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Troponin levels

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Posted 7/30/2006 6:12 PM (GMT 0)
I am new to this site and would like anyone who had a rise in troponin levels when at the hospital for chest pains to share their peak number with me and what their cardiolgist toldthem about the elevation.   I went to the Er room back in 2005 and first set of heart enzymes were normal but second set (4 hours later) was not.  My Peak Troponin level was 4.85 which the nurse gasped when she saw it and the cardio escorted her out of my hospital room.  Heart Cath doctor said I did not have a heart attack but a heart event.  My cardio echo doctor said I had an NSTEMI and the Electrophysio doctor said I had a heart attack.  They brushed it aside.

I came across an article the other day stating that patients who have Troponin levels past 2.0 have major heart muscle damage and at a very high risk of future heart attacks.    If this statement is true than I fit into this category and being humored by my Cardiologists.  Love to hear from others in same boat.   Thanks.  Ellie 

Posted 7/30/2006 10:26 PM (GMT 0)
Hi Ellie. Read this:

Diagnostic Value of Troponin: Acute Myocardial Infarction Diagnosis

Each year, approximately 6 million patients with chest pain are admitted to hospital emergency rooms as a result of cardiovascular disease. The accurate triage of patients with chest pain is one of the most difficult challenges for emergency room physicians. A recent analysis of 10,689 patients from the Acute Cardiac Ischemia Time-Insensitive Predictive Instrument (ACI-TIPI) trial suggests that of patients presenting with chest pain in the emergency room, ~2% are missed AMI cases (they are released after initial evaluation), 2.1% are missed myocardial infarction, and 2.3% are missed unstable angina. In the United States, missed AMI is the leading cause of medical malpractice claims against hospital emergency rooms and primary care physicians.

I have been researching Troponin vs CK/CK-MB which is the biomarkers tested to show that I had an MI back in 2003. Seems like Troponin is best in some cases and your level was very high indeed. Your doctors sound like the Keystone Cops! Did you have a cardiac catheterization? An NSTEMI is a "non-ST-segment-elevation myocardial infarction". I had to look that up for sure. I have heard of a non Q-wave mi and a Q-wave mi. Did they find any coronary artery blockages? What medicines are you taking?

I cant remember my ck-mb levels. The ER doctor just said you that have had a heart attack and we are sending you to a room. A cardiologist came to my room and told me how they knew, and told me the ck-mb levels. I had a terrible head ache even with all the morphine they had given me. They did an mri of my brain and found I had had a light stroke, which probably occured during my mi. I do remember losing consciousness during the awful chest, arm and jaw pain.

I am sorry to hear of how you were treated. Make sure you read the red sentence above.... My daughter's future Mother-in-law died about 4 days ago. She was 51 and a nurse. She had heart failure due to taking fen-phen. She went to the hospital where she worked, 2 times in one night. They still sent her home where she died. She had been just fine and working full time up until she died. I am going to post some random information I found while learning about topronin. I sure hope things are going better for you

Rj

Post Edited By Moderator (Admin) : 8/23/2010 4:25:14 PM (GMT-6)

Posted 7/31/2006 1:28 AM (GMT 0)

Thank You.  I have seen this information recently but never have actually talked with another patient who has had an elevated Troponin level.  My CK-MB was also elevated.  My troponin level was normal 2 hours after I got to the ER room.  They retook it 4 hours later and the 4.85 appearred and never went higher.  They continued taking it every 4 hours and it was coming down. When I was dismissed 48 hours later, it was 1.0.   Yes, they did a cath (36 hours later) and the cath doctor saw an area in the LAD that he stented.  50% blockage. But, I have had 3 stents previously with continued sporadic angina pains and I had the cardio's stumped.  There is an area of small vessels in the very bottom of the LAD that is too narrow to stent or by-pass.  I believe in this distal area there was some viable tissue screaming to be heard and when I had this so called Acute Event...it shut up the viable tissue and now the area is dead as all severe angina attacks are gone.  My symptoms of this "attack" was irregular heart rate, sweating, SOB, severe weakness.  NO CHEST PAIN!  At the ER room I was in A-FIB with 200 BPM.  Once they converted me back, I felt like a million dollars and wanted to go dancing.  Oh, I know I have the Keystone Cops. The left hand does not know what the right hand is doing.   There is also an Ego problem amongst them which is a shame.  Thanks for the name...it fits them to a tee.

I am sorry to hear of your daughter's future MIL.  Females do not get the respect we deserve and if we get mouthy they ignore us and we suffer more.  This happens even in well known heart places. 

Rj, did you have elevated Trops also?  With your MI did you have muscle damage?  My EF has always been in the 60 range but since this acute event I have an Obstruction.  They do not know how to treat this.  I am tired of doing their work for them. eyes

Wishing you well.

Ellie

P.S.  I am on Zebeta 10 mg. Crestor 10 mg. Zetia 10mg. Plavix and Avapro. I also take baby aspirin.  I was on Avalide 150/12.5 but he thinks the added diuetic may be hurting my obstruction.  He said I need to be well hydrated but who knows. 

Post Edited (Ellie2) : 7/30/2006 8:17:47 PM (GMT-6)

Posted 7/31/2006 2:02 AM (GMT 0)

Ellie, they never did the troponin test as far as I know. I have also been through the hellish ego with the cardios....You're right about women not getting proper attention. I raise cane with them and always have them mad at me.

I have had 8 caths since 2003 and 4 stents. 3 that overlap in my Lad. I also had a rotoblational arthectomy in my Lad, instead of bypass. I have a congenitially small Rca that is "insignificant". 65% blocked but too small to stent. My last EF was 45. Yes I have damage from the heart attack and I have lived with angina ever since. Now I am having arthritis that is hurting my chest, I think. I had my last cath about 2 months ago and nothing had changed.

I am kind of in limbo now. I am now worried about other ailments more than my heart, and that gives me piece of mind :) Thanks for the well wishes. It feels good and I say the same to you.

Rj

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