{"id":3590,"date":"2021-03-30T16:16:16","date_gmt":"2021-03-30T08:16:16","guid":{"rendered":"https:\/\/cardiothinklab.com\/dr-lee%e3%81%ae%e8%87%a8%e5%ba%8a%e7%97%87%e4%be%8b%ef%bc%9ahs-tnt%e3%81%ab%e3%82%88%e3%82%8b%e6%80%a5%e6%80%a7%e5%bf%83%e7%ad%8b%e6%a2%97%e5%a1%9e%e3%81%ae%e6%97%a9%e6%9c%9f%e3%80%8c%e3%83%ab\/"},"modified":"2026-02-12T00:25:43","modified_gmt":"2026-02-11T16:25:43","slug":"dr-lee-chien-changs-clinical-cases-on-hs-tnt-assays-part-1","status":"publish","type":"post","link":"https:\/\/cardiothinklab.com\/ja\/dr-lee-chien-changs-clinical-cases-on-hs-tnt-assays-part-1\/","title":{"rendered":"Dr Lee\u306e\u81e8\u5e8a\u75c7\u4f8b\uff1ahs-TnT\u306b\u3088\u308b\u6025\u6027\u5fc3\u7b4b\u6897\u585e\u306e\u65e9\u671f\u300c\u30eb\u30fc\u30eb\u30a4\u30f3\u300d"},"content":{"rendered":"\n<p>\u81e8\u5e8a\u75c7\u4f8b\u306e\u8a73\u7d30\u3092\u63d0\u793a\u3057\u3066\u3044\u307e\u3059\u3002\u4ee5\u4e0b\u306e\u3046\u3061\u6700\u3082\u53ef\u80fd\u6027\u306e\u9ad8\u3044\u8a3a\u65ad\u3092\u9078\u629e\u3057\u3066\u304f\u3060\u3055\u3044\u3002 \u8a3a\u65ad\u304a\u3088\u3073Dr Lee\u306e\u898b\u89e3\u306b\u95a2\u3059\u308b\u8a73\u7d30\u306f\u3001\u300c\u30af\u30ea\u30c3\u30af\u3057\u3066\u56de\u7b54\u3092\u8868\u793a\u300d\u30dc\u30bf\u30f3\u3092\u30af\u30ea\u30c3\u30af\u3057\u3066\u3054\u78ba\u8a8d\u304f\u3060\u3055\u3044\u3002<\/p>\n\n<p>\u9ad8\u611f\u5ea6\u30c8\u30ed\u30dd\u30cb\u30f3T\uff08hs-TnT\uff09\u304c\u6162\u6027\u7684\u306b\u4e0a\u6607\u3057\u3066\u3044\u308b\u975e\u6025\u6027\u5fc3\u7b4b\u6897\u585e\u306e\u75c7\u4f8b\u306b\u3064\u3044\u3066\u306f\u3001\u3053\u3053\u3092\u30af\u30ea\u30c3\u30af\u3057\u3066\u304f\u3060\u3055\u3044\u3002<\/p>\n\n<p class=\"has-text-color\" style=\"color:#dc305f\"><em>\u4ee5\u4e0b\u306e\u30bf\u30d6\u3092\u30af\u30ea\u30c3\u30af\u3059\u308b\u3068\u3001\u75c7\u4f8b\u304c\u5207\u308a\u66ff\u308f\u308a\u307e\u3059\u3002<\/em><\/p>\n<style type=\"text\/css\">\n.case-study table {\nmargin:0px !important;\n}\n<\/style>\n<div class=\"case-study\">\n<div class=\"su-tabs su-tabs-style-default su-tabs-mobile-stack\" data-active=\"1\" data-scroll-offset=\"0\" data-anchor-in-url=\"no\"><div class=\"su-tabs-nav\"><span class=\"\" data-url=\"\" data-target=\"blank\" tabindex=\"0\" role=\"button\">Case Study: 59-year old man<\/span><span class=\"\" data-url=\"\" data-target=\"blank\" tabindex=\"0\" role=\"button\">Case Study: 85-year old woman<\/span><span class=\"\" data-url=\"\" data-target=\"blank\" tabindex=\"0\" role=\"button\">Case Study: 66-year man<\/span><\/div><div class=\"su-tabs-panes\"><div class=\"su-tabs-pane su-u-clearfix su-u-trim\" data-title=\"Case Study: 59-year old man\">\n<table border=\"0\" cellpadding=\"0\" cellspacing=\"0\" width=\"100%\">\n<tbody>\n<tr>\n<td height=\"15\" style=\"font-size:1px; line-height:1px;\">&nbsp;<\/td>\n<\/tr>\n<tr>\n<td align=\"center\" valign=\"top\">\n<table border=\"0\" cellpadding=\"0\" cellspacing=\"0\" width=\"100%\">\n<tbody>\n<tr>\n<td align=\"left\" style=\"color:#0063ac; font-family: Arial; font-size:16px; line-height:24px; font-weight: bold;border-top:1px solid #000000;border-bottom:1px solid #000000;\" valign=\"top\" width=\"30%\">Case<\/td>\n<td align=\"left\" valign=\"top\" width=\"2%\">&nbsp;<\/td>\n<td align=\"left\" style=\"color:#544F40; font-family: Arial; font-size:14px; line-height:24px; font-weight: bold;border-top:1px solid #000000;border-bottom:1px solid #000000;\" valign=\"top\" width=\"60%\">59-year old man<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/td>\n<\/tr>\n<tr>\n<td height=\"15\" style=\"font-size:1px; line-height:1px;\">&nbsp;<\/td>\n<\/tr>\n<tr>\n<td align=\"center\" valign=\"top\">\n<table border=\"0\" cellpadding=\"0\" cellspacing=\"0\" width=\"100%\">\n<tbody>\n<tr>\n<td align=\"left\" style=\"color:#544F40; font-family: Arial; font-size:16px; line-height:24px; font-weight: normal;border-top:1px solid #000000;border-bottom:1px solid #000000;\" valign=\"top\" width=\"30%\">Key signs and symptoms<\/td>\n<td align=\"left\" valign=\"top\" width=\"2%\">&nbsp;<\/td>\n<td align=\"left\" style=\"color:#544F40; font-family: Arial; font-size:14px; line-height:24px; font-weight: normal;border-top:1px solid #000000;border-bottom:1px solid #000000;background:#dce4f4;padding:0 4px;\" valign=\"top\" width=\"60%\">Chest tightness and cold sweating for 2 hours.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/td>\n<\/tr>\n<tr>\n<td height=\"15\" style=\"font-size:1px; line-height:1px;\">&nbsp;<\/td>\n<\/tr>\n<tr>\n<td align=\"center\" valign=\"top\">\n<table border=\"0\" cellpadding=\"0\" cellspacing=\"0\" width=\"100%\">\n<tbody>\n<tr>\n<td align=\"left\" style=\"color:#544F40; font-family: Arial; font-size:16px; line-height:24px; font-weight: normal;border-top:1px solid #000000;border-bottom:1px solid #000000;\" valign=\"middle\" width=\"30%\">Medical history\/<br \/>\n\t\t\t\t\t\t\t\tClinical examination<\/td>\n<td align=\"left\" valign=\"top\" width=\"2%\">&nbsp;<\/td>\n<td align=\"left\" style=\"color:#544F40; font-family: Arial; font-size:14px; line-height:24px; font-weight: normal;border-top:1px solid #000000;border-bottom:1px solid #000000;background:#dce4f4;padding:0 4px;\" valign=\"top\" width=\"60%\"><strong>Medical history:<\/strong> Coronary artery disease status post stent, diabetes, hyperlipidemia, chronic hepatitis C.<br \/>\n\t\t\t\t\t\t\t\t<strong>Clinical examination:<\/strong> The presenting vitals are: BP 182\/107mmHg, HR 95BPM, RR 20BPM, temperature 36.1C, oxygen saturation 97%, Glasgow coma scale 15.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/td>\n<\/tr>\n<tr>\n<td height=\"15\" style=\"font-size:1px; line-height:1px;\">&nbsp;<\/td>\n<\/tr>\n<tr>\n<td align=\"center\" valign=\"top\">\n<table border=\"0\" cellpadding=\"0\" cellspacing=\"0\" width=\"100%\">\n<tbody>\n<tr>\n<td align=\"left\" style=\"color:#544F40; font-family: Arial; font-size:16px; line-height:24px; font-weight: normal;border-top:1px solid #000000;border-bottom:1px solid #000000;\" valign=\"middle\" width=\"30%\">Laboratory test<br \/>\n\t\t\t\t\t\t\t\tresults<\/td>\n<td align=\"left\" valign=\"top\" width=\"2%\">&nbsp;<\/td>\n<td align=\"left\" style=\"border-top:1px solid #000000;border-bottom:1px solid #000000;padding:0 0px;\" valign=\"top\" width=\"60%\">\n<table border=\"0\" cellpadding=\"0\" cellspacing=\"0\" width=\"100%\">\n<tbody>\n<tr>\n<td align=\"center\" style=\"background:#dce4f4;padding:0 2px;\" valign=\"top\">\n<table border=\"0\" cellpadding=\"0\" cellspacing=\"0\" width=\"100%\">\n<tbody>\n<tr>\n<td align=\"left\" style=\"color:#544F40; font-family: Arial; font-size:14px; line-height:24px; font-weight: normal;padding:0 0px;\" valign=\"top\" width=\"45%\"><strong>Test<\/strong><\/td>\n<td align=\"left\" valign=\"top\" width=\"2%\">&nbsp;<\/td>\n<td align=\"left\" style=\"color:#544F40; font-family: Arial; font-size:14px; line-height:24px; font-weight: normal\" valign=\"top\" width=\"15%\"><strong>Value<\/strong><\/td>\n<td align=\"left\" valign=\"top\" width=\"2%\">&nbsp;<\/td>\n<td align=\"left\" style=\"color:#544F40; font-family: Arial; font-size:14px; line-height:24px; font-weight: normal\" valign=\"top\" width=\"30%\"><strong>Reference range<\/strong><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/td>\n<\/tr>\n<tr>\n<td align=\"center\" style=\"background:#ecf0f9;padding:0 2px;\" valign=\"top\">\n<table border=\"0\" cellpadding=\"0\" cellspacing=\"0\" width=\"100%\">\n<tbody>\n<tr>\n<td align=\"left\" style=\"color:#544F40; font-family: Arial; font-size:14px; line-height:24px; font-weight: normal\" valign=\"top\" width=\"45%\">WBC (x103\/\u03bcL)<\/td>\n<td align=\"left\" valign=\"top\" width=\"2%\">&nbsp;<\/td>\n<td align=\"left\" style=\"color:#544F40; font-family: Arial; font-size:14px; line-height:24px; font-weight: normal\" valign=\"top\" width=\"15%\">8.19<\/td>\n<td align=\"left\" valign=\"top\" width=\"2%\">&nbsp;<\/td>\n<td align=\"left\" style=\"color:#544F40; font-family: Arial; font-size:14px; line-height:24px; font-weight: normal\" valign=\"top\" width=\"30%\">3.54 \u2013 9.06<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/td>\n<\/tr>\n<tr>\n<td align=\"center\" style=\"background:#dce4f4;padding:0 2px;\" valign=\"top\">\n<table border=\"0\" cellpadding=\"0\" cellspacing=\"0\" width=\"100%\">\n<tbody>\n<tr>\n<td align=\"left\" style=\"color:#544F40; font-family: Arial; font-size:14px; line-height:24px; font-weight: normal\" valign=\"top\" width=\"45%\">Hemoglobin (g\/dL)<\/td>\n<td align=\"left\" valign=\"top\" width=\"2%\">&nbsp;<\/td>\n<td align=\"left\" style=\"color:#544F40; font-family: Arial; font-size:14px; line-height:24px; font-weight: normal\" valign=\"top\" width=\"15%\">16<\/td>\n<td align=\"left\" valign=\"top\" width=\"2%\">&nbsp;<\/td>\n<td align=\"left\" style=\"color:#544F40; font-family: Arial; font-size:14px; line-height:24px; font-weight: normal\" valign=\"top\" width=\"30%\">10.8 \u2013 14.9<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/td>\n<\/tr>\n<tr>\n<td align=\"center\" style=\"background:#ecf0f9;padding:0 2px;\" valign=\"top\">\n<table border=\"0\" cellpadding=\"0\" cellspacing=\"0\" width=\"100%\">\n<tbody>\n<tr>\n<td align=\"left\" style=\"color:#544F40; font-family: Arial; font-size:14px; line-height:24px; font-weight: normal\" valign=\"top\" width=\"45%\">NT-proBNP (pg\/mL)<\/td>\n<td align=\"left\" valign=\"top\" width=\"2%\">&nbsp;<\/td>\n<td align=\"left\" style=\"color:#544F40; font-family: Arial; font-size:14px; line-height:24px; font-weight: normal\" valign=\"top\" width=\"15%\">12.5<\/td>\n<td align=\"left\" valign=\"top\" width=\"2%\">&nbsp;<\/td>\n<td align=\"left\" style=\"color:#544F40; font-family: Arial; font-size:14px; line-height:24px; font-weight: normal\" valign=\"top\" width=\"30%\">Rule out of acute heart failure<br \/>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t(AHF): &lt;300 pg\/mL<br \/>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\tRule in AHF:<br \/>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t&lt; 50 years: &gt;450 pg\/mL<br \/>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t50 &#8211; 75 years: &gt;900 pg\/mL<br \/>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t&gt;75 years: &gt;1800 pg\/mL<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/td>\n<\/tr>\n<tr>\n<td height=\"15\" style=\"font-size:1px; line-height:1px;\">&nbsp;<\/td>\n<\/tr>\n<tr>\n<td align=\"center\" valign=\"top\">\n<table border=\"0\" cellpadding=\"0\" cellspacing=\"0\" width=\"100%\">\n<tbody>\n<tr>\n<td