Elevation of troponin values in differential diagnosis of chest pain in view of pulmonary thromboembolism.
2012
Introduction. Acute coronary syndrome, as unstable form of ischaemic heart
disease, beside clinical presentation and electrocardiographic abnormalities,
is characterized by increased value of troponin one of cardiospecific
enzimes. Although troponin is a high specific and sensitive indicator of
acute coronary syndrome, any heart muscle injury may induce its increasing,
so there are some other diseases with the increased troponin value. Case
report. We presented a female patient with chest pain, admitted because of
suspicioun of acute coronary sindrome. Performed coronarography excluded
ischemic heart disease. Considering symtomatology, electrocardiographic
abnormalities, increased troponin and D-dimer values, as well as
echocardiography finding we considered pulmonary embolism as a differential
diagnosis, which was confirmed by pulmoangiography. Conclusion. Isolated
increased troponin values are not enough for diagnosis of acute coronary
syndrome.
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