AI Article Synopsis
- Elevated troponin levels are often associated with acute coronary syndrome (ACS), but they can also indicate myocardial necrosis due to other causes, especially when ischemia is absent.
- A case series of seven patients (ages 18-67) presented with chest discomfort and were diagnosed with various types of tachycardia; all had elevated troponin I levels but normal coronary arteries upon angiography.
- The study highlights the importance of investigating other causes of troponin elevation to avoid misdiagnosis and delayed treatment in patients not experiencing ACS.
Article Abstract
Troponin elevation is usually synonymous with acute coronary syndrome (ACS). Although sensitive for ACS, the elevation of serum troponin, in the absence of clinical evidence of ischemia, should prompt a search for other etiologies of myocardial necrosis. In fact, elevated values of troponin are correlated with myocardial necrosis even though it does not discriminate the mechanism involved. We report a series of seven patients (age range 18-67 years), who presented with complaints of chest discomfort and were found to have regular supraventricular tachycardia (5 patients) and one patient each with atrial fibrillation and ventricular tachycardia. All these patients had elevated troponin I and underwent coronary angiography that revealed normal epicardial coronary arteries. This is first case series in which all patients underwent coronary angiography and none of the patients was hemodynamically unstable at the time of presentation. Patients with elevated troponin due to conditions other than ACS can receive inappropriate and delayed definitive diagnosis and treatment.
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