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elevated troponin cause

Hey anyone seen troponins like this?this is a 38 year old male who is walking talking guy who demanded 2mg dilaudid every 20 minutes and was still walking talking after.

1. Acute Pericarditis

2. Acute Pulmonary Embolism

3. Acute Heart Failure

4. Myocarditis

5. Septic or critically ill patients

6. Renal Failure

7. False positive due to heterophilic antibodies, rheumatoid factor, fibrin clots, microparticles, and malfunction of the analyzer itself.

d troponins have been ruled out

He has a history of an MI in the past per patient hx only (all EKG's normal echo normal) and is a cocaine and benzo's abuser. Any ideas?

his levels are as follows

31.76 at 0005

26.37 at 0500

24.17 at 1238

Kymmi

Specializes in CVICU-ICU.

Yea...he has suffered some myocardial damage in the past 24 hours however the event is now over since his trops are trending back down.

Given his age.....I'd bet the coke had something to do with it.

SEOBowhntr

Specializes in Cardiac, Post Anesthesia, ICU, ER.

Most people don't really understand Troponin. Troponins can elevate anytime the heart is overstressed and may become mildly hypoxic or poorly perfused. Cocaine use can cause it d/t the extreme elevated HR and BP, hypoxia can cause it such as in a COPD patient in resp. distress, CHF w/ Pulm Edema can also elevate it, and CRF patients will often times have elevated troponins as a baseline. I've seen MANY of these that chronically run elevated troponins, and I've seen several doctors abuse this because they know no-one would do anything about it, admitting STABLE pts. to ICU and Stepdowns saying it was R/O MI (possible silent MI). :banghead:

Great tidbit of info. regarding Cocaine abusers.....Lopressor can have a potential FATAL effect on them due to the stimulation of both Alpha and Beta, giving a pure Beta-blockade such as Lopressor can result in increasing BP and HR d/t to Alpha being completely unopposed and actually worsen the patient hypertension and tachycardia.

Virgo_RN, BSN, RN

Specializes in Cardiac Telemetry, ED.

Any time you have a supply/demand mismatch significant to cause myocyte damage, you will see elevated trops. However, those trops are more than a little elevated, and since the first set was the highest, we don't really know what they peaked at. Any plan to cath him?

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