Tag Archives: troponin

Introduction Atrioventricular (AV) block is an uncommon complication of myocarditis, which is most often observed in combination with underlying conditions such as that caused by cardiac sarcoidosis (CS), giant cell myocarditis (GCM) and acute lymphocytic myocarditis. Myocarditis is a broad term that describes inflammation of the myocardium, which can range from mild and self-limiting to fulminant variants that require cardiac transplantation. Patients with proven GCM and CS may benefit from immunosuppression, and it is important to investigate for underlying infiltrative disease in cases of myocarditis and AV block as specific treatments ma

Introduction Most patients presenting as an emergency with chest pain do not have myocardial infarction (MI),1 which must, nevertheless, be ruled out in order to reassure and discharge from hospital. High-sensitivity cardiac troponin T (hs-TnT) and troponin I (hs-TnI) have streamlined the assessment and management of chest pain, as a rapid rule out of MI is now possible, particularly if hs-TnT or hs-TnI are undetectable at presentation.2-8 Undetectable troponin cannot, however, be used to exclude unstable angina, which by definition is not associated with a troponin rise.9 It is for this reason that physicians and cardiologists may be reluct

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Introduction For patients with acute coronary syndrome (ACS) who survive to reach hospital, the majority of mortality and morbidity over the following five years occurs after discharge.1 Of all complications, development of acute heart failure (AHF) and left ventricular systolic dysfunction (LVSD) are key determinants of adverse outcome. Approximately half of patients with ACS are readmitted to hospital, constituting a profound burden on healthcare resources.1 In several healthcare systems there are financial penalties when ACS patients are readmitted within 30 days.2 Prediction of the development of AHF and hospital readmission following ACS

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Amiodarone for the treatment of stable ventricular tachycardia – has the Resuscitation Council got it wrong? Dear Sirs, Amiodarone has been the UK Resuscitation Council’s recommendation for the treatment of haemodynamically stable ventricular tachycardia (VT) since 2000.1  It is my opinion that the evidence in support of amiodarone in this setting is poor and that superior agents may exist. In the last six years, three retrospective studies have been published showing a dismal success rate when amiodarone is used to treat patients with stable VT. Marill et al reported that eight out of 28 (29%) patients cardioverted using a dose of 150 m

PARTNER: transcatheter valves just as good as surgery for high risk aortic stenosis Transcatheter aortic valve implantation (TAVI) is just as effective at reducing mortality as surgery for severe aortic stenosis in elderly patients whose age and overall health posed high risks for conventional surgery, according to the results of the PARTNER (Placement of AoRTic TraNscathetER Valve trial). However, stroke rates were higher in the trancatheter group. The transcatheter approach involves delivering a bioprosthetic valve to its target location with a catheter using either transfemoral access or trans-apical access (through the ribs) if peripheral

Chest pain – troponin and athletes Dear Sirs. We recently admitted two young men with chest discomfort suggestive of an acute coronary syndrome, who were troponin I positive. One was a 26-year-old Caucasian with left-sided chest heaviness engaging in regular triathlons. While serial resting electrocardiograms were unremarkable, troponin I on admission and one month later were elevated at 0.1 and 0.09 mg/L, respectively (normal range 0-0.04). An echocardiogram was entirely normal. An exercise treadmill stress test (ETT) was performed to 13 minutes (99% target heart rate achieved) of a Bruce protocol without symptoms or changes in the E

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