cTnT). The half-life of cTn in the blood is about several hours. cTn can be quantitatively detected by highly sensitive labeled immunoassays, or by solid phase immunochromatography for rapid quantitative or qualitative detection. There are many reagents and methods for detecting cTnI. Some scholars have suggested that the use of serum specimens may be more appropriate than plasma specimens〔1〕. Hemolysis or fibrinogen, and even rheumatoid factor can sometimes affect certain cTnI determination methods. The stability of cTnI in the specimen should be considered, and attention should be paid to the specimen storage time and temperature. When using cTnI, different cTnI detection methods have different critical values. In addition, blood samples should be collected at least 6 to 9 hours after myocardial injury, which should be given full attention by clinicians. The current detection technology is highly sensitive and specific, and can even detect myocardial tissue necrosis <1.0g. Once cardiac troponin (cTn) is detected, it indicates that the patient has myocardial damage with clinical consequences.

Use of cTn in clinical diagnosis〔2〕 cTn is mainly used for the clinical diagnosis, risk estimation and prognosis judgment of myocardial ischemic injury such as ACS (including latent angina and unstable angina as well as acute myocardial infarction). In addition, it can also be used to determine the effect of clinical thrombolytic therapy after MI, estimate the area of ​​myocardial ischemic injury, clinically diagnose myocarditis, myocardial trauma (cardiac surgery), perioperative cardiac complications, severe sepsis or left heart failure caused by sepsis, congestive heart failure, and observe the clinical efficacy of certain therapeutic drugs.