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Troponin diagnosis

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https://www.readbyqxmd.com/read/28634541/campylobacter-jejuni-myocarditis-a-journey-from-the-gut-to-the-heart
#1
M Toba Obafemi, Homeyra Douglas
OBJECTIVES: Campylobacter jejuni is an unusual cause of myocarditis and could easily be missed. METHODS: We describe a case of a 25 year old man, who presented with 3 day history of vomiting and diarrhoea, followed by chest pain and significant high sensitive troponin rise. RESULTS: The patient's profuse diarrhoea was accompanied by raised inflammatory markers, electrocardiogram changes and evidence of cardiomyopathy on transthoracic echocardiogram...
2017: SAGE open medical case reports
https://www.readbyqxmd.com/read/28611878/physician-variability-in-management-of-emergency-department-patients-with-chest-pain
#2
Peter B Smulowitz, Orit Barrett, Matthew M Hall, Shamai A Grossman, Edward A Ullman, Victor Novack
INTRODUCTION: Chest pain is a common emergency department (ED) presentation accounting for 8-10 million visits per year in the United States. Physician-level factors such as risk tolerance are predictive of admission rates. The recent advent of accelerated diagnostic pathways and ED observation units may have an impact in reducing variation in admission rates on the individual physician level. METHODS: We conducted a single-institution retrospective observational study of ED patients with a diagnosis of chest pain as determined by diagnostic code from our hospital administrative database...
June 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28599827/late-detection-of-left-ventricular-dysfunction-using-two-dimensional-and-three-dimensional-speckle-tracking-echocardiography-in-patients-with-history-of-nonsevere-acute-myocarditis
#3
Thibault Caspar, Marie Fichot, Mickaël Ohana, Soraya El Ghannudi, Olivier Morel, Patrick Ohlmann
BACKGROUND: Acute myocarditis (AM) often involves the left ventricular (LV) subepicardium that might be displayed by cardiac magnetic resonance even late after the acute phase. In the absence of global or regional LV dysfunction, conventional transthoracic echocardiography (TTE) does not accurately identify tissue sequelae of AM. We sought to evaluate the diagnostic value of two-dimensional (2D) and three-dimensional (3D) speckle-tracking echocardiography to identify patients with a history of AM with preserved LV ejection fraction (LVEF)...
June 6, 2017: Journal of the American Society of Echocardiography
https://www.readbyqxmd.com/read/28597214/-diagnosis-of-ischemia-and-revascularization-in-patients-with-ventricular-tachyarrhythmia
#4
REVIEW
Thomas Deneke, Carsten W Israel
Sustained ventricular tachyarrhythmia usually occurs on the basis of structural heart disease, particularly coronary heart disease (CAD). Although monomorphic ventricular tachycardia (VT) appears mainly in patients with CAD, it is typically not triggered by acute ischemia, in contrast to polymorphic VT or ventricular fibrillation (VF). To judge if VT is caused by acute ischemia is even more difficult in context with an elevated highly sensitive troponin T which is generally elevated in sustained VT because tachycardia in chronic stable coronary artery sclerosis causes a mismatch between increased oxygen demand and limited oxygen supply...
June 8, 2017: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/28588346/a-rational-adoption-of-the-high-sensitive-assay-for-cardiac-troponin-i-in-diagnostic-routine
#5
Antonio Croce, Pietro Brunati, Carlo Colzani, Riccardo Terramocci, Stefano Favero, Gabriele Bordoni, Claudio Galli
We describe the adoption of high sensitive troponin I (hsTnI) in clinical practice in two hospital settings in Italy. Samples from 426 consecutive patients (mean age 68.8 ± 17.0) admitted to the Emergency Department with a suspected acute coronary syndrome (ACS) have been tested at admittance and after 3 and 6 hours by contemporary TnI and hsTnI. Results have been compared to the final clinical diagnosis. Troponin was detectable in 68.6% by TnI and 89.9% by hsTnI. Since hsTnI has a lower threshold for females, 38/41 patients with positive values only by hsTnI were women...
