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Troponin diagnosis

Noemi Pavo, Raphael Wurm, Stephanie Neuhold, Christopher Adlbrecht, Greisa Vila, Guido Strunk, Martin Clodi, Michael Resl, Helmut Brath, Rudolf Prager, Anton Luger, Richard Pacher, Martin Hülsmann
BACKGROUND: Diabetes has been linked epidemiologically to increased cancer incidence and mortality. Growth differentiation factor 15 (GDF-15) is increased in patients with diabetes and has recently been linked to the occurrence of cancer. We investigated whether circulating GDF-15 concentrations can predict the incidence of malignant diseases in a diabetic patient cohort already facing increased risk for cancer. METHODS: We prospectively enrolled a total of 919 patients with type 2 diabetes and no history of malignant disease, who were clinically followed up for 60 months...
October 18, 2016: Clinical Chemistry
Dario Gulin, Jozica Sikic, Jasna Cerkez Habek, Sandra Jerkovic Gulin, Edvard Galic
Eosinophilic myocarditis (EM) is a rare and potentially fatal disease if left untreated. Because the disease can have a delayed presentation and can appear even after 2 years, its underlying causes often remain unknown. We report the case of a 63-year-old man with an atypical clinical presentation of hypersensitive EM and significant coronary artery disease, which was confirmed through coronary angiography. The patient was treated with hydrochlorothiazide (12.5 mg once daily for 2 years) and budesonide/formoterol (160/4...
December 2016: Drug Saf Case Rep
Muhammad Shahid, Edward Hoey, Sandeep Basavarajaiah
We report a case of focal myocarditis in a young boy mimicking acute ST-segment elevation MI. He presented with chest pain and the EKG changes were consistent with infero-laeral ST-segment elevation MI. Coronary angiogram revealed smooth arteries with no obstruction. Troponin was significantly elevated and the echocardiogram exhibited mildly impaired LV function with hypokinetic inferior and lateral walls. Subsequently performed cardiac magnetic resonance imaging confirmed the diagnosis of myocarditis by exhibiting classic features of delayed gadolinium enhancement in the epi and mid-myocardial regions of the lateral wall sparing the sub-endocardial region...
August 24, 2016: American Journal of Cardiology
A Ollila, L Vikatmaa, J Virolainen, P Vikatmaa, A Leppäniemi, A Albäck, M Salmenperä, V Pettilä
BACKGROUND AND AIMS: Perioperative myocardial infarction is an underdiagnosed complication causing morbidity, mortality, and considerable costs. However, evidence of preventive and therapeutic options is scarce. We investigated the incidence and outcome of perioperative myocardial infarction in non-cardiac surgery patients in order to define a target population for future interventional trials. MATERIAL AND METHODS: We conducted a prospective single-center study on non-cardiac surgery patients aged 50 years or older...
October 13, 2016: Scandinavian Journal of Surgery: SJS
Shankar Iyer, Subhash Shivtarkar, Ameya Udyavar
Takotsubo cardiomyopathy, also called transient left ventricular apical ballooning syndrome or Gebrochenes-Herz-Syndrome, is a rare entity which may masquerade as acute coronary syndrome (ACS) with sudden onset of chest pain and/or dyspnea, transient left ventricle apical akinesia, electrocardiographic changes typical of ACS and mild increase in cardiac enzymes in the background of normal coronary arteries. Here, we present a case of a 45 year old female who presented with acute onset dyspnea and chest pain with severe ischemic changes on the ECG and raised troponin levels...
April 2016: Journal of the Association of Physicians of India
Noura E Attia
AIM: This study was designed to evaluate the cardiac biomarkers and ultrasonography in prediction and early diagnosis of traumatic pericarditis (TP) in Egyptian buffaloes. MATERIALS AND METHODS: A total number of 47 buffaloes were included in the study and divided into two groups: Healthy (n=10) and diseased groups (n=37). Diseased buffaloes were admitted to the Veterinary Teaching Hospital at Zagazig University, Egypt, with a history of anorexia, sudden, and severe reduction of milk production with no response to a previous medical treatment some animals had edema at the dewlap and congestion of the jugulars...
September 2016: Veterinary World
Rachel A Lindor, Marysia S Tweet, Kiran A Goyal, Christine M Lohse, Rajiv Gulati, Sharonne N Hayes, Annie T Sadosty
BACKGROUND: Spontaneous coronary artery dissection (SCAD) is an infrequently recognized but potentially fatal cause of acute coronary syndrome (ACS) that disproportionately affects women. Little is currently known about how patients with SCAD initially present. OBJECTIVES: We sought to describe patients who presented to the emergency department (ED) with symptoms of SCAD to improve providers' awareness and recognition of this condition. PATIENTS AND METHODS: We performed a retrospective medical record review of all patients who presented to the ED of a single academic medical center from January 1, 2002 through October 31, 2015 and were subsequently diagnosed with SCAD by angiography...