align=\"left\" style=\"color:#544F40; font-family: Arial; font-size:16px; line-height:24px; font-weight: normal;\" valign=\"top\" width=\"30%\"><strong>ECG<\/strong><br \/>\n\t\t\t\t\t\t\t\tReported by machine as normal sinus rhythm<\/td>\n<td align=\"left\" valign=\"top\" width=\"2%\">&nbsp;<\/td>\n<td align=\"right\" class=\"hero_image1\" valign=\"middle\" width=\"60%\"><img loading=\"lazy\" decoding=\"async\" alt=\"image\" height=\"174\" src=\"https:\/\/dianews.roche.com\/rs\/106-RRW-330\/images\/Infographic_20210322_asset_24.png\" style=\"border: none;display: block;\" width=\"365\"><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/td>\n<\/tr>\n<tr>\n<td height=\"15\" style=\"font-size:1px; line-height:1px;\">&nbsp;<\/td>\n<\/tr>\n<tr>\n<td align=\"center\" valign=\"top\">\n<table border=\"0\" cellpadding=\"0\" cellspacing=\"0\" width=\"100%\">\n<tbody>\n<tr>\n<td align=\"left\" style=\"color:#544F40; font-family: Arial; font-size:16px; line-height:24px; font-weight: normal;\" valign=\"top\" width=\"30%\"><strong>Troponin kinetic profile<\/strong><\/td>\n<td align=\"left\" valign=\"top\" width=\"2%\">&nbsp;<\/td>\n<td align=\"right\" class=\"hero_image1\" valign=\"middle\" width=\"60%\"><img loading=\"lazy\" decoding=\"async\" alt=\"image\" height=\"208\" src=\"https:\/\/dianews.roche.com\/rs\/106-RRW-330\/images\/Infographic_20210322_asset_25.png\" style=\"border: none;display: block;\" width=\"365\"><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/td>\n<\/tr>\n<tr>\n<td height=\"15\" style=\"font-size:1px; line-height:1px;\">&nbsp;<\/td>\n<\/tr>\n<tr>\n<td 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inline-block;        }        #ays-poll-id-69de7a5391e2b.box-apm i.ays_poll_far{                        font-family: 'Font Awesome 5 Free';        }        #ays-poll-id-69de7a5391e2b.box-apm .apm-choosing .ays-poll-each-answer-list{            \t\t\twidth: initial;\t\t\ttext-align: initial;\t\t\tdisplay: initial;\t\t\tpadding: 10px;        }        #ays-poll-id-69de7a5391e2b.box-apm .apm-choosing .ays-poll-each-answer-grid{            \t\t\twidth: 100%;\t\t\ttext-align: left;\t\t\tdisplay: inline-block;\t\t\tword-break: break-word;        }\t\t        #ays-poll-id-69de7a5391e2b.box-apm .apm-choosing .ays_label_poll{            \t\t\twidth: 100%;\t\t\ttext-align: center;\t\t\tdisplay: flex;\t\t\t;\t\t\talign-items: center;\t\t\tpadding: 10px;        }        #ays-poll-id-69de7a5391e2b.box-apm .apm-choosing .ays-poll-each-image{            \t\t\theight: 150px;\t\t\tborder-radius: 0px;\t\t\tobject-fit: cover;        }        #ays-poll-id-69de7a5391e2b.box-apm .apm-choosing .ays-poll-each-image-list{\t\t\twidth: 220px;        }        #ays-poll-id-69de7a5391e2b.box-apm .apm-choosing .ays-poll-each-image-grid{\t\t\twidth: 100%;        }        #ays-poll-id-69de7a5391e2b.box-apm .apm-choosing .ays-poll-answer-container-label-grid{\t\t\talign-items: center;        }        #ays-poll-id-69de7a5391e2b.box-apm .apm-choosing .ays-poll-answer-container-label-list{\t\t\tflex-direction: row;        }        #ays-poll-id-69de7a5391e2b.box-apm .ays_poll_grid_view_container{\t\t\tdisplay: flex;\t\t\tflex-wrap: wrap;\t\t\tjustify-content: space-between;\t\t\talign-items: flex-start;        }        #ays-poll-id-69de7a5391e2b.box-apm .ays-poll-answer-container-gird{\t\t\twidth: calc(50% - 5px);\t\t\tmargin-bottom: 1px;        }\t\t        #ays-poll-id-69de7a5391e2b.box-apm .ays_poll_label_without_padding{\t\t\tpadding: 10px;\t\t\talign-items: center;\t\t\tflex-direction: column;        }        #ays-poll-id-69de7a5391e2b.box-apm .apm-title-box div{\t\t\tfont-size: 20px;\t\t\tword-break: break-word;\t\t\tword-wrap: break-word;\t\t\ttext-align: center;        }        #ays-poll-id-69de7a5391e2b.box-apm .ays-poll-answer-container-list{\t\t\t\t\t\tmargin-bottom: 1px;\t\t\tdisplay: flex;\t\t\twidth: 100%;        }        #ays-poll-id-69de7a5391e2b.box-apm .ays-poll-maker-text-answer-main input,\t\t#ays-poll-id-69de7a5391e2b.box-apm .ays-poll-maker-text-answer-main textarea{\t\t\tmin-width: 150px;\t\t\tmax-width: 100%;\t\t\twidth: %;        }        #ays-poll-id-69de7a5391e2b.box-apm .ays-poll-password-box .ays-poll-password-button-box .ays-poll-password-button{\t\t\tbackground-color: #ffffff;\t\t\tcolor: #dc305f;\t\t\tborder-color: #ffffff;\t\t\toutline: none;\t\t\tbox-shadow: unset;\t\t\tborder: 0;\t\t\ttransition: .5s;        }        #ays-poll-id-69de7a5391e2b.box-apm .ays-poll-password-box .ays-poll-password-button-box .ays-poll-password-button:hover{\t\t\tbackground-color: #ffffffb5;        }        #ays-poll-id-69de7a5391e2b.box-apm .ays-poll-password-box .ays-poll-password-input-box .ays-poll-password-input{\t\t\tborder-color: #ffffff;        }\t\t#ays-poll-id-69de7a5391e2b.box-apm .apm-answers .apm-choosing label.ays_label_poll{            \t\t\tbox-shadow:unset;\t\t\tborder-radius: 0px;        }\t\t#ays-poll-id-69de7a5391e2b.box-apm.text-poll .apm-answers .ays-poll-text-types-inputs{            \t\t\tfont-size: 16px;        }\t\t\t\t\t\t        #ays-poll-id-69de7a5391e2b.choosing-poll label {\t            background-color: #dc305f;\t            border: 1px solid #ffffff;\t            text-transform: inherit;\t        }        .ays-poll-id-69de7a5391e2b.choosing-poll input[type=radio]:checked + label,\t\t.ays-poll-id-69de7a5391e2b:not(.ays-minimal-theme).choosing-poll input[type='checkbox']:checked + label,        .ays-poll-id-69de7a5391e2b.choosing-poll label.ays_enable_hover:hover {        \tbackground-color: #ffffff !important;            color: #dc305f;        }\t\t.ays-poll-id-69de7a5391e2b:not(.ays-minimal-theme).choosing-poll input[type='checkbox']{\t\t\tdisplay: none;\t\t}        .ays-poll-id-69de7a5391e2b.choosing-poll input[type=radio]:checked + label *,        .ays-poll-id-69de7a5391e2b.choosing-poll input[type=checkbox]:checked + label *,        .ays-poll-id-69de7a5391e2b.choosing-poll label.ays_enable_hover:hover * {            color: #dc305f;        }.ays-poll-id-69de7a5391e2b .apm-info-form input {            border-color: #ffffff;        }        div[class~=ays-poll-id-69de7a5391e2b] label.ays_label_font_size {            font-size: 16px;        }        button.ays-poll-next-btn:focus {            background: unset;            outline: none;        }        button.ays-poll-next-btn:disabled {            cursor: not-allowed;            background: dimgrey !important;            color: white !important;        }        button.ays-poll-next-btn:enabled {            cursor: pointer;        }        .ays-poll-id-69de7a5391e2b 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auto;\t\t\t}\t\t\t.ays-poll-id-69de7a5391e2b.box-apm .ays_question p{\t\t\t\tfont-size: 16px;\t\t\t}\t\t\t\t\t\t.ays-poll-id-69de7a5391e2b .apm-answers .apm-rating i.ays_poll_fa-star {\t\t\t\tfont-size: 4vw !important;\t\t\t}\t\t\t#ays-poll-id-69de7a5391e2b.box-apm .ays-poll-answer-container-gird{\t\t\t\twidth: 100%;\t\t\t}\t\t\t#ays-poll-id-69de7a5391e2b.box-apm .apm-title-box div{\t\t\t\tfont-size: 20px;\t\t\t\ttext-align: center;\t\t\t\tword-break: break-word;\t\t\t\tword-wrap: break-word;\t\t\t}\t\t\t.ays-poll-id-69de7a5391e2b.box-apm label.ays_label_font_size {\t\t\t\tfont-size: 16px;\t\t\t}\t\t\t#ays-poll-id-69de7a5391e2b.box-apm.text-poll .apm-answers .ays-poll-text-types-inputs{            \t\t\t\tfont-size: 16px;\t\t\t}\t\t\t#ays-poll-id-69de7a5391e2b.box-apm .apm-answers > .apm-choosing > .ays_label_poll > div.ays-poll-answer-image > img.ays-poll-each-image{\t\t\t\theight: 150px;\t\t\t}\t\t\t#ays-poll-id-69de7a5391e2b.box-apm .apm-answers .apm-choosing > label.ays-poll-answer-container-label-list > p.ays-poll-answers > span.ays-poll-each-answer-list {\t\t\t\tpadding: unset;\t\t\t\tword-wrap: break-word;\t\t\t}\t\t\t#ays-poll-id-69de7a5391e2b .ays-poll-btn{\t\t\t\tfont-size: 17px;\t\t\t\tline-height: 1;\t\t\t\twhite-space: normal;\t\t\t\tword-break: break-word;\t\t\t}\t\t}\t\t@media screen and (max-width: 768px){\t\t\t#ays-poll-id-69de7a5391e2b{\t\t\t\tmax-width: 100%;\t\t\t}\t\t}\t\t#ays-poll-container-6{        \twidth: 100%;\t\t}\t\t@media screen and (max-width: 768px){\t\t\t#ays-poll-container-6{\t\t\t\twidth: 100%;\t\t\t\tmax-width: 96%;\t\t\t}\t\t\t#ays-poll-id-69de7a5391e2b.box-apm .apm-choosing .ays-poll-each-image-list{\t\t\t\twidth: 100%;        \t}\t\t}\t\t\t           <\/style>        <script>            var dataCss = {\t\t\t\twidth: '100%',                maxWidth: '98%',                fontSize: '16px',                padding: '10px',                margin: '0 auto',                marginTop: '-1rem',                borderStyle: 'solid',                borderWidth: '2px',                borderColor: '#ffffff',                background: '#dc305f',                color: '#ffffff',                transition: '.3s ease',                WebkitAppearance: 'none',                appearance: 'none',                };            var hoverCss = {                background: '#ffffff',                color: '#dc305f',                borderColor: '#dc305f',            };        <\/script><div style='margin-bottom: 1rem;' class='ays-poll-main ' id='ays-poll-container-6' data-load-method=''>        <form style='margin-bottom: 0;' >                        <div                dir='ltr'        data-loading='load_gif'        data-load-gif='plg_default'        data-load-gif-font-size='64'                data-hide-bg-image='false'        data-gradient-check=''        data-gradient-dir='to bottom'        data-gradient-c1='#103251'        data-gradient-c2='#607593'        data-hide-bg-image-def-color='#dc305f'        data-show-social=''        class='box-apm ays-minimal-theme choosing-poll ays-poll-id-69de7a5391e2b '        id='ays-poll-id-69de7a5391e2b'        data-res='0'        data-res-sort='none'        data-restart ='false'        data-redirection = '0'        data-redirect-check = '0'        data-url-href = ''        data-href = ''        data-delay = '0'        data-id='6'        data-res-rgba = ''        data-percent-color = '#db305d'        data-enable-top-animation = ''        data-top-animation-scroll = '100'        data-info-form=''        data-enable-social-links=''        ><span class='ays_poll_passed_count'><i class='ays_poll_fa ays_poll_fa-users' aria-hidden='true'><\/i> 12<\/span><div class='ays_poll_cb_and_a'><\/div><div class='apm-title-box'><div>Prof Lee's Clinical Case - 3<\/div><\/div><div class='ays-poll-id-69de7a5391e2b ays_question'><p>What is the diagnosis of this case?