Are lytes and troponin part of routine blood work for acute stroke patients?
A. There are no established evidence-based guidelines outlining the specifics, but from the clinical standpoint, electrolytes are essential, as well as CBC with differential. Reasons for this are multiple, but mainly to maintain appropriate homeostasis where one has to monitor sodium, potassium, magnesium and phosphorus daily. This is important for early diagnosis of life threatening arrhythmias, unexplained comas and seizures. As for CK and troponin – these tests may be ordered selectively, usually helping the clinician to rule out painless MI and other cardiovascular conditions such as aortic dissection if the patient presents with atypical chest pain. Subacute MI in patients with “chronically abnormal” ECG may be suspected just by ordering the troponin and consequent echocardiogram helps to determine the presence of akinetic walls. This may directly affect the management path.