October 8, 2016: Journal of Emergency Medicine
Mayra de A Marques, Guilherme A P de Oliveira
Inherited myopathies affect both skeletal and cardiac muscle and are commonly associated with genetic dysfunctions, leading to the production of anomalous proteins. In cardiomyopathies, mutations frequently occur in sarcomeric genes, but the cause-effect scenario between genetic alterations and pathological processes remains elusive. Hypertrophic cardiomyopathy (HCM) was the first cardiac disease associated with a genetic background. Since the discovery of the first mutation in the β-myosin heavy chain, more than 1400 new mutations in 11 sarcomeric genes have been reported, awarding HCM the title of the "disease of the sarcomere...
2016: Frontiers in Physiology
Chung-Lieh Hung, Ding-Kuo Chien, Shou-Chuan Shih, Wen-Han Chang
BACKGROUND: Accurate diagnosis of acute coronary syndrome (ACS) in a timely fashion is challenging in the elderly population, especially elderly women, who usually exhibit atypical clinical symptoms. A multiple cardiac biomarker (MCB) based approach has been shown to improve diagnostic efficacy of ACS. However, data in various age groups and sex differences remain largely unexplored. METHODS: Point-of-care testing (POCT) was performed on 290 patients (aged ≥18 years) who were admitted to the emergency department (ED) with symptoms of acute chest pain under suspicion of acute coronary syndrome (ACS)...
October 7, 2016: BMC Cardiovascular Disorders
Astrid Petersmann, Till Ittermann, Cornelia Frieß, Norbert Lubenow, Thomas Kohlmann, Andreas Greinacher, Annette Masuch, Matthias Nauck
Determination of cardiac troponin I (cTnI) is one central means for diagnosis of myocardial infarction. Assay performance of three troponin I assays was compared previously in a large reference population detecting sex-differences in the 99th percentile only for the Dimension Vista cTnI assay. The present study examined the underlying effects. Values for cTnI were reused. Creatine kinase (CK) activity was determined in 2358 samples from blood donors. Information on physical activity was evaluated from health questionnaires...
November 1, 2016: Clinica Chimica Acta; International Journal of Clinical Chemistry
Eli Muchtar, Daniele Derudas, Michelle Mauermann, Teerin Liewluck, Angela Dispenzieri, Shaji K Kumar, David Dingli, Martha Q Lacy, Francis K Buadi, Suzanne R Hayman, Prashant Kapoor, Nelson Leung, Rajshekhar Chakraborty, Wilson Gonsalves, Stephen Russell, John A Lust, Yi Lin, Ronald S Go, Steven Zeldenrust, Robert A Kyle, S Vincent Rajkumar, Morie A Gertz
OBJECTIVE: To characterize the natural history of immunoglobulin light chain amyloidosis-associated myopathy and to provide guidelines for recognition. PATIENTS AND METHODS: Fifty-one patients with systemic immunoglobulin light chain amyloidosis and biopsy-confirmed muscle amyloid deposition diagnosed between January 1, 1995, and December 31, 2015, were included in this study. RESULTS: Common presenting symptoms were muscle weakness in 49 patients (96%), dysphagia in 23 (45%), myalgia in 17 (33%), macroglossia in 17 (33%), jaw claudication in 13 (25%), and hoarseness in 9 (18%)...
October 2016: Mayo Clinic Proceedings
Maha A Al-Mohaissen, Ronald G Carere, G B John Mancini, Karin H Humphries, Beth A Whalen, Terry Lee, Frank X Scheuermeyer, Andrew P Ignaszewski
BACKGROUND: Markers of plaque destabilization and disruption may have a role in identifying non-STE- type 1 Myocardial Infarction in patients presenting with troponin elevation. We hypothesized that a plaque disruption index (PDI) derived from multiple biomarkers and measured within 24 hours from the first detectable troponin in patients with acute non-STE- type 1 MI (NSTEMI-A) will confirm the diagnosis and identify these patients with higher specificity when compared to individual markers and coronary angiography...
2016: PloS One
Lieke J J Klinkenberg, Karin Wildi, Noreen van der Linden, Imre W K Kouw, Marijke Niens, Raphael Twerenbold, Maria Rubini Gimenez, Christian Puelacher, Jean Daniel Neuhaus, Petra Hillinger, Thomas Nestelberger, Jasper Boeddinghaus, Karin Grimm, Zaid Sabti, Judith A P Bons, Jeroen D E van Suijlen, Frans E S Tan, Joop Ten Kate, Otto Bekers, Luc J C van Loon, Marja P van Dieijen-Visser, Christian Mueller, Steven J R Meex
BACKGROUND: Interpretation of serial high-sensitivity cardiac troponin (hs-cTn) measurements for the diagnosis of acute myocardial infarction (AMI) assumes random fluctuation of hs-cTn around an individual's homeostatic set point. The aim of this study was to challenge this diagnostic concept. METHODS: Study 1 examined the presence of a diurnal hs-cTn rhythm by hourly blood sampling, day and night, in 24 individuals without a recent history of AMI. Study 2 assessed morning vs evening diagnostic accuracy of hs-cTnT and hs-cTnI in a prospective multicenter diagnostic study of 2782 unselected patients, presenting to the emergency department with acute chest pain...
