by nurseintraining18

Hello Coronary experts!

Thank you in advance for your help. I'm writing a paper about a patient who has an increased troponin level of 0.3 His EKG has PVCS and he presented to the emergency with chest pain. Is it possible he has undiagnosed stable angina or do you think he had an MI? I'm confused about the diagnosis as there was not much in the chart regarding it.

Thank you!

Re: troponin question!

If he's in the ER, resting on a bed with supplemental O2, etc and still having chest pain you can pretty much rule out stable angina.
There are a lot more pieces of info that would be nice, like besides PVCs what else does his EKG show? What was the PQRST history of the episode? What's his PMHx?
What do you have to write about (not that I'm volunteering to do your homework for you!!) but do you have to do a case study? Implement a care plan/intervention?

Re: troponin question!

Thanks for such a rapid response. His EKG looks normal with the exception of some PVCs. He was not put on oxygen and the chest pain has subsided. Is it possible he is totally fine with no underlying pathology in spite of the Troponin I of 0.3? According to my textbook, this troponin level is still within normal range?? Thank you!! His past medial history includes sinus trouble but that's about it. do you think it's angina or just a false alarm due to pvcs?

Re: troponin question!

We need more information. In the meantime, look up what can cause an elevated troponin in the excellent article in Chest: http://www.chestjournal.org/content/125/5/1877.full

Re: troponin question!

Originally Posted by Angie O'Plasty, RN

We need more information. In the meantime, look up what can cause an elevated troponin in the excellent article in Chest: http://www.chestjournal.org/content/125/5/1877.full

Excellent article, thanks!

Re: troponin question!

He could benefit from a stress, then I would feel more comfortable saying he has no underlying cardiac pathology.