Cardiac troponin I elevation with supraventricular tachycardia: two case reports and review of the literature

Xue, Feng; Jiang, Tingbo; Jiang, Bin; Cheng, Xiaoguang; He, Yao; Li, Xun; Yang, Xiangjun

doi:10.1186/1756-0500-7-136

Cited by 7 publications

(11 citation statements)

References 8 publications

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“…Поскольку у многих пациентов с СВТ возникают симптомы боли в груди, часто ошибочно им диагностируется ОИМ и назначается неподходящее лечение в виде антиагрегантных и тромболитических препаратов. Только коронарная ангиография позволяет исключить у пациентов с СВТ признаки поражения коронарных артерий [24,25]. В работе F. Xue и соавт.…”

Section: тропонины при тахикардии/тахиаритмииunclassified

“…Через несколько часов после госпитализации произошло еще более значимое повышение концентрации тропонина I -до 0,52 и 2,28 соответственно, в результате чего пациентам ошибочно был поставлен диагноз ОИМ и назначено соответствующее лечение. В течение нескольких дней после госпитализации пациентам проведена коронарография, которая не выявила никаких признаков обструкции венечных сосудов [25].…”

Section: тропонины при тахикардии/тахиаритмииunclassified

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Non-coronarogenic causes of increased cardiac troponins in clinical practice

Chaulin

Михайлович²,

Karslyan

et al. 2020

Journal of Clinical Practice

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Cardiospecific isoforms of troponins are the most sensitive and specific biomarkers for the diagnosis of myocardial infarction. However, though elevated troponin levels indicate myocardial damage, they do not determine the cause and mechanism of the damage. With the new highly sensitive methods, very minor damages of the heart muscle can be detected. Myocardial damage can occur in many non-coronarogenic diseases. In this review, we discuss the mechanisms of elevation, the diagnostic value of cardiac troponins in the renal failure, tachyarrhythmias, endocarditis, myocarditis, pericarditis, sepsis, neurogenic pathologies (stroke), pulmonary embolism. In addition, we pay attention to the main reasons for a false-positive increase of the concentration of cardiac troponins: heterophilic antibodies, rheumatoid factor, alkaline phosphatase, cross-reactions with skeletal muscle troponins.

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Section: тропонины при тахикардии/тахиаритмииunclassified

Non-coronarogenic causes of increased cardiac troponins in clinical practice

Chaulin

Михайлович²,

Karslyan

et al. 2020

Journal of Clinical Practice

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“…23,28 Tahikardija može uzrokovati porast troponina jer smanjuje vrijeme raspoloživo za dijastoličku koronarnu opskrbu. 29 Dinamika ST-segmenta u vrijeme epizoda tahikardije nije nuž-mismatch between myocardial oxygen supply and demand or as a result of direct damage to the myocardium.…”

Section: Lbbbunclassified

“…Tachycardia can also result in an increase of troponin because there is decreased time available for diastolic coronary perfusion 29 . Alteration in the ST-segment during episodes of tachycardia is not necessarily an indication of the presence of ischemia 30 .…”

