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.