Troponin I: how high is too high?

Elevated cardiac troponin I can occur in patients with cardiac injury or sepsis. However, extreme elevations of serum cardiac troponin I in pediatric patients without myocardial injury are rare. We present a case of a 14-year-old girl involved in a motor vehicle accident with muscle injury, who was readmitted with sepsis and severely elevated serum cardiac troponin I level in the absence of myocardial injury.

Ductal arteriosus aneurysm, right aortic arch, and isolated left subclavian artery in a neonate.

Ductal arteriosus aneurysm (DAA) is a well-recognized condition, especially in infancy, and is usually asymptomatic. We report the first case of a newborn who presented with significant inspiratory stridor and, using multiple imaging investigations, was subsequently diagnosed with the rare constellation of a congenital DAA, a right aortic arch and an isolated left subclavian artery with normal intra-cardiac anatomy. The patient underwent surgical resection of the DAA with significant improvement in symptoms.