<\/p><\/div><div class='ays-poll-id-69de7a5391e2b hideResults ays-poll-hide-result-box'> <\/div><div class='apm-answers apm-answers-without-submit ays_poll_list_view_container'>\t\t\t\t\t\t\t\t\t\t\t<div class='apm-choosing answer-ays-poll-id-69de7a5391e2b  ays-poll-field ays-poll-answer-container-list' >\t\t\t\t\t\t\t\t\t\t\t<input type=radio name='answer' id='radio-0-ays-poll-id-69de7a5391e2b' value='27' autocomplete=\"off\">\t\t\t\t\t\t\t\t\t\t\t<label \t\t\t\t\t\t\t\t\t\t\t\tfor='radio-0-ays-poll-id-69de7a5391e2b' \t\t\t\t\t\t\t\t\t\t\t\tclass='ays_label_poll   ays_enable_hover ays_label_font_size   ays-poll-answer-container-label-list' \t\t\t\t\t\t\t\t\t\t\t\tdata-answers-url=''\t\t\t\t\t\t\t\t\t\t\t> <p style='' class='ays-poll-answers'><span class='ays-poll-each-answer-grid'>CAD with NSTEMI<\/span><\/p><\/label>\t\t\t\t\t\t\t\t\t\t\t<\/div>\t\t\t\t\t\t\t\t\t\t\t<div class='apm-choosing answer-ays-poll-id-69de7a5391e2b  ays-poll-field ays-poll-answer-container-list' >\t\t\t\t\t\t\t\t\t\t\t<input type=radio name='answer' id='radio-1-ays-poll-id-69de7a5391e2b' value='28' autocomplete=\"off\">\t\t\t\t\t\t\t\t\t\t\t<label \t\t\t\t\t\t\t\t\t\t\t\tfor='radio-1-ays-poll-id-69de7a5391e2b' \t\t\t\t\t\t\t\t\t\t\t\tclass='ays_label_poll   ays_enable_hover ays_label_font_size   ays-poll-answer-container-label-list' \t\t\t\t\t\t\t\t\t\t\t\tdata-answers-url=''\t\t\t\t\t\t\t\t\t\t\t> <p style='' class='ays-poll-answers'><span class='ays-poll-each-answer-grid'>Unstable Angina<\/span><\/p><\/label>\t\t\t\t\t\t\t\t\t\t\t<\/div>\t\t\t\t\t\t\t\t\t\t\t<div class='apm-choosing answer-ays-poll-id-69de7a5391e2b  ays-poll-field ays-poll-answer-container-list' >\t\t\t\t\t\t\t\t\t\t\t<input type=radio name='answer' id='radio-2-ays-poll-id-69de7a5391e2b' value='29' autocomplete=\"off\">\t\t\t\t\t\t\t\t\t\t\t<label \t\t\t\t\t\t\t\t\t\t\t\tfor='radio-2-ays-poll-id-69de7a5391e2b' \t\t\t\t\t\t\t\t\t\t\t\tclass='ays_label_poll   ays_enable_hover ays_label_font_size   ays-poll-answer-container-label-list' \t\t\t\t\t\t\t\t\t\t\t\tdata-answers-url=''\t\t\t\t\t\t\t\t\t\t\t> <p style='' class='ays-poll-answers'><span class='ays-poll-each-answer-grid'>Hypertensive cardiomyopathy<\/span><\/p><\/label>\t\t\t\t\t\t\t\t\t\t\t<\/div>\t\t\t\t\t\t\t\t\t\t\t<div class='apm-choosing answer-ays-poll-id-69de7a5391e2b  ays-poll-field ays-poll-answer-container-list' >\t\t\t\t\t\t\t\t\t\t\t<input type=radio name='answer' id='radio-3-ays-poll-id-69de7a5391e2b' value='30' autocomplete=\"off\">\t\t\t\t\t\t\t\t\t\t\t<label \t\t\t\t\t\t\t\t\t\t\t\tfor='radio-3-ays-poll-id-69de7a5391e2b' \t\t\t\t\t\t\t\t\t\t\t\tclass='ays_label_poll   ays_enable_hover ays_label_font_size   ays-poll-answer-container-label-list' \t\t\t\t\t\t\t\t\t\t\t\tdata-answers-url=''\t\t\t\t\t\t\t\t\t\t\t> <p style='' class='ays-poll-answers'><span class='ays-poll-each-answer-grid'>Non-Cardiac Chest pain<\/span><\/p><\/label>\t\t\t\t\t\t\t\t\t\t\t<\/div><\/div><div class='apm-cashed-fa'><div>                                <i class='ays_poll_fas ays_poll_fa-star' style='font-size: 0'><\/i>                            <\/div><div>                                <i class='ays_poll_fas ays_poll_fa-star' style='font-size: 0'><\/i>                            <\/div><div>                                <i class='ays_poll_fas ays_poll_fa-star' style='font-size: 0'><\/i>                            <\/div><div>                                <i class='ays_poll_fas ays_poll_fa-star' style='font-size: 0'><\/i>                            <\/div><\/div><input type=\"hidden\" id=\"ays_finish_poll_show_res_6\" name=\"ays_finish_poll_show_res_6\" value=\"667c5fc5b5\" \/><input type=\"hidden\" name=\"_wp_http_referer\" value=\"\/ja\/wp-json\/wp\/v2\/posts\/3590\" \/><div class='apm-button-box'><input type='button' \t                    name='ays_finish_poll'\t                    class='btn ays-poll-btn choosing-btn ays_finish_poll'\t                    data-form='ays-poll-id-69de7a5391e2b'\t                    value=\"Vote\"\t                    ><\/div><div class='apm-title-box ays_res_mess'> <\/div><script>\t\t\t\tif(typeof aysPollOptions === 'undefined'){\t\t\t\t\tvar aysPollOptions = [];\t\t\t\t}\t\t\t\taysPollOptions['ays-poll-id-69de7a5391e2b']  = 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class=\"readmorebtnPoll1\">\n<td>\n<div class=\"wp-block-buttons\">\n<div class=\"wp-block-button readmorebtnPoll1\">\n\t\t\t\t\t\t\t<a class=\"wp-block-button__link\">Click to reveal the answer<\/a>\n\t\t\t\t\t\t<\/div>\n<\/p><\/div>\n<p>\t\t\t\t\t<script type=\"text\/javascript\">\n\t\t\t\t\t                                   $(document).ready(function() {\n\t\t\t\t\t                                   $(\".answer\").hide();\n\t\t\t\t\t                                   });\n\t\t\t\t\t                                   $(\".readmorebtnPoll1\").click(function() {\n\t\t\t\t\t                                       $(\".readmorebtnPoll1\").hide();\n\t\t\t\t\t                                   $(\".answer\").show(500);\n\t\t\t\t\t                                   });\n\t\t\t\t\t<\/script>\n\t\t\t\t<\/td>\n<\/tr>\n<tr class=\"answer\">\n<td height=\"15\" style=\"font-size:1px; line-height:1px;\">&nbsp;<\/td>\n<\/tr>\n<tr class=\"answer\">\n<td align=\"left\" style=\"color:#0063ac; font-family: Arial; font-size:16px; line-height:24px; font-weight: normal;\" valign=\"top\"><strong>Diagnosis<\/strong><\/td>\n<\/tr>\n<tr class=\"answer\">\n<td align=\"left\" class=\"answer\" style=\"color:#544F40; font-family: Arial; font-size:16px; line-height:24px; font-weight: normal;\" valign=\"top\" width=\"30%\"><strong>Coronary artery disease, 3-vessel disease, complicated with NSTEMI<\/strong><\/td>\n<\/tr>\n<tr class=\"answer\">\n<td height=\"10\" style=\"font-size:1px; line-height:1px;\">&nbsp;<\/td>\n<\/tr>\n<tr class=\"answer\">\n<td align=\"left\" style=\"padding-bottom:4px;\" valign=\"top\">\n<table border=\"0\" cellpadding=\"0\" cellspacing=\"0\" width=\"100%\">\n<tbody>\n<tr>\n<td align=\"left\" valign=\"middle\">\n<table align=\"center\" border=\"0\" cellpadding=\"0\" cellspacing=\"0\" width=\"100%\">\n<tbody>\n<tr>\n<td align=\"left\" style=\"font-family: Arial; font-size: 11px; font-weight: normal; color: #544F40; line-height: 16px; text-align: left;\" valign=\"top\" width=\"8\"><strong>\u2022<\/strong><\/td>\n<td align=\"left\" style=\"font-family: Arial; font-size: 13px; font-weight: normal; color:#544F40; line-height: 18px; text-align: left;\" valign=\"top\">Initial ECG showed normal by machine interpretation.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/td>\n<\/tr>\n<tr class=\"answer\">\n<td align=\"left\" style=\"padding-bottom:4px;\" valign=\"top\">\n<table border=\"0\" cellpadding=\"0\" cellspacing=\"0\" width=\"100%\">\n<tbody>\n<tr>\n<td align=\"left\" valign=\"middle\">\n<table align=\"center\" border=\"0\" cellpadding=\"0\" cellspacing=\"0\" width=\"100%\">\n<tbody>\n<tr>\n<td align=\"left\" style=\"font-family: Arial; font-size: 11px; font-weight: normal; color: #544F40; line-height: 16px; text-align: left;\" valign=\"top\" width=\"8\"><strong>\u2022<\/strong><\/td>\n<td align=\"left\" style=\"font-family: Arial; font-size: 13px; font-weight: normal; color:#544F40; line-height: 18px; text-align: left;\" valign=\"top\">Dynamic Troponin change and persistent symptoms justified the coronary angiography, which confirmed the RCA occlusion.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/td>\n<\/tr>\n<tr class=\"answer\">\n<td height=\"15\" style=\"font-size:1px; line-height:1px;\">&nbsp;<\/td>\n<\/tr>\n<tr>\n<td align=\"left\" class=\"answer\" style=\"color:#0063ac; font-family: Arial; font-size:16px; line-height:24px; font-weight: normal;\" valign=\"top\"><strong>Author\u2019s opinion<\/strong><\/td>\n<\/tr>\n<tr>\n<td height=\"15\" style=\"font-size:1px; line-height:1px;\">&nbsp;<\/td>\n<\/tr>\n<tr class=\"answer\">\n<td align=\"left\" style=\"padding-bottom:4px;\" valign=\"top\">\n<table border=\"0\" cellpadding=\"0\" cellspacing=\"0\" width=\"100%\">\n<tbody>\n<tr>\n<td align=\"left\" valign=\"middle\">\n<table align=\"center\" border=\"0\" cellpadding=\"0\" cellspacing=\"0\" width=\"100%\">\n<tbody>\n<tr>\n<td align=\"left\" style=\"font-family: Arial; font-size: 11px; font-weight: normal; color: #544F40; line-height: 16px; text-align: left;\" valign=\"top\" width=\"8\"><strong>\u2022<\/strong><\/td>\n<td align=\"left\" style=\"font-family: Arial; font-size: 13px; font-weight: normal; color:#544F40; line-height: 18px; text-align: left;\" valign=\"top\">The ECG interpreted by machine may be sometimes falsely negative. The dynamic change of troponin greater than 100% 3 hours later led to a review of ECG finding ST-elevation in III and aVF inferior leads.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/td>\n<\/tr>\n<tr class=\"answer\">\n<td align=\"left\" style=\"padding-bottom:4px;\" valign=\"top\">\n<table border=\"0\" cellpadding=\"0\" cellspacing=\"0\" width=\"100%\">\n<tbody>\n<tr>\n<td align=\"left\" valign=\"middle\">\n<table align=\"center\" border=\"0\" cellpadding=\"0\" cellspacing=\"0\" width=\"100%\">\n<tbody>\n<tr>\n<td align=\"left\" style=\"font-family: Arial; font-size: 11px; font-weight: normal; color: #544F40; line-height: 16px; text-align: left;\" valign=\"top\" width=\"8\"><strong>\u2022<\/strong><\/td>\n<td align=\"left\" style=\"font-family: Arial; font-size: 13px; font-weight: normal; color:#544F40; line-height: 18px; text-align: left;\" valign=\"top\">According to the criteria of the 2015 ESC guidelines, using the 0\/1-hour algorithm, NSTEMI can be ruled in if T0 &gt;52 ng\/L or delta change at T1 &gt;5 ng\/L. This patient has T1 delta change of 14 ng\/L. If apply ESC 0\/1-hour algorithm, this patient would have been diagnosed two hours earlier.