Elevated troponin and left bundle branch block in the setting of suspected septicemia and demand ischemia: to treat or not to treat.

Authors:   Sharma M , Toor R , Khalighi K .
Source:   Clin Pract 2018 Jul 10 . 8 ( 3 ) : 1073 . doi: 10.4081/cp.2018.1073 . 2018 07 10
PMID: 30090218
DOI: 10.4081/cp.2018.1073

ABSTRACT

Elevated troponin and atypical chest pain in the setting of septicemia and Type II Non ST elevation myocardial infarction is frequently encountered. These cases are not necessarily scheduled for emergent cardiac catheterization. High index of clinical suspicion and continuous in-patient cardiac monitoring with serial trending of cardiac enzymes are important in such cases. Subsequent sudden development of electrocardiogram changes requires prompt investigation with emergent coronary catheterization. These types of cases may be missed especially in females who present with atypical chest pain and in patients with Left bundle branch block.

Author information
  1. Department of Internal Medicine, Easton Hospital, Easton, PA.
  2. Department of MPH@GW, George Washington University, Milken Institute School of Public Health, Washington DC.
  3. Department of Cardiology, Director of Electrophysiology Lab, Easton Hospital, PA, USA.
KEYWORDS:
Myocardial infarction , cardiac enzymes , left bundle branch block , troponin elevation .
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