Adenocard?

I wouldn't think that Adenocard would cause the troponin to rise, but rather the strain on the heart by the SVT- kind of like when you can see ST changes on the 12 lead with people in SVT, Afib with RVR, etc that resolves when they are converted. 0.068 troponin is equivocal; higher than normal but not absolutely indicative of an MI. Still something that requires further evaluation.

Well said, neneRN. The elevated Troponin was probably not due to the Adenocard.

Also, in 41 year old pt's it's very uncommon to see troponin elevations from SVT's. (especially if no prior Hx of coronary disease!)...

It's in the patient's best interest to rule-out an ischemic event as the origin of the elevated tropinin and/or the SVT...thats why they took her out to be cathed...

(btw, was this pt:obese, have a Hx of HTN, diabetes? ?)

My answer is NO! adenocard will not raise trop. It was prob D/T the stresss from the SVT

Thanks all for the response. I learn something new every day and hope i continue to do so.

I am not sure of this patients cardiac history. May be she had other factors against her. This was not my patient but was placed in SDU ( I work ICU). The nurse who had this pt. told me about it and asked my opinion on Adenocard and elevated trop. It scares me when a reasonably young pt. c/o CP. They have not had the time to develop collateral circulation. I am glad she was shipped out for a cath. Maybe her problem was caught in time.

I saw a 45 y/o male have an AMI and it was not pretty. Never knew anyone could become that diaphoretic. I am in no hurry to see another have the same thing happen to them. This guy had a Widow-maker. Geez. Had severe cardiac damage.

Whats wrong with questioning the doc's decision? I would have asked why also! That troponin (

then been cathed had they been posititve. Do you do any other cardiac enzymes, like CKs or ACB?

yes, we do serial enzymes, usually q 6 to 8 hrs x 3 sets. ( cpk, ck-mb, and trop). if i remember correctly the cpk and mb were wnl.

we also started doing abnp's about 2 yers ago. (alpha-beta naturetic peptide, this is usually done to for chf). i had never heard of it before then, so imagine my expression when the doc called for the bnp. i'm like huh , what? lol. the highest i have ever seen was > 7000. ( normal 0-100, here). patient was placed on nesiritide (natrecor) gtt. and left the hospital in pretty good shape, considering.

i love cardiac nursing. i tell everyone i don't do babies and i don't do bones, give me some one with ami or a copd'er and i am a happy camper. (hehehe)

if any one has any thing to share concerning cardiac care, please pass it on. as i said i love learning new things to help my patients.

:roll :roll

a i ain't

anyone can count the seeds in an apple, only god can count the apples in a seed. anon

i have seen many times where initial ckmp & troponin were neg only to see the second set extremely elevated and find out the patient had a big mi. i am not an er nurse either, (although i worked an 8 week travel assignemnt there- which by no means qualifies me as an er nurse!! ) but work in the unit. many times we have questioned patients being admitted only to find later, it turned out to be in their best interest! :) also, as you probable know, not everyone has "chest pain". more often women then men never experience the chest and left arm pain. i can't tell you how many 40-50 y/o patients i've had in the last few weeks. (i work cvicu) most of them never experienced the typical chest pain we so often associate with an mi.

originally posted by cc nrse

also, as you probable know, not everyone has "chest pain". more often women then men never experience the chest and left arm pain. most of them never experienced the typical chest pain we so often associate with an mi.

so very true! diabetics also are known for having the "silent" mi...no chest/arm pain. of course peripheral neuropathy plays a large part in this but again, another reason to take a detailed hx on the patient.

Adenocard doesnt elevate tro, I had a patient in the CCU the other night came in for hypotension developed SVT 160-180 we had drawn labs prior to administrating the adenocard, one of which was Cardiac enzymes and CMP, 8 hours later when we drew another CPK & TRO the tro went down so I say no adenocard didnt raise the TROP, level however it did decrease the Mg level in my patient and raised the pottassium level!! Has anyone ever had this experience?