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/td>\n<\/tr>\n<tr class=\"answer\">\n<td height=\"15\" style=\"font-size:1px; line-height:1px;\">&nbsp;<\/td>\n<\/tr>\n<tr>\n<td height=\"20\" style=\"font-size:1px; line-height:1px;\">&nbsp;<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/div>\n<div class=\"su-tabs-pane su-u-clearfix su-u-trim\" data-title=\"Case Study: 85-year old woman\">\n<table border=\"0\" cellpadding=\"0\" cellspacing=\"0\" role=\"presentation\" width=\"100%\">\n<tbody>\n<tr>\n<td height=\"15\" style=\"font-size:1px; line-height:1px;\">&nbsp;<\/td>\n<\/tr>\n<tr>\n<td align=\"center\" valign=\"top\">\n<table border=\"0\" cellpadding=\"0\" cellspacing=\"0\" width=\"100%\">\n<tbody>\n<tr>\n<td align=\"left\" style=\"color:#0063ac; font-family: Arial; font-size:16px; line-height:24px; font-weight: bold;border-top:1px solid #000000;border-bottom:1px solid #000000;\" valign=\"top\" width=\"30%\">Case<\/td>\n<td align=\"left\" valign=\"top\" width=\"2%\">&nbsp;<\/td>\n<td align=\"left\" style=\"color:#544F40; font-family: Arial; font-size:14px; line-height:24px; font-weight: bold;border-top:1px solid #000000;border-bottom:1px solid #000000;\" valign=\"top\" width=\"60%\">85-year old woman<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/td>\n<\/tr>\n<tr>\n<td height=\"15\" style=\"font-size:1px; line-height:1px;\">&nbsp;<\/td>\n<\/tr>\n<tr>\n<td align=\"center\" valign=\"top\">\n<table border=\"0\" cellpadding=\"0\" cellspacing=\"0\" width=\"100%\">\n<tbody>\n<tr>\n<td align=\"left\" style=\"color:#544F40; font-family: Arial; font-size:16px; line-height:24px; font-weight: normal;border-top:1px solid #000000;border-bottom:1px solid #000000;\" valign=\"top\" width=\"30%\">Key signs and<br \/>\n\t\t\t\t\t\t\t\tsymptoms<\/td>\n<td align=\"left\" valign=\"top\" width=\"2%\">&nbsp;<\/td>\n<td align=\"left\" style=\"color:#544F40; font-family: Arial; font-size:14px; line-height:24px; font-weight: normal;border-top:1px solid #000000;border-bottom:1px solid #000000;background:#dce4f4;padding:0 4px;\" valign=\"top\" width=\"60%\">Acute onset of dyspnea accompanied with diaphoresis and altered level of consciousness.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/td>\n<\/tr>\n<tr>\n<td height=\"15\" style=\"font-size:1px; line-height:1px;\">&nbsp;<\/td>\n<\/tr>\n<tr>\n<td align=\"center\" valign=\"top\">\n<table border=\"0\" cellpadding=\"0\" cellspacing=\"0\" width=\"100%\">\n<tbody>\n<tr>\n<td align=\"left\" style=\"color:#544F40; font-family: Arial; font-size:16px; line-height:24px; font-weight: normal;border-top:1px solid #000000;border-bottom:1px solid #000000;\" valign=\"middle\" width=\"30%\">Medical history\/<br \/>\n\t\t\t\t\t\t\t\tClinical examination<\/td>\n<td align=\"left\" valign=\"top\" width=\"2%\">&nbsp;<\/td>\n<td align=\"left\" style=\"color:#544F40; font-family: Arial; font-size:14px; line-height:24px; font-weight: normal;border-top:1px solid #000000;border-bottom:1px solid #000000;background:#dce4f4;padding:0 4px;\" valign=\"top\" width=\"60%\"><strong>Medical history:<\/strong> Hemiplegic stroke with dependent ADL (activities of daily living), COPD (Chronic obstructive pulmonary disease), osteoarthritis, hypertension, and coronary artery disease.<br \/>\n\t\t\t\t\t\t\t\t<strong>Clinical examination:<\/strong> Irregular heart beat, systolic murmur at right upper sternal border, and bilateral rales. No leg edema. BP 132\/50 mmHg, heart rate 75 BPM, respiratory rate 22 BPM, body temperature 36.1C, oxygen saturation 100%.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/td>\n<\/tr>\n<tr>\n<td height=\"15\" style=\"font-size:1px; line-height:1px;\">&nbsp;<\/td>\n<\/tr>\n<tr>\n<td align=\"center\" valign=\"top\">\n<table border=\"0\" cellpadding=\"0\" cellspacing=\"0\" width=\"100%\">\n<tbody>\n<tr>\n<td align=\"left\" style=\"color:#544F40; font-family: Arial; font-size:16px; line-height:24px; font-weight: normal;border-top:1px solid #000000;border-bottom:1px solid #000000;\" valign=\"middle\" width=\"30%\">Laboratory test<br \/>\n\t\t\t\t\t\t\t\tresults<\/td>\n<td align=\"left\" valign=\"top\" width=\"2%\">&nbsp;<\/td>\n<td align=\"left\" style=\"border-top:1px solid #000000;border-bottom:1px solid #000000;padding:0 0px;\" valign=\"top\" width=\"60%\">\n<table border=\"0\" cellpadding=\"0\" cellspacing=\"0\" width=\"100%\">\n<tbody>\n<tr>\n<td align=\"center\" style=\"background:#dce4f4;padding:0 2px;\" valign=\"top\">\n<table border=\"0\" cellpadding=\"0\" cellspacing=\"0\" width=\"100%\">\n<tbody>\n<tr>\n<td align=\"left\" style=\"color:#544F40; font-family: Arial; font-size:14px; line-height:24px; font-weight: normal;padding:0 0px;\" valign=\"top\" width=\"45%\"><strong>Test<\/strong><\/td>\n<td align=\"left\" valign=\"top\" width=\"2%\">&nbsp;<\/td>\n<td align=\"left\" style=\"color:#544F40; font-family: Arial; font-size:14px; line-height:24px; font-weight: normal\" valign=\"top\" width=\"15%\"><strong>Value<\/strong><\/td>\n<td align=\"left\" valign=\"top\" width=\"2%\">&nbsp;<\/td>\n<td align=\"left\" style=\"color:#544F40; font-family: Arial; font-size:14px; line-height:24px; font-weight: normal\" valign=\"top\" width=\"30%\"><strong>Reference range<\/strong><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/td>\n<\/tr>\n<tr>\n<td align=\"center\" style=\"background:#ecf0f9;padding:0 2px;\" valign=\"top\">\n<table border=\"0\" cellpadding=\"0\" cellspacing=\"0\" width=\"100%\">\n<tbody>\n<tr>\n<td align=\"left\" style=\"color:#544F40; font-family: Arial; font-size:14px; line-height:24px; font-weight: normal\" valign=\"top\" width=\"45%\">WBC (x103\/\u03bcL)<\/td>\n<td align=\"left\" valign=\"top\" width=\"2%\">&nbsp;<\/td>\n<td align=\"left\" style=\"color:#544F40; font-family: Arial; font-size:14px; line-height:24px; font-weight: normal\" valign=\"top\" width=\"15%\">15.77<\/td>\n<td align=\"left\" valign=\"top\" width=\"2%\">&nbsp;<\/td>\n<td align=\"left\" style=\"color:#544F40; font-family: Arial; font-size:14px; line-height:24px; font-weight: normal\" valign=\"top\" width=\"30%\">3.54 \u2013 9.06<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/td>\n<\/tr>\n<tr>\n<td align=\"center\" style=\"background:#dce4f4;padding:0 2px;\" valign=\"top\">\n<table border=\"0\" cellpadding=\"0\" cellspacing=\"0\" width=\"100%\">\n<tbody>\n<tr>\n<td align=\"left\" style=\"color:#544F40; font-family: Arial; font-size:14px; line-height:24px; font-weight: normal\" valign=\"top\" width=\"45%\">Hemoglobin (g\/dL)<\/td>\n<td align=\"left\" valign=\"top\" width=\"2%\">&nbsp;<\/td>\n<td align=\"left\" style=\"color:#544F40; font-family: Arial; font-size:14px; line-height:24px; font-weight: normal\" valign=\"top\" width=\"15%\">5.9<\/td>\n<td align=\"left\" valign=\"top\" width=\"2%\">&nbsp;<\/td>\n<td align=\"left\" style=\"color:#544F40; font-family: Arial; font-size:14px; line-height:24px; font-weight: normal\" valign=\"top\" width=\"30%\">10.8 \u2013 14.9<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/td>\n<\/tr>\n<tr>\n<td align=\"center\" style=\"background:#ecf0f9;padding:0 2px;\" valign=\"top\">\n<table border=\"0\" cellpadding=\"0\" cellspacing=\"0\" width=\"100%\">\n<tbody>\n<tr>\n<td align=\"left\" style=\"color:#544F40; font-family: Arial; font-size:14px; line-height:24px; font-weight: normal\" valign=\"top\" width=\"45%\">Creatinine clearance (ml\/min)<\/td>\n<td align=\"left\" valign=\"top\" width=\"2%\">&nbsp;<\/td>\n<td align=\"left\" style=\"color:#544F40; font-family: Arial; font-size:14px; line-height:24px; font-weight: normal\" valign=\"top\" width=\"15%\">2.2<\/td>\n<td align=\"left\" valign=\"top\" width=\"2%\">&nbsp;<\/td>\n<td align=\"left\" style=\"color:#544F40; font-family: Arial; font-size:14px; line-height:24px; font-weight: normal\" valign=\"top\" width=\"30%\">0.6 \u2013 1.2<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/td>\n<\/tr>\n<tr>\n<td align=\"center\" style=\"background:#dce4f4;padding:0 2px;\" valign=\"top\">\n<table border=\"0\" cellpadding=\"0\" cellspacing=\"0\" width=\"100%\">\n<tbody>\n<tr>\n<td align=\"left\" style=\"color:#544F40; font-family: Arial; font-size:14px; line-height:24px; font-weight: normal\" valign=\"top\" width=\"45%\">NT-proBNP (pg\/mL)<\/td>\n<td align=\"left\" valign=\"top\" width=\"2%\">&nbsp;<\/td>\n<td align=\"left\" style=\"color:#544F40; font-family: Arial; font-size:14px; line-height:24px; font-weight: normal\" valign=\"top\" width=\"15%\">34851<\/td>\n<td align=\"left\" valign=\"top\" width=\"2%\">&nbsp;<\/td>\n<td align=\"left\" style=\"color:#544F40; font-family: Arial; font-size:14px; line-height:24px; font-weight: normal\" valign=\"top\" width=\"30%\">Rule out of acute heart failure<br \/>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t(AHF): &lt;300 pg\/mL<br \/>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\tRule in AHF:<br \/>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t&lt; 50 years: &gt;450 pg\/mL<br \/>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t50 &#8211; 75 years: &gt;900 pg\/mL<br \/>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t&gt;75 years: &gt;1800 pg\/mL<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/td>\n<\/tr>\n<tr>\n<td height=\"15\" style=\"font-size:1px; line-height:1px;\">&nbsp;<\/td>\n<\/tr>\n<tr>\n<td align=\"center\" valign=\"top\">\n<table border=\"0\" cellpadding=\"0\" cellspacing=\"0\" width=\"100%\">\n<tbody>\n<tr>\n<td align=\"left\" style=\"color:#544F40; font-family: Arial; font-size:16px; line-height:24px; font-weight: normal;\" valign=\"top\" width=\"30%\"><strong>ECG<\/strong><br \/>\n\t\t\t\t\t\t\t\tMarked ST-segment depression in leads V2 to V6 and slight ST-segment depression in leads I and aVL<\/td>\n<td align=\"left\" valign=\"top\" width=\"2%\">&nbsp;<\/td>\n<td align=\"right\" class=\"hero_image1\" valign=\"middle\" width=\"60%\"><img loading=\"lazy\" decoding=\"async\" alt=\"image\" height=\"209\" src=\"https:\/\/dianews.roche.com\/rs\/106-RRW-330\/images\/Infographic_20210322_asset_43.png\" style=\"border: none;display: block;\" width=\"365\"><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/td>\n<\/tr>\n<tr>\n<td height=\"15\" style=\"font-size:1px; line-height:1px;\">&nbsp;<\/td>\n<\/tr>\n<tr>\n<td align=\"center\" valign=\"top\">\n<table border=\"0\" cellpadding=\"0\" cellspacing=\"0\" width=\"100%\">\n<tbody>\n<tr>\n<td align=\"left\" style=\"color:#544F40; font-family: Arial; font-size:16px; line-height:24px; font-weight: normal;\" valign=\"top\" width=\"30%\"><strong>Troponin kinetic profile<\/strong><\/td>\n<td align=\"left\" valign=\"top\" width=\"2%\">&nbsp;<\/td>\n<td align=\"right\" class=\"hero_image1\" valign=\"middle\" width=\"60%\"><img loading=\"lazy\" decoding=\"async\" alt=\"image\" height=\"182\" src=\"https:\/\/dianews.roche.com\/rs\/106-RRW-330\/images\/Infographic_20210322_asset_44.png\" style=\"border: none;display: block;\" width=\"365\"><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/td>\n<\/tr>\n<tr>\n<td height=\"15\" style=\"font-size:1px; line-height:1px;\">&nbsp;<\/td>\n<\/tr>\n<tr>\n<td align=\"left\" style=\"color:#0063ac; font-family: Arial; font-size:16px; line-height:24px; font-weight: normal;\" valign=\"top\"><strong>Chest X-ray<\/strong><\/td>\n<\/tr>\n<tr>\n<td align=\"left\" style=\"color:#544F40; font-family: Arial; font-size:13px; line-height:24px; font-weight: normal;\" valign=\"top\">Cardiomegaly and mediastinal widening. Opacities at