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Troponin diagnosis

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https://www.readbyqxmd.com/read/28720694/myocardial-infarction-masquerading-as-myocarditis-in-a-patient-with-factor-v-leiden-unmasked-with-mr
#1
Jason Leo Walsh, Benjamin Howell Lole Harris, Walid Gharzuddine, Hussain Isma'eel
We present a case of a 21-year-old man presenting with sharp left-sided chest pain. A CT pulmonary angiogram was negative, ECG was unremarkable and a mild troponin rise was observed. Myocarditis was suspected as the most likely diagnosis, particularly in view of the patient's previous diagnosis of myocarditis 3 years prior. A cardiac MRI was indicative of an acute mid-anterior myocardial infarction (MI) and an old inferior MI with an associated aneurysm. A subsequent angiogram revealed a subtotal occlusion in the second diagonal artery, likely precipitated by homozygous factor V Leiden...
July 18, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28719430/high-sensitivity-cardiac-troponin-t-improves-the-diagnosis-of-perioperative-mi
#2
Jamie C Brown, Eslam Samaha, Srikar Rao, Mohammad A Helwani, Andreas Duma, Frank Brown, Brian F Gage, J Philip Miller, Allan S Jaffe, Fred S Apple, Mitchell G Scott, Peter Nagele
BACKGROUND: The diagnosis of myocardial infarction (MI) after noncardiac surgery has traditionally relied on using relatively insensitive contemporary cardiac troponin (cTn) assays. We hypothesized that using a recently introduced novel high-sensitivity cTnT (hscTnT) assay would increase the detection rate of perioperative MI. METHODS: In this ancillary study of the Vitamins in Nitrous Oxide trial, readjudicated incidence rates of myocardial injury (new isolated cTn elevation) and MI were compared when diagnosed by contemporary cTnI versus hscTnT...
July 14, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28717414/cardiac-magnetic-resonance-in-patients-with-acute-cardiac-injury-and-unobstructed-coronary-arteries
#3
Giovanni Salvatore Camastra, Stefano Sbarbati, Massimiliano Danti, Luca Cacciotti, Raffaella Semeraro, Sabino Walter Della Sala, Gerardo Ansalone
AIM: To define the role of cardiac magnetic resonance (CMR) by analyzing a particular group of patients with suspected acute coronary syndrome (ACS) and normal coronary angiogram. METHODS: From January 2009 to December 2015, we examined 220 patients with clinical suspicion of ACS, Troponin elevation [the threshold used to define a positive Troponin T test (TnT) was 0.1 ng/mL] and no significant coronary disease at angiography (the patients were considered to have significant angiographic disease only a 50% stenosis was detected in any of their coronary arteries)...
June 28, 2017: World Journal of Radiology
https://www.readbyqxmd.com/read/28712188/a-novel-link-between-adipokines-and-lipoprotein-a-to-contemplate-their-diagnostic-role-in-patients-with-stemi-and-nstemi
#4
Shazia Rashid, Rukhshan Khurshid, Uzma Faryal Amir, Arif Malik, Sumera Qazi
BACKGROUND: Early detection of cardiac events allow better and cost-effective triage and welltimed management of these patients. Study was conducted to evaluate the prognostic significance of plasma adiponectin, resistin and lipoprotein (a) in a group of patients with ST segment elevation myocardial infarction and non-ST-segment elevation myocardial infarction. These parameters were also compared with other predictors like troponin T, troponin I and CK-MB. METHODS: Present study was based on the 100 patients with AMI of whom 52 had a diagnosis of STEMI, and 48 had NSTEMI...
January 2017: Journal of Ayub Medical College, Abbottabad: JAMC
https://www.readbyqxmd.com/read/28712187/utility-of-heart-type-fatty-acid-binding-protein-h-fabp-point-of-care-test-in-the-early-hours-of-stemi-compared-with-troponin-i-in-pakistani-population
#5
Walid Ahmad Abbasi, Muhammad Saleem, Shahid Rasheed, Azhar Mahmood Kiyani
BACKGROUND: Acute coronary syndrome remains a dominant cause of high morbidity and mortality despite advancements in treatment This study was conducted to examine the utility of point-of-care test of heart-type fatty-acid binding protein (h-FABP) and compare it with the point-of-care test of cardiac troponin I (cTnI) in the first 06 hours of STEMI. METHODS: This cross-sectional, comparative study which was conducted in Rawalpindi institute of cardiology, Rawalpindi, Pakistan, from January to June 2015...