October 5, 2016: Clinical Chemistry
Corey Heitz, Justin Morgenstern, William K Milne
This prospectively planned, secondary analysis of data from a large multi-center trial evaluated the diagnostic characteristics of using hs-cTnT levels below the level of detection (LoD), along with EKG findings, to rule out AMI on presentation to the ED. The primary outcome was diagnosis of AMI and the secondary outcome was major adverse cardiac events (MACE) within 30 days. A total of 1,282 patients were included in the study, 16.6% of which were diagnosed with AMI at the index visit. This article is protected by copyright...
October 5, 2016: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Kalkan Asim, Yeniocak Selman, Yazici Suleyman, Karcioglu Ozgur, Bilir Ozlem, Ersunan Gokhan
INTRODUCTION: Lithium overdose can be associated with cardiac toxicity, especially in those with underlying heart disease. Toxic levels of serum lithium are associated with cardiotoxic effects ranging from simple ECG disorders to dysrhythmias, cardiomyopathy and even acute myocardial infarction (AMI). This report describes a patient with AMI accompanied by high blood levels of lithium. CASE PRESENTATION: A 62-year-old woman was admitted to the emergency department due to weakness and acute chest pain...
July 2016: Iranian Red Crescent Medical Journal
Ioannis Vogiatzis, Irena Dapcevic, Antonis Datsios, Kostas Koutsambasopoulos, Argirios Gontopoulos, Savas Grigoriadis
INTRODUCTION: The propeptide of brain natriuretic peptide (ProBNP) is used for the diagnosis of left ventricle dysfunction and heart failure. In patients with an Acute Coronary Syndrome (ACS) it can contribute to both short and long term prognosis of cardiovascular events that could be very important for management and therapy of these patients. AIM: The aim of this study was to evaluate the prognostic value of ProBNP for the clinical course after an acute coronary syndrome, compared with that of cardiac troponine T (cTnT) and the risk stratification of patients with acute coronary syndrome, both during hospitalization and six months later...
July 27, 2016: Medical Archives
O Nallet, N Ketata, N Ferrier, X Marcaggi
Acute chest pain is a common reason of consultation in the emergency department. The difficulty lies in discriminating patients with acute coronary syndrome or other life-threatening conditions from those non-cardiovascular, non-life-threatening chest pain. Only 15 to 25 % of patients with acute chest pain actually have acute coronary syndrome. Algorithms using high sensitivity troponin at admission and a second assessment 1 or 3hours later are validated to "rule in" or "rule out" the diagnosis of non ST-elevation myocardial infarction...
September 29, 2016: Annales de Cardiologie et D'angéiologie
Issam Salouage, Sihem El Aidli, Sarra Kastalli, Riadh Daghfous, Mohamed Lakhal
Anaphylactic reactions are often induced by drugs, and the most frequent ones are penicillin derivates. The concurrence of acute coronary syndrome with hypersensitivity and anaphylactic or anaphylactoid reactions constitutes the Kounis syndrome. We report a case of a coronary stent thrombosis with a fatal outcome complicating an anaphylactic shock induced by amoxicillin-clavulanic acid association. A 58-year-old woman with a history of triple coronary stenting was treated by amoxicillin/clavulanic acid association for pharyngitis...
July 21, 2016: Thérapie
Geza S Bodor
Heart diseases, especially coronary artery diseases (CAD), are the leading causes of morbidity and mortality in developed countries. Effective therapy is available to ensure patient survival and to prevent long term sequelae after an acute ischemic event caused by CAD, but appropriate therapy requires rapid and accurate diagnosis. Research into the pathology of CAD have demonstrated the usefulness of measuring concentrations of chemicals released from the injured cardiac muscle can aid the diagnosis of diseases caused by myocardial ischemia...
April 2016: EJIFCC
Michael J Daly, Dewar D Finlay, Daniel Guldenring, Raymond R Bond, Aaron J McCann, Peter J Scott, Jennifer A Adgey, Mark T Harbinson
INTRODUCTION: Epicardial potentials (EPs) derived from the body surface potential map (BSPM) improve acute myocardial infarction (AMI) diagnosis. In this study, we compared EPs derived from the 80-lead BSPM using a standard thoracic volume conductor model (TVCM) with those derived using a patient-specific torso model (PSTM) based on body mass index (BMI). METHODS: Consecutive patients presenting to both the emergency department and pre-hospital coronary care unit between August 2009 and August 2011 with acute ischaemic-type chest pain at rest were enrolled...
September 26, 2016: European Heart Journal. Acute Cardiovascular Care
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