2017: Disease Markers
https://www.readbyqxmd.com/read/28584814/predictors-of-extracorporeal-membrane-oxygenation-support-for-children-with-acute-myocarditis
#6
Han-Ping Wu, Mao-Jen Lin, Wen-Chieh Yang, Kang-Hsi Wu, Chun-Yu Chen
The clinical presentation of acute myocarditis in children may range from asymptomatic to sudden cardiac arrest. This study analyzed the clinical spectrum of acute myocarditis in children to identify factors that could aid primary care physicians to predict the need for extracorporeal membrane oxygenation (ECMO) earlier and consult the pediatric cardiologist promptly. Between October 2011 and September 2016, we retrospectively analyzed 60 patients aged 18 years or younger who were admitted to our pediatric emergency department with a definite diagnosis of acute myocarditis...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28573785/biomarker-release-after-percutaneous-coronary-intervention-in-patients-without-established-myocardial-infarction-as-assessed-by-cardiac-magnetic-resonance-with-late-gadolinium-enhancement
#7
Rodrigo Morel Vieira de Melo, Whady Hueb, Cesar Higa Nomura, Expedito Eustáquio Ribeiro da Silva, Alexandre Volney Villa, Fernando Teiichi Costa Oikawa, Leandro Menezes Alves da Costa, Paulo Cury Rezende, Cibele Larrosa Garzillo, Eduardo Gomes Lima, Jose Antonio Franchini Ramires, Roberto Kalil Filho
OBJECTIVES: This study aimed to evaluate the amount and pattern of cardiac biomarker release after elective percutaneous coronary intervention (PCI) in patients without evidence of a new myocardial infarction (MI) after the procedure as assessed by cardiac magnetic resonance (CMR) with late gadolinium enhancement (LGE). BACKGROUND: The release of myocardial necrosis biomarkers after PCI frequently occurs. However, the correlation between biomarker release and the diagnosis of procedure-related MI type 4a has been controversial...
June 2, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28571623/reprint-of-assay-validation-of-the-cardiac-isoform-of-troponin-i-in-double-crested-cormorant-phalacrocorax-auritus-plasma-for-diagnosis-of-cardiac-damage
#8
Melissa Daigneault, Kendal E Harr, Karen M Dean, Steven J Bursian
Cardiac abnormalities, initially found in Deepwater Horizon weathered MC252 crude oil exposed Double Crested Cormorants (DCCOs) upon gross necropsy, were further investigated using echocardiography. Clinical and statistically significant changes including decreased ventricular myocardial contractility and arrhythmia were elucidated by echocardiography and interpreted by boarded cardiologists as potentially life threatening. The objective of this investigation was to initiate development of an antemortem, sensitive blood screening test for cardiac damage due to oil exposure of avian species...
May 29, 2017: Ecotoxicology and Environmental Safety
https://www.readbyqxmd.com/read/28569321/achieving-biosensing-at-attomolar-concentrations-of-cardiac-troponin-t-in-human-biofluids-by-developing-a-label-free-nanoplasmonic-analytical-assay
#9
Thakshila Liyanage, Andeep Sangha, Rajesh Sardar
Acute myocardial infarction (heart attack) is the fifth leading cause of death in the United States (Dariush et al., Circulation, 2015, 131, e29-e322). This highlights the need for early, rapid, and sensitive detection of its occurrence and severity through assaying cardiac biomarkers in human fluids. Herein we report chip-based fabrication of the first label-free, nanoplasmonic biosensor to assay cardiac troponin T (cTnT) in human biofluids (plasma, serum, and urine) with high specificity. The sensing mechanism is based on the adsorption model that measures the localized surface plasmon resonance (LSPR) wavelength shift of anti-cTnT functionalized gold triangular nanoprisms (Au TNPs) induced by a change of their local dielectric environment upon binding of cTnT...
June 1, 2017: Analyst
https://www.readbyqxmd.com/read/28566132/early-diagnostic-performance-of-heart-type-fatty-acid-binding-protein-in-suspected-acute-myocardial-infarction-evidence-from-a-meta-analysis-of-contemporary-studies
#10
Li-Qian Xu, Yun-Mei Yang, Hong Tong, Chang-Fu Xu
BACKGROUND: Although cardiac troponin is the cornerstone in diagnosis of acute myocardial infarction (AMI), the accuracy is still suboptimal in the early hours after chest pain onset. Due to its small size, heart-type fatty acid-binding protein (H-FABP) has been reported accurate in diagnosis of AMI, however, this remains undetermined. The aim is to investigate the diagnostic performance of H-FABP alone and in conjunction with high-sensitivity troponin (hs-Tn) within six hours of symptom onset...
May 4, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28545635/outcomes-in-patients-with-chest-pain-discharged-after%C3%A2-evaluation-using-a-high-sensitivity-troponin-t-assay
#11
Atosa Nejatian, Åsa Omstedt, Jonas Höijer, L O Hansson, Therese Djärv, Kai M Eggers, Per Svensson
BACKGROUND: Most patients with chest pain are discharged from the emergency department (ED) with the diagnosis "unspecified chest pain." It is unknown if evaluation with a high-sensitivity troponin T (hsTnT) assay affects prognosis in this large population. OBJECTIVES: The aim was to investigate whether the introduction of an hsTnT assay is associated with reduced incidence of major adverse cardiac events (MACEs) and cardiovascular (CV) risk profile in patients with chest pain discharged from the ED...