January 2017: Journal of Ayub Medical College, Abbottabad: JAMC
https://www.readbyqxmd.com/read/28710236/complement-factor-b-mutation-associated-ahus-and-myocardial-infarction
#6
Natália Noronha, Filipa Dias Costa, Andrea Dias, Alexandra Dinis
A 6-month-old female infant was referred with a 3-day history of low-grade fever, slight nasal congestion and rhinorrhoea. On admission, the clinical findings were unremarkable and she was discharged home. However, she became progressively more listless with a decreased urine output and was once again seen in the emergency department. Analytically she was found to have metabolic acidosis, hyperkalaemia, thrombocytopaenia, anaemia and schistocytes in the peripheral blood smear. Based on these findings, the diagnosis of haemolyticâ-uremic syndrome was made...
July 14, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28705229/brugada-syndrome-in-a-patient-with-amyotrophic-lateral-sclerosis-a-case-report
#7
Anusha Battineni, Rohit Gummi, Naresh Mullaguri, Raghav Govindarajan
BACKGROUND: Amyotrophic lateral sclerosis is a fatal neuromuscular disorder characterized by progressive death of the upper and lower motor neurons in the central nervous system. Patients with this disease die mostly as a result of respiratory failure; however, owing to prolonged survival through assisted ventilation, cardiovascular causes are increasingly responsible for mortality. We report what is to the best of our knowledge the first case of type 2 Brugada syndrome causing ventricular tachyarrhythmia and cardiac arrest in a patient with upper limb onset amyotrophic lateral sclerosis...
July 14, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28702739/value-of-the-neutrophil-to-lymphocyte-ratio-in-predicting-left-ventricular-recovery-in-patients-with-peripartum-cardiomyopathy
#8
Ufuk Gürkan, Haldun Akgöz, Şukru Aksoy, Özlem Can Gürkan, Altug Osken, Sennur Unal Dayi, Dilaver Oz, Recep Haci
OBJECTIVE: The aim of this study was to assess the value of the neutrophil-to-lymphocyte ratio (NLR) in predicting left ventricular (LV) recovery in patients with peripartum cardiomyopathy (PPCM). METHODS: Patients with PPCM (n = 40), who were admitted to our tertiary reference hospital between 2007 and 2015 were retrospectively analyzed. All patients were followed-up for at least 12 months after the diagnosis. All patients had standard echocardiographic examination at baseline and the last follow-up visit...
July 12, 2017: Wiener Klinische Wochenschrift
https://www.readbyqxmd.com/read/28701316/diagnostic-performance-of-high-sensitivity-compared-with-contemporary-cardiac-troponin-i-for-the-diagnosis-of-acute-myocardial-infarction
#9
Yader Sandoval, Stephen W Smith, Sarah E Thordsen, Charles A Bruen, Michelle D Carlson, Kenneth W Dodd, Brian E Driver, Katherine Jacoby, Benjamin K Johnson, Sara A Love, Johanna C Moore, Anne Sexter, Karen Schulz, Nathaniel L Scott, Jennifer Nicholson, Fred S Apple
BACKGROUND: We examined the diagnostic performance of high-sensitivity cardiac troponin I (hs-cTnI) vs contemporary cTnI with use of the 99th percentile alone and with a normal electrocardiogram (ECG) to rule out acute myocardial infarction (MI) and serial changes (deltas) to rule in MI. METHODS: We included consecutive patients presenting to a US emergency department with serial cTnI on clinical indication (NCT02060760). Diagnostic performance for acute MI, including MI subtypes, and 30-day outcomes were examined...
July 12, 2017: Clinical Chemistry
https://www.readbyqxmd.com/read/28692218/-interpretation-of-high-sensitivity-troponin-in-patients-with-chronic-kidney-failure
#10
Manon Kolb, Alexandre Guinand, Marco Roffi, Patrick Saudan, Mathieu Nendaz
New assays with lower levels of detection of troponin (« high-sensitivity troponin ») increase the difficulty of interpretation of this test for the diagnosis of acute coronary syndrome in patients with chronic kidney disease (CKD). Their baseline concentration of troponin is frequently above the upper reference level, which lowers its specificity. To improve its diagnostic performance after clinical and electrocardiographic evaluation, cut-off levels 2 to 3 times higher than the standard reference have been suggested...
