The Need for Serial Troponin Testing absolute cTn elevations are seen in multiple chronic cardiac and noncardiac conditions rise or fall !! in serial.

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Presentation transcript:

The Need for Serial Troponin Testing absolute cTn elevations are seen in multiple chronic cardiac and noncardiac conditions rise or fall !! in serial cTn levels strongly supports an acutely evolving cardiac injury (most commonly, acute myocardial infarction)

Case #1 a 48-year-old man who presented to the emergency department with chest discomfort lasting 2 hours and a 3-day history of flu-like symptoms whose ECG showed diffuse ST-segment changes flu-like 2 hours ST-changes

Case #2 a 60-year-old woman with a medical history of heart failure who presented to the emergency department with chest pain lasting 1.5 hours whose ECG was nondiagnostic heart failure 1.5 hours ECG nondiagnostic

Case #3 a 54-year-old man with a medical history of diabetes mellitus who presented with chest discomfort lasting 1 hour whose ECG was normal diabetes mellitus 1 hour ECG normal

Case #1 0.9 The cutoff for the TnI assay (0.04 ng/mL)

Case #2 0.09 The cutoff for the TnI assay (0.04 ng/mL) 0.05

Case #3 53 6.3 0.06 The cutoff for the TnI assay (0.04 ng/mL)