bilateral lungs<\/td>\n<\/tr>\n<tr>\n<td align=\"left\" style=\"color:#0063ac; font-family: Arial; font-size:16px; line-height:24px; font-weight: normal;\" valign=\"top\"><strong>Transthoracic<br \/>\n\t\t\t\tEchocardiography<\/strong><\/td>\n<\/tr>\n<tr>\n<td align=\"left\" style=\"color:#544F40; font-family: Arial; font-size:13px; line-height:24px; font-weight: normal;\" valign=\"top\">Severe aortic stenosis with mild aortic regurgitation<\/td>\n<\/tr>\n<tr>\n<td height=\"10\" style=\"font-size:1px; line-height:1px;\">&nbsp;<\/td>\n<\/tr>\n<tr>\n<td align=\"center\" class=\"hero_image1\" valign=\"middle\" width=\"560\"><img loading=\"lazy\" decoding=\"async\" alt=\"image\" height=\"644\" src=\"https:\/\/dianews.roche.com\/rs\/106-RRW-330\/images\/Infographic_20210322_asset_42.png\" style=\"border: none;display: block;\" width=\"560\"><\/td>\n<\/tr>\n<tr>\n<td height=\"15\" style=\"font-size:1px; line-height:1px;\">&nbsp;<\/td>\n<\/tr>\n<tr>\n<td><input type=\"hidden\" 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data-delay = '0'        data-id='7'        data-res-rgba = ''        data-percent-color = '#db305d'        data-enable-top-animation = ''        data-top-animation-scroll = '100'        data-info-form=''        data-enable-social-links=''        ><span class='ays_poll_passed_count'><i class='ays_poll_fa ays_poll_fa-users' aria-hidden='true'><\/i> 4<\/span><div class='ays_poll_cb_and_a'><\/div><div class='apm-title-box'><div>Prof Lee's Clinical Case - 10<\/div><\/div><div class='ays-poll-id-69de7a5394288 ays_question'><p>What is the diagnosis of this case?<\/p><\/div><div class='ays-poll-id-69de7a5394288 hideResults ays-poll-hide-result-box'> <\/div><div class='apm-answers apm-answers-without-submit ays_poll_list_view_container'>\t\t\t\t\t\t\t\t\t\t\t<div class='apm-choosing answer-ays-poll-id-69de7a5394288  ays-poll-field ays-poll-answer-container-list' >\t\t\t\t\t\t\t\t\t\t\t<input type=radio name='answer' id='radio-0-ays-poll-id-69de7a5394288' value='31' autocomplete=\"off\">\t\t\t\t\t\t\t\t\t\t\t<label \t\t\t\t\t\t\t\t\t\t\t\tfor='radio-0-ays-poll-id-69de7a5394288' \t\t\t\t\t\t\t\t\t\t\t\tclass='ays_label_poll   ays_enable_hover ays_label_font_size   ays-poll-answer-container-label-list' \t\t\t\t\t\t\t\t\t\t\t\tdata-answers-url=''\t\t\t\t\t\t\t\t\t\t\t> <p style='' class='ays-poll-answers'><span class='ays-poll-each-answer-grid'>Takotsubo syndrome<\/span><\/p><\/label>\t\t\t\t\t\t\t\t\t\t\t<\/div>\t\t\t\t\t\t\t\t\t\t\t<div class='apm-choosing answer-ays-poll-id-69de7a5394288  ays-poll-field ays-poll-answer-container-list' >\t\t\t\t\t\t\t\t\t\t\t<input type=radio name='answer' id='radio-1-ays-poll-id-69de7a5394288' value='32' autocomplete=\"off\">\t\t\t\t\t\t\t\t\t\t\t<label \t\t\t\t\t\t\t\t\t\t\t\tfor='radio-1-ays-poll-id-69de7a5394288' \t\t\t\t\t\t\t\t\t\t\t\tclass='ays_label_poll   ays_enable_hover ays_label_font_size   ays-poll-answer-container-label-list' \t\t\t\t\t\t\t\t\t\t\t\tdata-answers-url=''\t\t\t\t\t\t\t\t\t\t\t> <p style='' class='ays-poll-answers'><span class='ays-poll-each-answer-grid'>NSTEMI\/ Acute Pulmonary edema<\/span><\/p><\/label>\t\t\t\t\t\t\t\t\t\t\t<\/div>\t\t\t\t\t\t\t\t\t\t\t<div class='apm-choosing answer-ays-poll-id-69de7a5394288  ays-poll-field ays-poll-answer-container-list' >\t\t\t\t\t\t\t\t\t\t\t<input type=radio name='answer' id='radio-2-ays-poll-id-69de7a5394288' value='33' autocomplete=\"off\">\t\t\t\t\t\t\t\t\t\t\t<label \t\t\t\t\t\t\t\t\t\t\t\tfor='radio-2-ays-poll-id-69de7a5394288' \t\t\t\t\t\t\t\t\t\t\t\tclass='ays_label_poll   ays_enable_hover ays_label_font_size   ays-poll-answer-container-label-list' \t\t\t\t\t\t\t\t\t\t\t\tdata-answers-url=''\t\t\t\t\t\t\t\t\t\t\t> <p style='' class='ays-poll-answers'><span class='ays-poll-each-answer-grid'>Pericarditis<\/span><\/p><\/label>\t\t\t\t\t\t\t\t\t\t\t<\/div>\t\t\t\t\t\t\t\t\t\t\t<div class='apm-choosing answer-ays-poll-id-69de7a5394288  ays-poll-field ays-poll-answer-container-list' >\t\t\t\t\t\t\t\t\t\t\t<input type=radio name='answer' id='radio-3-ays-poll-id-69de7a5394288' value='34' autocomplete=\"off\">\t\t\t\t\t\t\t\t\t\t\t<label \t\t\t\t\t\t\t\t\t\t\t\tfor='radio-3-ays-poll-id-69de7a5394288' \t\t\t\t\t\t\t\t\t\t\t\tclass='ays_label_poll   ays_enable_hover ays_label_font_size   ays-poll-answer-container-label-list' \t\t\t\t\t\t\t\t\t\t\t\tdata-answers-url=''\t\t\t\t\t\t\t\t\t\t\t> <p style='' class='ays-poll-answers'><span class='ays-poll-each-answer-grid'>Tachyarrhythmias<\/span><\/p><\/label>\t\t\t\t\t\t\t\t\t\t\t<\/div><\/div><div class='apm-cashed-fa'><div>                                <i class='ays_poll_fas ays_poll_fa-star' style='font-size: 0'><\/i>                            <\/div><div>                                <i class='ays_poll_fas ays_poll_fa-star' style='font-size: 0'><\/i>                            <\/div><div>                                <i class='ays_poll_fas ays_poll_fa-star' style='font-size: 0'><\/i>                            <\/div><div>                    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height=\"15\" style=\"font-size:1px; line-height:1px;\">&nbsp;<\/td>\n<\/tr>\n<tr class=\"readmorebtnPoll2\">\n<td>\n<div class=\"wp-block-buttons\">\n<div class=\"wp-block-button readmorebtnPoll2\">\n\t\t\t\t\t\t\t<a class=\"wp-block-button__link\">Click to reveal the answer<\/a>\n\t\t\t\t\t\t<\/div>\n<\/p><\/div>\n<p>\t\t\t\t\t<script type=\"text\/javascript\">\n\t\t\t\t\t                                   $(document).ready(function() {\n\t\t\t\t\t                                   $(\".answer2\").hide();\n\t\t\t\t\t                                   });\n\t\t\t\t\t                                   $(\".readmorebtnPoll2\").click(function() {\n\t\t\t\t\t$(\".readmorebtnPoll2\").hide();                                      \n\t\t\t\t\t                                   $(\".answer2\").show(500);\n\t\t\t\t\t                                   });\n\t\t\t\t\t<\/script>\n\t\t\t\t<\/td>\n<\/tr>\n<tr class=\"answer2\">\n<td align=\"left\" style=\"color:#0063ac; font-family: Arial; font-size:16px; line-height:24px; font-weight: normal;\" valign=\"top\"><strong>Outcome:<\/strong><\/td>\n<\/tr>\n<tr class=\"answer2\">\n<td align=\"left\" style=\"color:#544F40; font-family: Arial; font-size:13px; line-height:24px; font-weight: normal;\" valign=\"top\">The patient\u2019s family chose to receive palliative care and she did not undergo emergency cardiac intervention. She died 2 days after ED admission.<\/td>\n<\/tr>\n<tr class=\"answer2\">\n<td height=\"15\" style=\"font-size:1px; line-height:1px;\">&nbsp;<\/td>\n<\/tr>\n<tr class=\"answer2\">\n<td align=\"left\" style=\"color:#0063ac; font-family: Arial; font-size:16px; line-height:24px; font-weight: normal;\" valign=\"top\"><strong>Diagnosis<\/strong><\/td>\n<\/tr>\n<tr class=\"answer2\">\n<td align=\"left\" style=\"padding-bottom:4px;\" valign=\"top\">\n<table border=\"0\" cellpadding=\"0\" cellspacing=\"0\" width=\"100%\">\n<tbody>\n<tr>\n<td align=\"left\" valign=\"middle\">\n<table align=\"center\" border=\"0\" cellpadding=\"0\" cellspacing=\"0\" width=\"100%\">\n<tbody>\n<tr>\n<td align=\"left\" style=\"font-family: Arial; font-size: 11px; font-weight: normal; color: #544F40; line-height: 16px; text-align: left;\" valign=\"top\" width=\"8\"><strong>1.<\/strong><\/td>\n<td align=\"left\" style=\"font-family: Arial; font-size: 13px; font-weight: bold; color:#544F40; line-height: 18px; text-align: left;padding:0 0 0 3px;\" valign=\"top\">Acute myocardial infarction\/NSTEMI<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/td>\n<\/tr>\n<tr class=\"answer2\">\n<td align=\"left\" style=\"padding-bottom:4px;\" valign=\"top\">\n<table border=\"0\" cellpadding=\"0\" cellspacing=\"0\" width=\"100%\">\n<tbody>\n<tr>\n<td align=\"left\" valign=\"middle\">\n<table align=\"center\" border=\"0\" cellpadding=\"0\" cellspacing=\"0\" width=\"100%\">\n<tbody>\n<tr>\n<td align=\"left\" style=\"font-family: Arial; font-size: 11px; font-weight: normal; color: #544F40; line-height: 16px; text-align: left;\" valign=\"top\" width=\"8\"><strong>2.<\/strong><\/td>\n<td align=\"left\" style=\"font-family: Arial; font-size: 13px; font-weight: bold; color:#544F40; line-height: 18px; text-align: left;padding:0 0 0 3px;\" valign=\"top\">Acute pulmonary edema<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/td>\n<\/tr>\n<tr class=\"answer2\">\n<td align=\"left\" style=\"color:#544F40; font-family: Arial; font-size:13px; line-height:20px; font-weight: normal;\" valign=\"top\">The typical dynamic rise and fall of cTnT-hs confirmed the diagnosis of myocardial infarction.<\/td>\n<\/tr>\n<tr class=\"answer2\">\n<td height=\"15\" style=\"font-size:1px; line-height:1px;\">&nbsp;<\/td>\n<\/tr>\n<tr class=\"answer2\">\n<td align=\"left\" style=\"color:#0063ac; font-family: Arial; font-size:16px; line-height:24px; font-weight: normal;\" valign=\"top\"><strong>Author\u2019s opinion<\/strong><\/td>\n<\/tr>\n<tr class=\"answer2\">\n<td height=\"15\" style=\"font-size:1px; line-height:1px;\">&nbsp;<\/td>\n<\/tr>\n<tr class=\"answer2\">\n<td align=\"left\" style=\"padding-bottom:4px;\" valign=\"top\">\n<table border=\"0\" cellpadding=\"0\" cellspacing=\"0\" width=\"100%\">\n<tbody>\n<tr>\n<td align=\"left\" valign=\"middle\">\n<table align=\"center\" border=\"0\" cellpadding=\"0\" cellspacing=\"0\" width=\"100%\">\n<tbody>\n<tr>\n<td align=\"left\" style=\"font-family: Arial; font-size: 11px; font-weight: normal; color: #544F40; line-height: 16px; text-align: left;\" valign=\"top\" width=\"8\"><strong>\u2022<\/strong><\/td>\n<td align=\"left\" style=\"font-family: Arial; font-size: 13px; font-weight: normal; color:#544F40; line-height: 18px; text-align: left;\" valign=\"top\">The very high baseline (T0) TnT level raises the suspicion of MI. Formally it is a rule-in case although not automatically a MI. However, there are confounders caused troponin elevation with this patient such as older age, severe anemia, renal dysfunction, acute heart failure, hypoxia in presence of pulmonary edema. Therefore, diagnosis as a MI is unable to establish at T0.