October 19, 2016: Revue Médicale Suisse
https://www.readbyqxmd.com/read/28690956/thyrotoxicosis-mimicking-st-elevation-myocardial-infarction
#11
Ingrid Rymer De Marchena, Anna Gutman, Julie Zaidan, Harout Yacoub, Wissam Hoyek
Hyperthyroidism is well known to be associated with cardiac disease. Delay in making the diagnosis and occurrence of complications are common and are associated with a worse outcome. A 54-year-old male, non-smoker, with no past medical history and no significant family history presented to our hospital with severe left sided chest pain, "crushing" in nature. Electrocardiogram showed ST-segment elevations in the inferior leads. Troponin I level was 0.32 ng/mL (normal range 0-0.05 ng/mL) on presentation. The patient underwent an emergent coronary angiography which showed no evidence of occlusive coronary artery disease...
June 7, 2017: Curēus
https://www.readbyqxmd.com/read/28689634/impact-of-the-australian-gender-specific-thresholds-using-the-abbott-high-sensitivity-troponin-i-assay-in-clinical-care
#12
Robert Bender, Faith Njue, Samuel Vasikaran, Ramon Lambert, Jamie Rankin, Graham S Hillis, Damon A Bell
The aim of this study was to ascertain the impact of gender specific hs-TnI thresholds in a clinical setting and determine the clinical characteristics and discharge diagnosis for individuals presenting to the Emergency Department (ED) with elevated troponin I with the Abbott high-sensitivity troponin I (hs-TnI) assay, but non-elevated troponin I on the previous generation assay (STAT TnI-II). Medical records of individuals presenting to the Royal Perth Hospital ED with elevated hs-TnI between 12 November 2013 and 24 December 2013 were retrospectively reviewed...
August 2017: Pathology
https://www.readbyqxmd.com/read/28687586/a-rash-with-a-heavy-heart
#13
Sergio Barros-Gomes, Niyada Naksuk, Dragan Jevremovic, Hector R Villarraga
Cardiac amyloidosis (CA) is relatively rare and frequently misdiagnosed. Other disorders presenting with increased left ventricular (LV) mass can mimic its diagnosis. This case illustrates unique findings of primary light chain (AL) amyloidosis in a patient with remarkable signs of CA. Here, we report a 49-year-old man with prior diagnosis of hypertrophy cardiomyopathy (HCM) based on an echocardiogram performed 1 year earlier that presented with 8 weeks of periorbital rash. He had numbness in the past 3 years...
July 7, 2017: Echo Research and Practice
https://www.readbyqxmd.com/read/28680021/potential-of-lipoproteins-as-biomarkers-in-acute-myocardial-infarction
#14
Haseeb Ahmad Khan, Aishah Ekhzaimy, Isra Khan, Meena Kishore Sakharkar
Acute myocardial infarction (AMI), commonly known as heart attack, is a medical emergency that is potentially fatal if not promptly and properly managed. The early diagnosis of AMI is critically important for the timely institution of pharmacotherapy to prevent myocardial damage and preserve cardiac function. Ischemic insults during AMI cause myocardial tissue damage, releasing the cardiac muscle protein troponin T into the blood stream. Therefore, serum troponin T levels are used as a sensitive and specific indicator of myocardial injury for diagnosing AMI...
July 2017: Anatolian Journal of Cardiology
https://www.readbyqxmd.com/read/28669701/comparative-evaluation-of-2-hour-rapid-diagnostic-algorithms-for-acute-myocardial-infarction-using-high-sensitivity-cardiac-troponin-t
#15
Andrew D McRae, Grant Innes, Michelle Graham, Eddy Lang, James E Andruchow, Hong Yang, Yunqi Ji, Shabnam Vatanpour, Danielle A Southern, Dongmei Wang, Isolde Seiden-Long, Lawrence DeKoning, Peter Kavsak
BACKGROUND: Symptoms of acute coronary syndrome account for a large proportion of emergency department (ED) visits and hospitalizations. High-sensitivity troponin can rapidly rule out or rule in acute myocardial infarction (AMI) within a short time of ED arrival. We sought to validate test characteristics and classification performance of 2-hour high-sensitivity troponin T (hsTnT) algorithms for the rapid diagnosis of AMI. METHODS: We included consecutive patients from 4 academic EDs with suspected cardiac chest pain who had hsTnT assays performed 2 hours apart (± 30 minutes) as part of routine care...
