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