In the described acute pericarditis case, which cardiac biomarker is more likely to be elevated?

In the described acute pericarditis case, which cardiac biomarker is more likely to be elevated?

• A. Troponin
• B. BNP
• C. CK
• D. Myoglobin

Answer: (C)

Pericarditis is inflammation of the pericardial sac, so the biomarker pattern depends on whether the heart muscle itself is involved. Troponin rises with myocardial injury, such as in myocardial infarction or myopericarditis, and can be normal in pure pericarditis where the myocardium isn’t damaged. BNP reflects ventricular stretch and fluid overload, not pericardial inflammation. CK marks muscle injury more broadly, including skeletal muscle and, to some extent, cardiac muscle injury when present; in many acute pericarditis cases the inflammatory process can irritate surrounding tissues and cause a modest CK rise even if the myocardium isn’t severely damaged. Myoglobin rises early with muscle injury but is less specific and less helpful in differentiating pericardial disease. Therefore, in an acute pericarditis scenario without clear myocarditis, CK is more likely to be elevated than troponin, making it the best fit among the options.

Pericarditis is inflammation of the pericardial sac, so the biomarker pattern depends on whether the heart muscle itself is involved. Troponin rises with myocardial injury, such as in myocardial infarction or myopericarditis, and can be normal in pure pericarditis where the myocardium isn’t damaged. BNP reflects ventricular stretch and fluid overload, not pericardial inflammation. CK marks muscle injury more broadly, including skeletal muscle and, to some extent, cardiac muscle injury when present; in many acute pericarditis cases the inflammatory process can irritate surrounding tissues and cause a modest CK rise even if the myocardium isn’t severely damaged. Myoglobin rises early with muscle injury but is less specific and less helpful in differentiating pericardial disease. Therefore, in an acute pericarditis scenario without clear myocarditis, CK is more likely to be elevated than troponin, making it the best fit among the options.