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/td>\n<\/tr>\n<tr class=\"answer2\">\n<td height=\"15\" style=\"font-size:1px; line-height:1px;\">&nbsp;<\/td>\n<\/tr>\n<tr>\n<td height=\"20\" style=\"font-size:1px; line-height:1px;\">&nbsp;<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/div>\n<div class=\"su-tabs-pane su-u-clearfix su-u-trim\" data-title=\"Case Study: 66-year man\">\n<table border=\"0\" cellpadding=\"0\" cellspacing=\"0\" width=\"100%\">\n<tbody>\n<tr>\n<td height=\"15\" style=\"font-size:1px; line-height:1px;\">&nbsp;<\/td>\n<\/tr>\n<tr>\n<td align=\"center\" valign=\"top\">\n<table border=\"0\" cellpadding=\"0\" cellspacing=\"0\" width=\"100%\">\n<tbody>\n<tr>\n<td align=\"left\" style=\"color:#0063ac; font-family: Arial; font-size:16px; line-height:24px; font-weight: bold;border-top:1px solid #000000;border-bottom:1px solid #000000;\" valign=\"top\" width=\"30%\">Case<\/td>\n<td align=\"left\" valign=\"top\" width=\"2%\">&nbsp;<\/td>\n<td align=\"left\" style=\"color:#544F40; font-family: Arial; font-size:14px; line-height:24px; font-weight: bold;border-top:1px solid #000000;border-bottom:1px solid #000000;\" valign=\"top\" width=\"60%\">66-year man<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/td>\n<\/tr>\n<tr>\n<td height=\"15\" style=\"font-size:1px; line-height:1px;\">&nbsp;<\/td>\n<\/tr>\n<tr>\n<td align=\"center\" valign=\"top\">\n<table border=\"0\" cellpadding=\"0\" cellspacing=\"0\" width=\"100%\">\n<tbody>\n<tr>\n<td align=\"left\" style=\"color:#544F40; font-family: Arial; font-size:16px; line-height:24px; font-weight: normal;border-top:1px solid #000000;border-bottom:1px solid #000000;\" valign=\"top\" width=\"30%\">Key signs and symptoms<\/td>\n<td align=\"left\" valign=\"top\" width=\"2%\">&nbsp;<\/td>\n<td align=\"left\" style=\"color:#544F40; font-family: Arial; font-size:14px; line-height:24px; font-weight: normal;border-top:1px solid #000000;border-bottom:1px solid #000000;background:#dce4f4;padding:0 4px;\" valign=\"top\" width=\"60%\">Acute onset chest pain with radiation to left upper arm for 1 day. Chest pain persisted after took nitroglycerin. Also complained of exertional dyspnea.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/td>\n<\/tr>\n<tr>\n<td height=\"15\" style=\"font-size:1px; line-height:1px;\">&nbsp;<\/td>\n<\/tr>\n<tr>\n<td align=\"center\" valign=\"top\">\n<table border=\"0\" cellpadding=\"0\" cellspacing=\"0\" width=\"100%\">\n<tbody>\n<tr>\n<td align=\"left\" style=\"color:#544F40; font-family: Arial; font-size:16px; line-height:24px; font-weight: normal;border-top:1px solid #000000;border-bottom:1px solid #000000;\" valign=\"middle\" width=\"30%\">Medical history\/<br \/>\n\t\t\t\t\t\t\t\tClinical examination<\/td>\n<td align=\"left\" valign=\"top\" width=\"2%\">&nbsp;<\/td>\n<td align=\"left\" style=\"color:#544F40; font-family: Arial; font-size:14px; line-height:24px; font-weight: normal;border-top:1px solid #000000;border-bottom:1px solid #000000;background:#dce4f4;padding:0 4px;\" valign=\"top\" width=\"60%\"><strong>Clinical examination:<\/strong> BP 123\/75mmHg, HR 109BPM, RR 20BPM, oxygen saturation 95%, Glasgow coma scale 15.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/td>\n<\/tr>\n<tr>\n<td height=\"15\" style=\"font-size:1px; line-height:1px;\">&nbsp;<\/td>\n<\/tr>\n<tr>\n<td align=\"center\" valign=\"top\">\n<table border=\"0\" cellpadding=\"0\" cellspacing=\"0\" width=\"100%\">\n<tbody>\n<tr>\n<td align=\"left\" style=\"color:#544F40; font-family: Arial; font-size:16px; line-height:24px; font-weight: normal;border-top:1px solid #000000;border-bottom:1px solid #000000;\" valign=\"middle\" width=\"30%\">Laboratory test<br \/>\n\t\t\t\t\t\t\t\tresults<\/td>\n<td align=\"left\" valign=\"top\" width=\"2%\">&nbsp;<\/td>\n<td align=\"left\" style=\"border-top:1px solid #000000;border-bottom:1px solid #000000;padding:0 0px;\" valign=\"top\" width=\"60%\">\n<table border=\"0\" cellpadding=\"0\" cellspacing=\"0\" width=\"100%\">\n<tbody>\n<tr>\n<td align=\"center\" style=\"background:#dce4f4;padding:0 2px;\" valign=\"top\">\n<table border=\"0\" cellpadding=\"0\" cellspacing=\"0\" width=\"100%\">\n<tbody>\n<tr>\n<td align=\"left\" style=\"color:#544F40; font-family: Arial; font-size:14px; line-height:24px; font-weight: normal;padding:0 0px;\" valign=\"top\" width=\"45%\"><strong>Test<\/strong><\/td>\n<td align=\"left\" valign=\"top\" width=\"2%\">&nbsp;<\/td>\n<td align=\"left\" style=\"color:#544F40; font-family: Arial; font-size:14px; line-height:24px; font-weight: normal\" valign=\"top\" width=\"15%\"><strong>Value<\/strong><\/td>\n<td align=\"left\" valign=\"top\" width=\"2%\">&nbsp;<\/td>\n<td align=\"left\" style=\"color:#544F40; font-family: Arial; font-size:14px; line-height:24px; font-weight: normal\" valign=\"top\" width=\"30%\"><strong>Reference range<\/strong><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/td>\n<\/tr>\n<tr>\n<td align=\"center\" style=\"background:#ecf0f9;padding:0 2px;\" valign=\"top\">\n<table border=\"0\" cellpadding=\"0\" cellspacing=\"0\" width=\"100%\">\n<tbody>\n<tr>\n<td align=\"left\" style=\"color:#544F40; font-family: Arial; font-size:14px; line-height:24px; font-weight: normal\" valign=\"top\" width=\"45%\">WBC (x103\/\u03bcL)<\/td>\n<td align=\"left\" valign=\"top\" width=\"2%\">&nbsp;<\/td>\n<td align=\"left\" style=\"color:#544F40; font-family: Arial; font-size:14px; line-height:24px; font-weight: normal\" valign=\"top\" width=\"15%\">8.48<\/td>\n<td align=\"left\" valign=\"top\" width=\"2%\">&nbsp;<\/td>\n<td align=\"left\" style=\"color:#544F40; font-family: Arial; font-size:14px; line-height:24px; font-weight: normal\" valign=\"top\" width=\"30%\">3.54 \u2013 9.06<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/td>\n<\/tr>\n<tr>\n<td align=\"center\" style=\"background:#dce4f4;padding:0 2px;\" valign=\"top\">\n<table border=\"0\" cellpadding=\"0\" cellspacing=\"0\" width=\"100%\">\n<tbody>\n<tr>\n<td align=\"left\" style=\"color:#544F40; font-family: Arial; font-size:14px; line-height:24px; font-weight: normal\" valign=\"top\" width=\"45%\">Segmented neutrophil (%)<\/td>\n<td align=\"left\" valign=\"top\" width=\"2%\">&nbsp;<\/td>\n<td align=\"left\" style=\"color:#544F40; font-family: Arial; font-size:14px; line-height:24px; font-weight: normal\" valign=\"top\" width=\"15%\">56.7<\/td>\n<td align=\"left\" valign=\"top\" width=\"2%\">&nbsp;<\/td>\n<td align=\"left\" style=\"color:#544F40; font-family: Arial; font-size:14px; line-height:24px; font-weight: normal\" valign=\"top\" width=\"30%\">50 \u2013 70<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/td>\n<\/tr>\n<tr>\n<td align=\"center\" style=\"background:#ecf0f9;padding:0 2px;\" valign=\"top\">\n<table border=\"0\" cellpadding=\"0\" cellspacing=\"0\" width=\"100%\">\n<tbody>\n<tr>\n<td align=\"left\" style=\"color:#544F40; font-family: Arial; font-size:14px; line-height:24px; font-weight: normal\" valign=\"top\" width=\"45%\">Hemoglobin (g\/dL)<\/td>\n<td align=\"left\" valign=\"top\" width=\"2%\">&nbsp;<\/td>\n<td align=\"left\" style=\"color:#544F40; font-family: Arial; font-size:14px; line-height:24px; font-weight: normal\" valign=\"top\" width=\"15%\">17.9<\/td>\n<td align=\"left\" valign=\"top\" width=\"2%\">&nbsp;<\/td>\n<td align=\"left\" style=\"color:#544F40; font-family: Arial; font-size:14px; line-height:24px; font-weight: normal\" valign=\"top\" width=\"30%\">10.8 \u2013 14.9<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/td>\n<\/tr>\n<tr>\n<td align=\"center\" style=\"background:#dce4f4;padding:0 2px;\" valign=\"top\">\n<table border=\"0\" cellpadding=\"0\" cellspacing=\"0\" width=\"100%\">\n<tbody>\n<tr>\n<td align=\"left\" style=\"color:#544F40; font-family: Arial; font-size:14px; line-height:24px; font-weight: normal\" valign=\"top\" width=\"45%\">Creatinine clearance (ml\/min)<\/td>\n<td align=\"left\" valign=\"top\" width=\"2%\">&nbsp;<\/td>\n<td align=\"left\" style=\"color:#544F40; font-family: Arial; font-size:14px; line-height:24px; font-weight: normal\" valign=\"top\" width=\"15%\">71.2<\/td>\n<td align=\"left\" valign=\"top\" width=\"2%\">&nbsp;<\/td>\n<td align=\"left\" style=\"color:#544F40; font-family: Arial; font-size:14px; line-height:24px; font-weight: normal\" valign=\"top\" width=\"30%\">90 \u2013 139<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/td>\n<\/tr>\n<tr>\n<td align=\"center\" style=\"background:#ecf0f9;padding:0 2px;\" valign=\"top\">\n<table border=\"0\" cellpadding=\"0\" cellspacing=\"0\" width=\"100%\">\n<tbody>\n<tr>\n<td align=\"left\" style=\"color:#544F40; font-family: Arial; font-size:14px; line-height:24px; font-weight: normal\" valign=\"top\" width=\"45%\">NT-proBNP (pg\/mL)<\/td>\n<td align=\"left\" valign=\"top\" width=\"2%\">&nbsp;<\/td>\n<td align=\"left\" style=\"color:#544F40; font-family: Arial; font-size:14px; line-height:24px; font-weight: normal\" valign=\"top\" width=\"15%\">204<\/td>\n<td align=\"left\" valign=\"top\" width=\"2%\">&nbsp;<\/td>\n<td align=\"left\" style=\"color:#544F40; font-family: Arial; font-size:14px; line-height:24px; font-weight: normal\" valign=\"top\" width=\"30%\">Rule out of acute heart failure<br \/>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t(AHF): &lt;300 pg\/mL<br \/>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\tRule in AHF:<br \/>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t&lt; 50 years: &gt;450 pg\/mL<br \/>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t50 &#8211; 75 years: &gt;900 pg\/mL<br \/>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t&gt;75 years: &gt;1800 pg\/mL<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/td>\n<\/tr>\n<tr>\n<td height=\"15\" style=\"font-size:1px; line-height:1px;\">&nbsp;<\/td>\n<\/tr>\n<tr>\n<td align=\"center\" valign=\"top\">\n<table border=\"0\" cellpadding=\"0\" cellspacing=\"0\" width=\"100%\">\n<tbody>\n<tr>\n<td align=\"left\" style=\"color:#544F40; font-family: Arial; font-size:16px; line-height:24px; font-weight: normal;\" valign=\"top\" width=\"30%\"><strong>ECG<\/strong><br \/>\n\t\t\t\t\t\t\t\tNormal sinus rhythm with mild ST elevation and Q wave over II and III<\/td>\n<td align=\"left\" valign=\"top\" width=\"2%\">&nbsp;<\/td>\n<td align=\"right\" class=\"hero_image1\" valign=\"middle\" width=\"60%\"><img loading=\"lazy\" decoding=\"async\" alt=\"image\" height=\"175\" src=\"https:\/\/dianews.roche.com\/rs\/106-RRW-330\/images\/Infographic_20210322_asset_20.png\" style=\"border: none;display: block;\" width=\"365\"><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/td>\n<\/tr>\n<tr>\n<td height=\"15\" style=\"font-size:1px; line-height:1px;\">&nbsp;<\/td>\n<\/tr>\n<tr>\n<td align=\"center\" valign=\"top\">\n<table border=\"0\" cellpadding=\"0\" cellspacing=\"0\" width=\"100%\">\n<tbody>\n<tr>\n<td align=\"left\" style=\"color:#544F40; font-family: Arial; font-size:16px; line-height:24px; font-weight: normal;\" valign=\"top\" width=\"30%\"><strong>Troponin kinetic profile<\/strong><\/td>\n<td