Section: Zaključakmentioning

confidence: 99%

Causes of Elevated Troponin in Patients with Normal Coronary Angiography

Reschner

2019

Cardiologia Croatica

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Uzroci povišenog troponina u bolesnika s urednom koronarografijom causes of elevated troponin in patients with Normal coronary angiographyIzvorni znanstveni članak Original scientific paper 2019;14(7-8):159. UvodTroponin je strukturna komponenta sarkomere i sastoji se od triju proteina: troponin C (cTnC), troponin I (cTnI) i troponin T (cTnT), te kontrolira mišićne kontrakcije skeletnih mišića i miokarda, odgovarajući na prisutnost intracelularnog kalcija. Približno 6 -8 % cTnT-a te 2,8 -8,3 % cTnI-a nađeno je u citosolu 1 . Najčešće se SAŽETAK: Porast troponina u većini slučajeva upućuje na oštećenje stanica miokarda, no povišene vrijednosti troponina nisu uvijek posljedica infarkta ili ishemije. Svrha je ovog istraživanja bila osvijetliti različite uzroke povišenoga troponina u bolesnika s normalnim nalazom koronarografije. U Kliničkom bolničkom centru Zagreb 2014. godine izdvojeno je 947 bolesnika iz baze podataka Laboratorija za invazivnu kardiologiju, u kojih je učinjena koronarografija radi postavljanja dijagnoze akutnoga koronarnog sindroma (ACS). Trideset dva bolesnika (3,38 %) nisu imala uzrok oštećenja miocita od koronarne bolesti srca (CAD), definiranoj kao stenoza lumena koronarnih arterija veća od 30 %. Porast miokardnoga troponina T (cTnT) u bolesnika s normalnim koronarnim arterijama rezultat su različitih uzroka, uključujući hipertenzivnu bolest srca, Takotsubo sindrom, supraventrikulsku tahikardiju, miokarditis i dilatativnu kardiomiopatiju, da spomenemo samo neke. Osim u ACS-u, cTnT može biti povišen u nizu različitih stanja, o čemu treba razmišljati kada se razmatra klinička slika, i to može biti odraz nekroze miokarda i u odsutnosti značajne CAD.SUMMaRY: Troponin elevation usually indicates myocardial cell injury. However, elevated values of troponin are not always a consequence of infarction or ischemia. The aim of this study was to elucidate the diverse etiologies of elevated troponin in patients with normal coronary angiography. There were 947 patients at the Zagreb University Hospital Centre identified from the catheterization database who underwent coronary angiography in 2014 due to suspected acute coronary syndrome. We identified 32 (3.38%) patients who had an alternative cause for myocyte injury other than coronary artery disease, defined as coronary artery lumen stenosis above 30%. The elevation of cardiac troponin T (cTnT) in patients with normal coronary angiography was found to be the consequence of diverse etiologies, including hypertensive heart disease, Takotsubo syndrome, supraventricular tachycardia, myocarditis, and dilated cardiomyopathy, to name a few. Apart from acute coronary syndrome, cTnT can be elevated in a number of different conditions, which should be considered according to clinical presentation, and that could still reflect myocardial necrosis even in the absence of significant coronary artery disease.KLJUČNE RIJEČI: troponin, koronarna bolest srca, normalan nalaz koronarografije, oštećenje stanica miokarda.

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“…In addition, continuous cTnI elevation has been recently reported to occur in a substantial proportion of patients with Fabry disease, a rare X-linked disorder affecting homozygous males and heterozygous females [7]. Paroxysmal supraventricular tachycardia may induce elevations in cTnI in the absence of coronary artery disease (CAD) [8,9]. However, elevation of high sensitivity cTnI has not been reported with chronic alcoholism without alcoholic cardiomyopathy.…”

Section: Introductionmentioning

confidence: 99%

Troponin I Elevation Due to Alcoholism in Absence of Acute Coronary Syndrome: A Case Report

et al. 2014

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Cardiac troponin I (cTnI), a sensitive and specific marker for myocardial injury, has been utilized for the diagnosis of an acute myocardial infarction. However, a variety of clinical scenarios without evidence of acute coronary syndrome (ACS), such as pulmonary embolism, sepsis, renal failure or stress-induced cardiomyopathy may also cause the elevation of cTnI. We described a 55-year-old Hispanic male with abnormal elevations of cTnI without objective evidence of myocardial infarction damage. We hypothesized that his long-term chronic alcoholic intoxication is causing the myocardial injury, responsive for cTnI elevation. We proposed that alcohol-induced early myocardial damage, independent of alcoholic cardiomyopathy, might be related to alcohol-induced cTnI elevation in this patient. This is the first report suggesting that the abnormal elevations of cTnI can be seen in patients with chronic alcoholism without objective evidence of myocardial infarction.

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Cardiac troponin I elevation with supraventricular tachycardia: two case reports and review of the literature

Cited by 7 publications

References 8 publications

Non-coronarogenic causes of increased cardiac troponins in clinical practice

Non-coronarogenic causes of increased cardiac troponins in clinical practice

Causes of Elevated Troponin in Patients with Normal Coronary Angiography

Troponin I Elevation Due to Alcoholism in Absence of Acute Coronary Syndrome: A Case Report

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