{"id":2581,"date":"2020-06-15T23:58:55","date_gmt":"2020-06-15T23:58:55","guid":{"rendered":"https:\/\/www.awanuilabs.co.nz\/central\/wellington\/?page_id=2581"},"modified":"2020-06-15T23:59:34","modified_gmt":"2020-06-15T23:59:34","slug":"high-sensitivity-troponin-t-case-studies","status":"publish","type":"page","link":"https:\/\/www.awanuilabs.co.nz\/central\/wellington\/high-sensitivity-troponin-t-case-studies\/","title":{"rendered":"High sensitivity Troponin T case studies"},"content":{"rendered":"\n<p><strong>(<em>Aotea News<\/em>, June 2011)<\/strong><\/p>\n\n\n\n<p>These case studies relate to the article&nbsp;<em><a href=\"https:\/\/www.awanuilabs.co.nz\/central\/wellington\/the-merits-of-high-sensitivity-troponin-t-in-primary-care\/\">The merits of high sensitivity Troponin&nbsp;T in primary care<\/a><\/em>.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">A 63-year-old man with a 10 year history of type 2 diabetes<\/h2>\n\n\n\n<p>The patient has a dizzy spell while mowing his lawn. Hypoglycaemia is not an issue and he recovers quickly after resting but he is sufficiently worried to come to you the next morning.<\/p>\n\n\n\n<p>There are no clinical findings but there seems to be a possibility of a silent infarct so you request high sensitivity troponin T in a specimen taken 18 hours after the event. The result is 6ng\/L.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Interpretation<\/h3>\n\n\n\n<p>This result is well under the 99th centile and, given the time since the symptoms, rules out myocardial infarction.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">A 75-year-old patient with atrial fibrillation and mild congestive heart failure<\/h2>\n\n\n\n<p>A patient has an episode of minor chest discomfort overnight and has become slightly more breathless than usual, but is not seriously distressed.<\/p>\n\n\n\n<p>High sensitivity Troponin T about 12 hours after the pain is 52ng\/L.<\/p>\n\n\n\n<p>You are surprised and worried by this result as you had considered myocardial infarction to be unlikely and were hoping for confirmation through a normal result.<\/p>\n\n\n\n<p>With some difficulty you persuade the cardiology registrar to review the patient at A&amp;E. Repeat troponin at 18 hours is 50ng\/L.<\/p>\n\n\n\n<p>The patient is kept overnight and a further specimen at 24 hours is again 52ng\/L.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Interpretation<\/h3>\n\n\n\n<p>The stable pattern of abnormal results does not support myocardial infarction but is quite typical in patients with tachycardias or heart failure, even when there has not been clinical deterioration.<\/p>\n\n\n\n<p>The difficulty for you is in assessing the significance of the first result and deciding whether to refer or manage yourself.<\/p>\n\n\n\n<p>The latter course requires you to seriously consider repeat testing for troponin as the first result has not allowed you to rule in or rule out myocardial infarction.<\/p>\n\n\n\n<p>A question to consider might be whether it would influence your decision if the first result in this patient had been 26 rather than 52.<\/p>\n","protected":false},"excerpt":{"rendered":"(Aotea News, June 2011) These case studies relate to the article&nbsp;The merits of high sensitivity Troponin&nbsp;T in primary care. A 63-year-old man with a 10 year history of type 2 diabetes The patient has a dizzy spell while mowing his lawn. Hypoglycaemia is not an issue and he recovers quickly after resting but he is [&hellip;]","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"page-left-sidebar.php","meta":{"footnotes":""},"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v24.2 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>High sensitivity Troponin T case studies &#8211; Awanui Labs - Wellington<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.awanuilabs.co.nz\/central\/wellington\/high-sensitivity-troponin-t-case-studies\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"High sensitivity Troponin T case studies &#8211; Awanui Labs - Wellington\" \/>\n<meta property=\"og:description\" content=\"(Aotea News, June 2011) These case studies relate to the article&nbsp;The merits of high sensitivity Troponin&nbsp;T in primary care. 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