align=\"left\" valign=\"top\" width=\"2%\">&nbsp;<\/td>\n<td align=\"right\" class=\"hero_image1\" valign=\"middle\" width=\"60%\"><img loading=\"lazy\" decoding=\"async\" alt=\"image\" height=\"183\" src=\"https:\/\/dianews.roche.com\/rs\/106-RRW-330\/images\/Infographic_20210322_asset_21.png\" style=\"border: none;display: block;\" width=\"365\"><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/td>\n<\/tr>\n<tr>\n<td height=\"15\" style=\"font-size:1px; line-height:1px;\">&nbsp;<\/td>\n<\/tr>\n<tr>\n<td align=\"left\" style=\"color:#0063ac; font-family: Arial; font-size:16px; line-height:24px; font-weight: normal;\" valign=\"top\"><strong>Chest X-ray<\/strong><\/td>\n<\/tr>\n<tr>\n<td height=\"10\" style=\"font-size:1px; line-height:1px;\">&nbsp;<\/td>\n<\/tr>\n<tr>\n<td align=\"center\" class=\"hero_image1\" valign=\"middle\" width=\"560\"><img decoding=\"async\" alt=\"image\" src=\"https:\/\/dianews.roche.com\/rs\/106-RRW-330\/images\/Infographic_20210322_asset_22.png\" style=\"border: none;display: block;\" width=\"560\"><\/td>\n<\/tr>\n<tr>\n<td height=\"15\" style=\"font-size:1px; line-height:1px;\">&nbsp;<\/td>\n<\/tr>\n<tr>\n<td align=\"left\" style=\"color:#0063ac; font-family: Arial; font-size:16px; line-height:24px; font-weight: normal;\" valign=\"top\"><strong>Coronary angiography<\/strong><\/td>\n<\/tr>\n<tr>\n<td height=\"10\" style=\"font-size:1px; line-height:1px;\">&nbsp;<\/td>\n<\/tr>\n<tr>\n<td align=\"center\" class=\"hero_image1\" valign=\"middle\" width=\"560\"><img decoding=\"async\" alt=\"image\" src=\"https:\/\/dianews.roche.com\/rs\/106-RRW-330\/images\/Infographic_20210322_asset_23.png\" style=\"border: none;display: block;\" width=\"560\"><\/td>\n<\/tr>\n<tr>\n<td height=\"15\" style=\"font-size:1px; line-height:1px;\">&nbsp;<\/td>\n<\/tr>\n<tr>\n<td align=\"left\" style=\"color:#544F40; font-family: Arial; font-size:12px; line-height:20px; font-weight: normal;\" valign=\"top\"><strong>LM:<\/strong> Patent<br \/>\n\t\t\t\t<strong>LAD:<\/strong> Proximal diffuse stenosis<br \/>\n\t\t\t\t<strong>LCX:<\/strong> Proximal stenosis 40%<br \/>\n\t\t\t\t<strong>RCA:<\/strong> proximal stenosis 40%<\/td>\n<\/tr>\n<tr>\n<td height=\"15\" style=\"font-size:1px; line-height:1px;\">&nbsp;<\/td>\n<\/tr>\n<tr>\n<td><input type=\"hidden\" id=\"ays_finish_poll_8\" name=\"ays_finish_poll_8\" value=\"667c5fc5b5\" \/><input type=\"hidden\" name=\"_wp_http_referer\" value=\"\/ja\/wp-json\/wp\/v2\/posts\/3590\" \/><input type=\"hidden\" id=\"ays_finish_poll_show_res_8\" name=\"ays_finish_poll_show_res_8\" value=\"667c5fc5b5\" \/><input type=\"hidden\" name=\"_wp_http_referer\" value=\"\/ja\/wp-json\/wp\/v2\/posts\/3590\" \/><style>        #ays-poll-id-69de7a539676b.box-apm {            width: 100%;                        margin: 0 auto !important;            border-style: solid;            border-color: #ffffff;            border-radius: 0;            border-width: 0px;            box-shadow: none;background-color: #dc305f;            background-position: center center;            background-repeat: no-repeat;            background-size: cover;            max-width: 100%;            position: relative;            padding-bottom: 60px;        }        .ays-poll-id-69de7a539676b.ays-minimal-theme .apm-choosing{\t\t    display: flex;\t\t    align-items: center;\t\t}        .ays-poll-id-69de7a539676b div.ays-image-logo-show{\t\t\tposition: absolute;\t\t\tbottom: -5px;    \t\tleft: 1px;\t\t\tmargin: 2px 0 0 0;\t\t\tpadding: 2px;\t\t\twidth: 100%;\t\t\theight: 65px;\t\t\ttext-align: left;\t\t\t\t}        .ays-poll-id-69de7a539676b .ays-poll-image-logo{\t\t\twidth: 55px;\t\t\theight: 55px;\t\t}\t\t.ays-poll-id-69de7a539676b.ays-minimal-theme .apm-choosing input[type=radio]:checked + label, .ays-poll-id-69de7a539676b.ays-minimal-theme .apm-choosing label.ays_enable_hover:hover{        \tbackground-color: #ffffff !important;\t\t    color: #ffffff !important;\t\t    border-color: #ffffff !important;\t\t    font-weight: initial !important;\t\t    margin:3px 0 !important;\t\t}\t\t.ays-poll-id-69de7a539676b.ays-minimal-theme .apm-choosing input[type=radio]:checked + label *,\t\t.ays-poll-id-69de7a539676b.ays-minimal-theme .apm-choosing input[type=checkbox]:checked + label *,\t\t.ays-poll-id-69de7a539676b.ays-minimal-theme .apm-choosing label.ays_enable_hover:hover *{\t\t    color: #ffffff;\t\t}\t\t.ays-poll-id-69de7a539676b.ays-minimal-theme .apm-choosing input[type=radio]{\t\t\t\t\t\tborder-radius: 50%;\t\t\twidth: 20px;\t\t\theight: 19px;\t\t\tmargin: 3px !important;\t\t\tborder: 1px solid #1e8cbe;\t\t\topacity: 1;\t\t}\t\t.ays-poll-id-69de7a539676b.ays-minimal-theme .apm-answers .apm-choosing input[type=radio]:checked::after{\t\t\tcontent: '';\t\t\tborder-radius: 50%;\t\t\twidth: 11px;\t\t\theight: 11px;\t\t\tbackground-color: #1e8cbe;\t\t\t \t\t}\t\t.ays-poll-id-69de7a539676b.ays-minimal-theme .apm-choosing input[type=radio]:focus{\t\t\toutline-offset: 0 !important;    \t\toutline: unset !important;\t\t}\t\t.ays-poll-id-69de7a539676b.ays-minimal-theme .apm-choosing label{\t\t\tborder-color: #ffffff !important;\t\t    font-weight: initial !important;\t\t    margin:3px 0 !important;\t\t}\t\t.ays-poll-id-69de7a539676b.ays-minimal-theme .apm-choosing input[type='radio']{\t\t    display: block !important;\t\t}\t\t.ays-poll-id-69de7a539676b.ays-minimal-theme input[type='button'].ays-poll-btn:hover, .ays-poll-id-69de7a539676b.ays-minimal-theme input[type='button'].ays-poll-btn:focus{\t\t\ttext-decoration: none;\t\t}\t\t.ays-poll-id-69de7a539676b.ays-minimal-theme input[type='button'].ays-poll-btn{\t\t    color: initial !important;\t\t    background: initial !important;\t\t    border: 1px solid #ffffff;\t\t    border-radius: 3px;\t\t}\t\t.ays-poll-id-69de7a539676b.ays-minimal-theme .ays_poll_passed_count{\t\t    color: #ffffff !important;\t\t    background: initial !important;\t\t    border: 1px solid #ffffff;\t\t    border-radius: 3px;\t\t}\t\t.ays-poll-id-69de7a539676b.ays-minimal-theme .ays_poll_passed_count i.ays_poll_fa:before{\t\t    color: #ffffff !important;\t\t    \t\t}        .ays-poll-id-69de7a539676b.ays-minimal-theme .answer-percent{        \tcolor: initial !important;\t\t}        .ays-poll-id-69de7a539676b.box-apm span.ays_poll_passed_count{            background-color: #ffffff;            color: #dc305f;        }        #ays-poll-id-69de7a539676b.box-apm span.ays_poll_passed_count i{            color: #dc305f;        }        #ays-poll-id-69de7a539676b.box-apm .apm-title-box{            background-color: #dc305f;        }        .ays-poll-id-69de7a539676b .answer-percent {            background-color: #ffffff;            color: #dc305f !important;        }        .ays-poll-id-69de7a539676b .ays-poll-btn{            color: #dc305f !important;            background-color: #ffffff !important;            overflow: hidden;        }        #ays-poll-id-69de7a539676b .ays-poll-view-more-button{\t\t    border-radius: 0;\t\t}        .ays-poll-id-69de7a539676b.box-apm * {            color: #ffffff;        }        .ays-poll-id-69de7a539676b.box-apm .apm-title-box div {            color: #ffffff;            text-transform: inherit;            font-family: inherit;\t\t\t        }        #ays-poll-id-69de7a539676b.box-apm i {            color: #db305d;            font-size: 24px;            font-style: normal;                    }\t\t#ays-poll-id-69de7a539676b .ays-poll-btn{       \t\twidth: auto;\t\t\tfont-size: 17px;\t\t\tpadding: 10px 20px;\t\t\tborder-radius: 3px;\t\t\tcolor: #dc305f !important;\t\t\tbackground: #ffffff !important;\t\t\tborder: none;\t\t\tline-height: 12px !important;\t\t}\t\t#ays-poll-id-69de7a539676b .apm-add-answer input.ays-poll-new-answer-apply-text{            width: 100%;\t\t\tmargin-bottom: 0;\t\t\tmargin-right: 5px;\t\t\tborder-color: #ffffff; \t\t\tpadding: 7px;\t\t\tfont-size: 14px;\t\t\tcolor: black;\t\t\theight: 40px; \t\t\toutline: none;\t\t\tdisplay: inline-block;        }        #ays-poll-id-69de7a539676b.box-apm i.ays_poll_far{                        font-family: 'Font Awesome 5 Free';        }        #ays-poll-id-69de7a539676b.box-apm .apm-choosing .ays-poll-each-answer-list{            \t\t\twidth: initial;\t\t\ttext-align: initial;\t\t\tdisplay: initial;\t\t\tpadding: 10px;        }        #ays-poll-id-69de7a539676b.box-apm .apm-choosing .ays-poll-each-answer-grid{            \t\t\twidth: 100%;\t\t\ttext-align: left;\t\t\tdisplay: inline-block;\t\t\tword-break: break-word;        }\t\t        #ays-poll-id-69de7a539676b.box-apm .apm-choosing .ays_label_poll{            \t\t\twidth: 100%;\t\t\ttext-align: center;\t\t\tdisplay: flex;\t\t\t;\t\t\talign-items: center;\t\t\tpadding: 10px;        }        #ays-poll-id-69de7a539676b.box-apm .apm-choosing .ays-poll-each-image{            \t\t\theight: 150px;\t\t\tborder-radius: 0px;\t\t\tobject-fit: cover;        }        #ays-poll-id-69de7a539676b.box-apm .apm-choosing .ays-poll-each-image-list{\t\t\twidth: 220px;        }        #ays-poll-id-69de7a539676b.box-apm .apm-choosing .ays-poll-each-image-grid{\t\t\twidth: 100%;        }        #ays-poll-id-69de7a539676b.box-apm .apm-choosing 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flex;\t\t\twidth: 100%;        }        #ays-poll-id-69de7a539676b.box-apm .ays-poll-maker-text-answer-main input,\t\t#ays-poll-id-69de7a539676b.box-apm .ays-poll-maker-text-answer-main textarea{\t\t\tmin-width: 150px;\t\t\tmax-width: 100%;\t\t\twidth: %;        }        #ays-poll-id-69de7a539676b.box-apm .ays-poll-password-box .ays-poll-password-button-box .ays-poll-password-button{\t\t\tbackground-color: #ffffff;\t\t\tcolor: #dc305f;\t\t\tborder-color: #ffffff;\t\t\toutline: none;\t\t\tbox-shadow: unset;\t\t\tborder: 0;\t\t\ttransition: .5s;        }        #ays-poll-id-69de7a539676b.box-apm .ays-poll-password-box .ays-poll-password-button-box .ays-poll-password-button:hover{\t\t\tbackground-color: #ffffffb5;        }        #ays-poll-id-69de7a539676b.box-apm .ays-poll-password-box .ays-poll-password-input-box .ays-poll-password-input{\t\t\tborder-color: #ffffff;        }\t\t#ays-poll-id-69de7a539676b.box-apm .apm-answers .apm-choosing label.ays_label_poll{            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'none',                };            var hoverCss = {                background: '#ffffff',                color: '#dc305f',                borderColor: '#dc305f',            };        <\/script><div style='margin-bottom: 1rem;' class='ays-poll-main ' id='ays-poll-container-8' data-load-method=''>        <form style='margin-bottom: 0;' >                        <div                dir='ltr'        data-loading='load_gif'        data-load-gif='plg_default'        data-load-gif-font-size='64'                data-hide-bg-image='false'        data-gradient-check=''        data-gradient-dir='to bottom'        data-gradient-c1='#103251'        data-gradient-c2='#607593'        data-hide-bg-image-def-color='#dc305f'        data-show-social=''        class='box-apm ays-minimal-theme choosing-poll ays-poll-id-69de7a539676b '        id='ays-poll-id-69de7a539676b'        data-res='0'        data-res-sort='none'        data-restart ='false'        data-redirection = '0'        data-redirect-check = '0'        data-url-href = ''        data-href = ''        data-delay = '0'        data-id='8'        data-res-rgba = ''        data-percent-color = '#db305d'        data-enable-top-animation = ''        data-top-animation-scroll = '100'        data-info-form=''        data-enable-social-links=''        ><span class='ays_poll_passed_count'><i class='ays_poll_fa ays_poll_fa-users' aria-hidden='true'><\/i> 1<\/span><div class='ays_poll_cb_and_a'><\/div><div class='apm-title-box'><div>Prof Lee's Clinical Case - 2<\/div><\/div><div class='ays-poll-id-69de7a539676b ays_question'><p>What is the diagnosis of this case?