May 30, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28536746/characteristics-of-clinically-diagnosed-pediatric-myocarditis-in-a-contemporary-multi-center-cohort
#12
Ryan J Butts, Gerard J Boyle, Shriprasad R Deshpande, Katheryn Gambetta, Kenneth R Knecht, Carolina A Prada-Ruiz, Marc E Richmond, Shawn C West, Ashwin K Lal
The objective of this study was to describe a contemporary cohort of pediatric patients hospitalized for clinically suspected myocarditis. A retrospective chart review was performed at seven tertiary pediatric hospitals. Electronic medical records were searched between 2008 and 2012 for patients ≤18 years admitted with an ICD-9 code consistent with myocarditis. Patients were excluded if the admitting or consulting cardiologist did not suspect myocarditis during the admission or an alternative diagnosis was determined...
May 23, 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/28532247/high-sensitivity-cardiac-troponin-t-in-patients-not-having-an-acute-coronary-syndrome-results-from-the-trapid-ami-study
#13
Richard Nowak, Christian Mueller, Evangelos Giannitsis, Michael Christ, Jordi Ordonez-Llanos, Christopher DeFilippi, James McCord, Richard Body, Mauro Panteghini, Tomas Jernberg, Mario Plebani, Franck Verschuren, John K French, Robert Christenson, Gordon Jacobsen, Carina Dinkel, Bertil Lindahl
PURPOSE: To describe the baseline, 1 hr and delta high sensitivity cardiac troponin (hs-cTnT) values in patients with suspected acute myocardial infarction (AMI) but without a final acute coronary syndrome (ACS) diagnosis. MATERIALS AND METHODS: hs-cTnT assay for RAPID rule out of acute myocardial infarction (TRAPID-AMI) was a prospective diagnostic trial that enrolled emergency department (ED) patients with suspected AMI. Final patient diagnoses were adjudicated by a clinical events committee and subjects placed in different clinical groups: AMI, unstable angina, non-ACS cardiac, non-cardiac and unknown origin...
June 14, 2017: Biomarkers: Biochemical Indicators of Exposure, Response, and Susceptibility to Chemicals
https://www.readbyqxmd.com/read/28515106/direct-comparison-of-2-rule-out-strategies-for-acute-myocardial-infarction-2-h-accelerated-diagnostic-protocol-vs-2-h-algorithm
#14
Karin Wildi, Louise Cullen, Raphael Twerenbold, Jaimi H Greenslade, William Parsonage, Jasper Boeddinghaus, Thomas Nestelberger, Zaid Sabti, Maria Rubini-Giménez, Christian Puelacher, Janosch Cupa, Lukas Schumacher, Patrick Badertscher, Karin Grimm, Nikola Kozhuharov, Claudia Stelzig, Michael Freese, Katharina Rentsch, Jens Lohrmann, Wanda Kloos, Andreas Buser, Tobias Reichlin, John Pickering, Martin Than, Christian Mueller
BACKGROUND: We compared 2 high-sensitivity cardiac troponin (hs-cTn)-based 2-h strategies in patients presenting with suspected acute myocardial infarction (AMI) to the emergency department (ED): the 2-h accelerated diagnostic protocol (2h-ADP) combining hs-cTn, electrocardiogram, and a risk score, and the 2-h algorithm exclusively based on hs-cTn concentrations and their absolute changes. METHODS: Analyses were performed in 2 independent diagnostic cohorts [European Advantageous Predictors of Acute Coronary Syndrome Evaluation (APACE) study, Australian-New Zealand 2-h Accelerated Diagnostic Protocol to Assess patients with chest Pain symptoms using contemporary Troponins as the only biomarker (ADAPT) study] employing hs-cTnT (Elecsys) and hs-cTnI (Architect)...
May 17, 2017: Clinical Chemistry
https://www.readbyqxmd.com/read/28509705/yield-of-cardiac-magnetic-resonance-imaging-in-patients-with-acute-coronary-syndrome-and-no-obstructive-coronary-artery-disease
#15
Mahraz Parvand, Andrew Starovoytov, Tara L Sedlak
PURPOSE: Ten percent to 25% of women and 6%-10% of men with acute coronary syndrome (ACS) are found to have no obstructive coronary artery disease (CAD) on coronary computed tomography angiogram or invasive coronary angiography. The etiology of presentation is often unclear. We examined the diagnostic yield of cardiac magnetic resonance imaging (CMR) in patients with signs and symptoms suggestive of an ACS and no obstructive CAD. METHODS: We retrospectively studied patients with signs and symptoms suggestive of an ACS and no obstructive CAD on coronary computed tomography angiogram or invasive coronary angiography who had CMR performed at St...