May 3, 2017: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/28661786/impact-of-a-soccer-game-on-cardiac-biomarkers-in-adolescent-players
#16
Seyed Mohsen Hosseini, Mojtaba Azizi, Ali Samadi, Nahid Talebi, Gatterer Hannes, Martin Burtscher
PURPOSE: Biochemical markers such as cardiac troponin I (cTnI) and N-terminal pro B-type natriuretic peptide (NT-proBNP) have become indispensable tools for the diagnosis of myocardial injury, providing highly sensitive and specific information about cardiac cell damage and wall stress. The purpose of the present research was to examine the response of cardiac biomarkers to a soccer game in adolescent male soccer players. METHODS: 22 trained adolescent male soccer players (14-16 years) were selected in a purposive manner...
June 29, 2017: Pediatric Exercise Science
https://www.readbyqxmd.com/read/28659139/the-unique-value-of-cardiovascular-magnetic-resonance-in-patients-with-suspected-acute-coronary-syndrome-and-culprit-free-coronary-angiograms
#17
Roman Panovský, Júlia Borová, Martin Pleva, Věra Feitová, Petr Novotný, Vladimír Kincl, Tomáš Holeček, Jaroslav Meluzín, Ondřej Sochor, Radka Štěpánová
BACKGROUND: Patients with chest pain, elevated troponin, and unobstructed coronary disease present a clinical dilemma. The purpose of this study was to investigate the incremental diagnostic value of cardiovascular magnetic resonance (CMR) in a cohort of patients with suspected acute coronary syndrome (ACS) and unobstructed coronary arteries. RESULTS: Data files of patients meeting the inclusion criteria in two cardiology centres were searched and analysed. The inclusion criteria included: 1) thoracic pain suspected with ACS; 2) a significant increase in the high-sensitive Troponin T value; 3) ECG changes; 4) coronary arteries without any significant stenosis; 5) a CMR examination included in the diagnostic process; 6) an uncertain diagnosis before the CMR exam; and 7) the absence of known CMR and contrast media contraindications...
June 28, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/28652952/fibromuscular-dysplasia-with-spontaneous-coronary-artery-disease-presenting-as-acute-myocardial-infarction
#18
Ali Farooq, Waseem Amjad, Ata Ur Rahim Bajwa, Hassaan Yasin, Rizwan Ali, Muhammad Pervaiz
A 40-year-old female presented to a rural hospital with crushing substernal chest pain. An initial electrocardiogram showed ST elevation in lead II and aVF with elevated troponin I. She was immediately transferred to a tertiary care hospital. An emergent coronary angiogram did not show any significant coronary artery disease. On the second day, the patient experienced recurrence of severe chest pain with ST elevations in leads I, aVL, V5-V6, ST depressions in V1-V3, T-wave inversion over V2-V5. The troponin I level increased to > 40 ng/ml (normal 0...
May 23, 2017: Curēus
https://www.readbyqxmd.com/read/28650717/heart-type-fatty-acid-binding-protein-is-a-sensitive-biomarker-for-early-ami-detection-in-troponin-negative-patients-a-pilot-study
#19
Luisa Agnello, Giulia Bivona, Giuseppina Novo, Concetta Scazzone, Roberto Muratore, Piero Levantino, Chiara Bellia, Bruna Lo Sasso, Marcello Ciaccio
BACKGROUND: Early detecting AMI in individuals presenting to the ED with chest pain continues to be a challenge. cTn is the gold standard for AMI diagnosis but early presenters (<1 hours from symptom onset) maybe cTn negative on admission. We analysed the diagnostic value of h-FABP and hs-TnI in patients presenting to ED with chest pain and no cTnI elevations. METHODS: 28 AMI and 28 no-AMI individuals both presented to ED within one hour from pain onset were included...
June 26, 2017: Scandinavian Journal of Clinical and Laboratory Investigation
https://www.readbyqxmd.com/read/28647406/unstable-angina-in-the-era-of-cardiac-troponin-assays-with-improved-sensitivity-a-clinical-dilemma
#20
K M Eggers, T Jernberg, B Lindahl
INTRODUCTION: There is an expectation that with the adoption of more sensitive cardiac troponin (cTn) assays, unstable angina would become a rarity. However, recent data from the SWEDEHEART registry demonstrated that 15% of patients admitted with non ST-elevation acute coronary syndrome (NSTE-ACS) still were regarded having unstable angina. We aimed to further investigate the clinical characteristics and outcome of these patients. METHODS: Retrospective registry-based analysis (SWEDEHEART) including 3204 unstable patients, 18,194 non ST-elevation myocardial infarction (NSTEMI) patients and 977 controls without acute cardiovascular disease...
June 21, 2017: American Journal of Medicine
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