 |
|
Elevated Cardiac Troponin Levels in Patients With Submassive Pulmonary Embolism
James D. Douketis, MD, FRCP;
Mark A. Crowther, MD, MSc, FRCP;
Eric B. Stanton, MD, FRCP, FACC;
Jeffrey S. Ginsberg, MD, FRCP
Arch Intern Med. 2002;162:79-81.
Background Cardiac troponins are reliable markers of myocardial injury that are
being used increasingly in patients presenting with undifferentiated chest
pain or dyspnea to diagnose an acute coronary syndrome. If elevated cardiac
troponin levels also occur in patients with pulmonary embolism because of
right ventricular dilation and myocardial injury, such patients could be misdiagnosed.
We performed a prospective cohort study to determine the prevalence of elevated
cardiac troponin I (cTnI) levels in patients with submassive pulmonary embolism.
Methods Consecutive patients with objectively confirmed submassive pulmonary
embolism and no previous history of ischemic heart disease, other cardiac
disease, or renal insufficiency were included. Creatine kinase and cTnI levels
were measured within 24 hours of clinical presentation on 2 occasions 8 to
12 hours apart.
Results Of 24 patients with submassive pulmonary embolism, 5 (20.8%) had elevated
cTnI levels of 0.4 µg/L or higher (95% confidence interval, 7.1-42.2%).
One of these patients had a cTnI level higher than 2.3 µg/L that was
suggestive of myocardial infarction.
Conclusion Pulmonary embolism should be considered in the differential diagnosis
of patients presenting with undifferentiated chest pain or dyspnea and an
elevated cardiac troponin level.
From the Department of Medicine, McMaster University (Drs Douketis,
Crowther, Stanton, and Ginsberg) and St Joseph's Hospital (Drs Douketis, Crowther
and Stanton), Hamilton, Ontario.
RELATED ARTICLE
Archives of Internal Medicine Reader's Choice: Continuing Medical Education
Arch Intern Med. 2002;162(1):111.
FULL TEXT
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
|
Prognostic Value of Troponins in Acute Pulmonary Embolism: A Meta-Analysis
Becattini et al.
Circulation 2007;116:427-433.
ABSTRACT
| FULL TEXT
Time Course of Degradation of Cardiac Troponin I in Patients With Acute ST-Elevation Myocardial Infarction: The ASSENT-2 Troponin Substudy
Madsen et al.
Circ. Res. 2006;99:1141-1147.
ABSTRACT
| FULL TEXT
Use of Admission Troponin in Critically Ill Medical Patients
Minkin et al.
J Intensive Care Med 2005;20:286-290.
ABSTRACT
Increased cardiac troponin I on admission predicts in-hospital mortality in acute pulmonary embolism
La Vecchia et al.
Heart 2004;90:633-637.
ABSTRACT
| FULL TEXT
Common Causes of Troponin Elevations in the Absence of Acute Myocardial Infarction: Incidence and Clinical Significance
Roongsritong et al.
Chest 2004;125:1877-1884.
ABSTRACT
| FULL TEXT
Troponin testing: beware pulmonary embolus
Conroy et al.
Emerg. Med. J. 2004;21:123-124.
ABSTRACT
| FULL TEXT
Cardiac troponin i in acute pericarditis
Imazio et al.
J Am Coll Cardiol 2003;42:2144-2148.
ABSTRACT
| FULL TEXT
Detectable Serum Cardiac Troponin T as a Marker of Poor Prognosis Among Patients With Chronic Precapillary Pulmonary Hypertension
Torbicki et al.
Circulation 2003;108:844-848.
ABSTRACT
| FULL TEXT
Cardiac Troponin T Monitoring Identifies High-Risk Group of Normotensive Patients With Acute Pulmonary Embolism
Pruszczyk et al.
Chest 2003;123:1947-1952.
ABSTRACT
| FULL TEXT
British Thoracic Society guidelines for the management of suspected acute pulmonary embolism
Thorax 2003;58:470-483.
FULL TEXT
Right Ventricular Infarction in a Patient With Acute Pulmonary Embolism and Normal Coronary Arteries
Pruszczyk et al.
Arch Intern Med 2003;163:1110-1111.
FULL TEXT
Importance of Cardiac Troponins I and T in Risk Stratification of Patients With Acute Pulmonary Embolism
Konstantinides et al.
Circulation 2002;106:1263-1268.
ABSTRACT
| FULL TEXT
Troponin T elevation in lobar lung disease
Jolobe
Postgrad. Med. J. 2002;78:443-443.
FULL TEXT
|
