Highest Troponin Levels You've Seen?

  1. Hello Everyone,

    First, a caveat. I'm in my last semester of school doing a precepted clinical in CCU, so basically, I know absolutely nothing about anything. Please forgive my ignorance, but if you would indulge me, I'd appreciate it.

    Just curious -- what is the highest troponin level you've ever seen? I had a patient last week admitted through ER with an initial trop of .21, chest pain, a slightly depressed ST segment (ECG normal otherwise), and a dx of r/o MI. During the night, his next two trops came back at 78 and 144. He came to the unit on nitro and heparin drips and received MS IV push twice for mild chest pain. We kept him NPO, doc was of course notified (when each lab was received), and pt sent to cath lab in am. He is now post CABG and doing well. But 144?!! Seems pretty high to me, and my preceptor had never seen a number that high, either.
    •  
  2. 43 Comments

  3. by   aCRNAhopeful
    Ours don't read any higher than 80, it just says >80
  4. by   resumecpr
    Try 250. Intubated, IAPB, tombstones. That was a fun night.
  5. by   Korinth
    Medical Overflow onto our oncology floor, troponin was 50, apparently he had been fainting at home for several days when they finally got him to come to the hospital.
  6. by   aCRNAhopeful
    Quote from resumecpr
    Try 250. Intubated, IAPB, tombstones. That was a fun night.
    Those massive MI cardiogenic shock patients are pretty nuts. Only had one or two of them in my short career but that does make for one crazy shift.
  7. by   NYNurseRN
    Actually, a coworker on the job, 300
  8. by   teatree13
    Actual patient in nursing school 580
  9. by   Floridanurse8257
    Just had one tonight...270.61...intubated, tombstones on monitor, shocky....yep, was glad to send this man to unit bed.
  10. by   tri-rn
    What's "tombstones" on the monitor?
  11. by   cardiacmadeline
    Quote from tri-rn
    What's "tombstones" on the monitor?
    Elevated ST segments. They look like tombstones, you will know if you ever see it.
  12. by   pbear
    My instituion stops counting at 100.
  13. by   Floridanurse8257
    To tri-rn: Tombstones are the elevations of the ST segment that are so high (in lead II) that they resemble an upside down U, or an old-fashioned grave marker, tombstone. It was long ago, considered a very very bad thing. It meant your patient has sustained damage to his/her heart and would likely need a tombstone soon. Now, though not a good thing to see, it is not necessarily an indication of impending death. New medicine, new treatments. Thank God.
  14. by   Penelope_Pitstop
    [FONT="Lucida Sans Unicode"]I think my troponin is rising just reading this thread!

    This MedSurg girl freaks out over anything > 0.04.

    More power to y'all...

close