胸痛伴显著升高的肌钙蛋白:警惕假阳性。

IF 1 Q3 MEDICINE, GENERAL & INTERNAL Cureus Pub Date : 2025-01-06 eCollection Date: 2025-01-01 DOI:10.7759/cureus.77018
Taarunya T Narayanan, Tamara Naneishvili, William Moody, John Townend, Peter Ludman
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引用次数: 0

摘要

高灵敏度心肌肌钙蛋白被认为是诊断急性心肌梗死和心肌损伤的金标准。然而,需要记住假阳性的发生。我们描述了诊断一位45岁女性的临床挑战,她多次出现在急诊科,不典型胸痛和高敏感性肌钙蛋白I (HsTnI)异常升高,尽管多次正常成像,包括心脏mri和侵入性冠状动脉造影。本报告强调仔细解释肌钙蛋白水平升高的重要性,特别是当临床发现和进一步的研究不支持肌钙蛋白(Tn)升高的心脏来源时。
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Chest Pain With Significantly Elevated Troponins: Be Wary of False Positives.

High-sensitivity cardiac troponins are considered a gold standard for diagnosing acute myocardial infarction and myocardial injury. However, the occurrence of false positives needs to be kept in mind.  We describe the clinical challenges in diagnosing a 45-year-old woman who repeatedly presented to the emergency department with atypical chest pain and extremely elevated high sensitivity troponin I (HsTnI), despite normal imaging including cardiac MRIs and invasive coronary angiograms, on multiple occasions.  This report emphasizes the importance of carefully interpreting elevated troponin levels, especially when clinical findings and further investigations do not support a cardiac origin for troponin (Tn) elevation.

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