June 2017: Critical Pathways in Cardiology
https://www.readbyqxmd.com/read/28503297/cardiovascular-involvement-and-manifestations-of-systemic-chikungunya-virus-infection-a-systematic-review
#16
María Fernanda Alvarez, Adrián Bolívar-Mejía, Alfonso J Rodriguez-Morales, Eduardo Ramirez-Vallejo
BACKGROUND: In the last three years, chikungunya virus disease has been spreading, affecting particularly the Americas, producing more than two million cases. In this setting, not only new disease-related epidemiological patterns have been found, but also new clinical findings have been reported by different research groups. These include findings on the cardiovascular system, including clinical, electrocardiographic and echocardiographic alterations. METHODS: We performed a systematic review looking for reports about cardiovascular compromise during chikungunya disease...
2017: F1000Research
https://www.readbyqxmd.com/read/28501386/atrioesophageal-fistula-after-ablation-for-atrial-fibrillation
#17
Trisha Mackle, Kevin Pistawka
BACKGROUND: Atrioesophageal fistula (AEF) is a rare and highly fatal complication of ablation procedures for atrial fibrillation. We report a diagnostically challenging case of AEF that highlights the unfortunate outcome that can be expected when this condition is not promptly diagnosed and managed accordingly. The varied clinical presentations are reviewed and recommended diagnostic and management approaches are presented. CASE REPORT: A 79-year-old female who was 5 weeks post-ablation presented to a community emergency department with chest pain and a transient episode of left-arm weakness...
May 10, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28466882/asia-pacific-consensus-statement-on-the-optimal-use-of-high-sensitivity-troponin-assays-in-acute-coronary-syndromes-diagnosis-focus-on-hs-tni
#18
COMMENT
Jack Wei Chieh Tan, Carolyn S P Lam, Sazzli Shahlan Kasim, Tar Choon Aw, Joel M Abanilla, Wei-Ting Chang, Van Phuoc Dang, Maria Iboleon-Dy, Sari Sri Mumpuni, Arintaya Phommintikul, Manh Cuong Ta, Punkiat Topipat, Kai Hang Yiu, Louise Cullen
OBJECTIVE: High-sensitivity troponin (hs-Tn) assays need to be applied appropriately to improve diagnosis and patient outcomes in acute coronary syndromes (ACS). METHODS: Experts from Asia Pacific convened in 2015 to provide data-driven consensus-based, region-specific recommendations and develop an algorithm for the appropriate incorporation of this assay into the ACS assessment and treatment pathway. RESULTS: Nine recommendations were developed by the expert panel: (1) troponin is the preferred cardiac biomarker for diagnostic assessment of ACS and is indicated for patients with symptoms of possible ACS; (2) hs-Tn assays are recommended; (3) serial testing is required for all patients; (4) testing should be performed at presentation and 3 hours later; (5) gender-specific cut-off values should be used for hs-Tn I assays; (6) hs-Tn I level >10 times the upper limit of normal should be considered to 'rule in' a diagnosis of ACS; (7) dynamic change >50% in hs-Tn I level from presentation to 3-hour retest identifies patients at high risk for ACS; (8) where only point-of-care testing is available, patients with elevated readings should be considered at high risk, while patients with low/undetectable readings should be retested after 6 hours or sent for laboratory testing and (9) regular education on the appropriate use of troponin tests is essential...
2017: Heart Asia
https://www.readbyqxmd.com/read/28462952/high-sensitivity-cardiac-troponin-i-assays-in-the-diagnosis-of-acute-myocardial-infarction
#19
EDITORIAL
Andrew R Chapman, David E Newby, Nicholas L Mills
No abstract text is available yet for this article.
2017: Heart Asia
https://www.readbyqxmd.com/read/28460039/prognostic-value-of-elevated-high-sensitivity-cardiac-troponin-t-in-patients-admitted-to-an-emergency-department-with-atrial-fibrillation
#20
Kiril M Stoyanov, Evangelos Giannitsis, Moritz Biener, Matthias Mueller-Hennessen, Katharina Arens, Hugo A Katus, Mehrshad Vafaie
Aims: Elevated levels of high-sensitivity cardiac troponin T (hsTnT) indicate underlying heart disease and are known to predict adverse outcomes in various patient populations. Their role in atrial fibrillation (AF) is still under debate. Methods and results: This retrospective study included 2898 consecutive patients presenting with AF to the emergency department of the Department of Cardiology, Heidelberg University Hospital. Multivariable Cox regression was used to assess associations between hsTnT and mortality...
April 27, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
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