<\/p><\/div><div class='ays-poll-id-69de7a539676b hideResults ays-poll-hide-result-box'> <\/div><div class='apm-answers apm-answers-without-submit ays_poll_list_view_container'>\t\t\t\t\t\t\t\t\t\t\t<div class='apm-choosing answer-ays-poll-id-69de7a539676b  ays-poll-field ays-poll-answer-container-list' >\t\t\t\t\t\t\t\t\t\t\t<input type=radio name='answer' id='radio-0-ays-poll-id-69de7a539676b' value='35' autocomplete=\"off\">\t\t\t\t\t\t\t\t\t\t\t<label \t\t\t\t\t\t\t\t\t\t\t\tfor='radio-0-ays-poll-id-69de7a539676b' \t\t\t\t\t\t\t\t\t\t\t\tclass='ays_label_poll   ays_enable_hover ays_label_font_size   ays-poll-answer-container-label-list' \t\t\t\t\t\t\t\t\t\t\t\tdata-answers-url=''\t\t\t\t\t\t\t\t\t\t\t> <p style='' class='ays-poll-answers'><span class='ays-poll-each-answer-grid'>Unstable Angina<\/span><\/p><\/label>\t\t\t\t\t\t\t\t\t\t\t<\/div>\t\t\t\t\t\t\t\t\t\t\t<div class='apm-choosing answer-ays-poll-id-69de7a539676b  ays-poll-field ays-poll-answer-container-list' >\t\t\t\t\t\t\t\t\t\t\t<input type=radio name='answer' id='radio-1-ays-poll-id-69de7a539676b' value='36' autocomplete=\"off\">\t\t\t\t\t\t\t\t\t\t\t<label \t\t\t\t\t\t\t\t\t\t\t\tfor='radio-1-ays-poll-id-69de7a539676b' \t\t\t\t\t\t\t\t\t\t\t\tclass='ays_label_poll   ays_enable_hover ays_label_font_size   ays-poll-answer-container-label-list' \t\t\t\t\t\t\t\t\t\t\t\tdata-answers-url=''\t\t\t\t\t\t\t\t\t\t\t> <p style='' class='ays-poll-answers'><span class='ays-poll-each-answer-grid'>AMI<\/span><\/p><\/label>\t\t\t\t\t\t\t\t\t\t\t<\/div>\t\t\t\t\t\t\t\t\t\t\t<div class='apm-choosing answer-ays-poll-id-69de7a539676b  ays-poll-field ays-poll-answer-container-list' >\t\t\t\t\t\t\t\t\t\t\t<input type=radio name='answer' id='radio-2-ays-poll-id-69de7a539676b' value='37' autocomplete=\"off\">\t\t\t\t\t\t\t\t\t\t\t<label \t\t\t\t\t\t\t\t\t\t\t\tfor='radio-2-ays-poll-id-69de7a539676b' \t\t\t\t\t\t\t\t\t\t\t\tclass='ays_label_poll   ays_enable_hover ays_label_font_size   ays-poll-answer-container-label-list' \t\t\t\t\t\t\t\t\t\t\t\tdata-answers-url=''\t\t\t\t\t\t\t\t\t\t\t> <p style='' class='ays-poll-answers'><span class='ays-poll-each-answer-grid'>Tachyarrhythmias<\/span><\/p><\/label>\t\t\t\t\t\t\t\t\t\t\t<\/div>\t\t\t\t\t\t\t\t\t\t\t<div class='apm-choosing answer-ays-poll-id-69de7a539676b  ays-poll-field ays-poll-answer-container-list' >\t\t\t\t\t\t\t\t\t\t\t<input type=radio name='answer' id='radio-3-ays-poll-id-69de7a539676b' value='38' autocomplete=\"off\">\t\t\t\t\t\t\t\t\t\t\t<label \t\t\t\t\t\t\t\t\t\t\t\tfor='radio-3-ays-poll-id-69de7a539676b' \t\t\t\t\t\t\t\t\t\t\t\tclass='ays_label_poll   ays_enable_hover ays_label_font_size   ays-poll-answer-container-label-list' \t\t\t\t\t\t\t\t\t\t\t\tdata-answers-url=''\t\t\t\t\t\t\t\t\t\t\t> <p style='' class='ays-poll-answers'><span class='ays-poll-each-answer-grid'>Myopericarditis<\/span><\/p><\/label>\t\t\t\t\t\t\t\t\t\t\t<\/div><\/div><div class='apm-cashed-fa'><div>                                <i class='ays_poll_fas ays_poll_fa-star' style='font-size: 0'><\/i>                            <\/div><div>                                <i class='ays_poll_fas ays_poll_fa-star' style='font-size: 0'><\/i>                            <\/div><div>                                <i class='ays_poll_fas ays_poll_fa-star' style='font-size: 0'><\/i>                            <\/div><div>                                <i class='ays_poll_fas ays_poll_fa-star' style='font-size: 0'><\/i>                            <\/div><\/div><input type=\"hidden\" id=\"ays_finish_poll_show_res_8\" name=\"ays_finish_poll_show_res_8\" value=\"667c5fc5b5\" \/><input type=\"hidden\" name=\"_wp_http_referer\" value=\"\/ja\/wp-json\/wp\/v2\/posts\/3590\" \/><div class='apm-button-box'><input type='button' \t                    name='ays_finish_poll'\t                    class='btn ays-poll-btn choosing-btn ays_finish_poll'\t                    data-form='ays-poll-id-69de7a539676b'\t                    value=\"Vote\"\t                    ><\/div><div class='apm-title-box ays_res_mess'> <\/div><script>\t\t\t\tif(typeof aysPollOptions === 'undefined'){\t\t\t\t\tvar aysPollOptions = [];\t\t\t\t}\t\t\t\taysPollOptions['ays-poll-id-69de7a539676b']  = 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class=\"readmorebtnPoll3\">\n<td>\n<div class=\"wp-block-buttons\">\n<div class=\"wp-block-button readmorebtnPoll3\">\n\t\t\t\t\t\t\t<a class=\"wp-block-button__link\">Click to reveal the answer<\/a>\n\t\t\t\t\t\t<\/div>\n<\/p><\/div>\n<p>\t\t\t\t\t<script type=\"text\/javascript\">\n\t\t\t\t\t                                   $(document).ready(function() {\n\t\t\t\t\t                                   $(\".answer3\").hide();\n\t\t\t\t\t                                   });\n\t\t\t\t\t                                   $(\".readmorebtnPoll3\").click(function() {\n\t\t\t\t\t$(\".readmorebtnPoll3\").hide();                                      \n\t\t\t\t\t                                   $(\".answer3\").show(500);\n\t\t\t\t\t                                   });\n\t\t\t\t\t<\/script>\n\t\t\t\t<\/td>\n<\/tr>\n<tr class=\"answer3\">\n<td height=\"15\" style=\"font-size:1px; line-height:1px;\">&nbsp;<\/td>\n<\/tr>\n<tr class=\"answer3\">\n<td align=\"left\" style=\"color:#0063ac; font-family: Arial; font-size:16px; line-height:24px; font-weight: normal;\" valign=\"top\"><strong>Diagnosis<\/strong><\/td>\n<\/tr>\n<tr class=\"answer3\">\n<td align=\"left\" style=\"color:#544F40; font-family: Arial; font-size:16px; line-height:24px; font-weight: normal;\" valign=\"top\" width=\"30%\"><strong>Acute myocardial infarction\/Strict Posterior Infarction<\/strong><\/td>\n<\/tr>\n<tr class=\"answer3\">\n<td height=\"10\" style=\"font-size:1px; line-height:1px;\">&nbsp;<\/td>\n<\/tr>\n<tr class=\"answer3\">\n<td align=\"left\" style=\"padding-bottom:4px;\" valign=\"top\">\n<table border=\"0\" cellpadding=\"0\" cellspacing=\"0\" width=\"100%\">\n<tbody>\n<tr>\n<td align=\"left\" valign=\"middle\">\n<table align=\"center\" border=\"0\" cellpadding=\"0\" cellspacing=\"0\" width=\"100%\">\n<tbody>\n<tr>\n<td align=\"left\" style=\"font-family: Arial; font-size: 11px; font-weight: normal; color: #544F40; line-height: 16px; text-align: left;\" valign=\"top\" width=\"8\"><strong>\u2022<\/strong><\/td>\n<td align=\"left\" style=\"font-family: Arial; font-size: 13px; font-weight: normal; color:#544F40; line-height: 18px; text-align: left;\" valign=\"top\">Typical chest pain symptom.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/td>\n<\/tr>\n<tr class=\"answer3\">\n<td align=\"left\" style=\"padding-bottom:4px;\" valign=\"top\">\n<table border=\"0\" cellpadding=\"0\" cellspacing=\"0\" width=\"100%\">\n<tbody>\n<tr>\n<td align=\"left\" valign=\"middle\">\n<table align=\"center\" border=\"0\" cellpadding=\"0\" cellspacing=\"0\" width=\"100%\">\n<tbody>\n<tr>\n<td align=\"left\" style=\"font-family: Arial; font-size: 11px; font-weight: normal; color: #544F40; line-height: 16px; text-align: left;\" valign=\"top\" width=\"8\"><strong>\u2022<\/strong><\/td>\n<td align=\"left\" style=\"font-family: Arial; font-size: 13px; font-weight: normal; color:#544F40; line-height: 18px; text-align: left;\" valign=\"top\">ST segment elevation in III and avF lead. Strict posterior leads not registered. Probably missed strict posterior MI and inferior involvement possible.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/td>\n<\/tr>\n<tr class=\"answer3\">\n<td align=\"left\" style=\"padding-bottom:4px;\" valign=\"top\">\n<table border=\"0\" cellpadding=\"0\" cellspacing=\"0\" width=\"100%\">\n<tbody>\n<tr>\n<td align=\"left\" valign=\"middle\">\n<table align=\"center\" border=\"0\" cellpadding=\"0\" cellspacing=\"0\" width=\"100%\">\n<tbody>\n<tr>\n<td align=\"left\" style=\"font-family: Arial; font-size: 11px; font-weight: normal; color: #544F40; line-height: 16px; text-align: left;\" valign=\"top\" width=\"8\"><strong>\u2022<\/strong><\/td>\n<td align=\"left\" style=\"font-family: Arial; font-size: 13px; font-weight: normal; color:#544F40; line-height: 18px; text-align: left;\" valign=\"top\">Coronary angiography showed stenosis in left circumflex artery.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/td>\n<\/tr>\n<tr class=\"answer3\">\n<td height=\"15\" style=\"font-size:1px; line-height:1px;\">&nbsp;<\/td>\n<\/tr>\n<tr class=\"answer3\">\n<td align=\"left\" style=\"color:#0063ac; font-family: Arial; font-size:16px; line-height:24px; font-weight: normal;\" valign=\"top\"><strong>Author\u2019s opinion<\/strong><\/td>\n<\/tr>\n<tr class=\"answer3\">\n<td height=\"15\" style=\"font-size:1px; line-height:1px;\">&nbsp;<\/td>\n<\/tr>\n<tr class=\"answer3\">\n<td align=\"left\" style=\"padding-bottom:4px;\" valign=\"top\">\n<table border=\"0\" cellpadding=\"0\" cellspacing=\"0\" width=\"100%\">\n<tbody>\n<tr>\n<td align=\"left\" valign=\"middle\">\n<table align=\"center\" border=\"0\" cellpadding=\"0\" cellspacing=\"0\" width=\"100%\">\n<tbody>\n<tr>\n<td align=\"left\" style=\"font-family: Arial; font-size: 11px; font-weight: normal; color: #544F40; line-height: 16px; text-align: left;\" valign=\"top\" width=\"8\"><strong>\u2022<\/strong><\/td>\n<td align=\"left\" style=\"font-family: Arial; font-size: 13px; font-weight: normal; color:#544F40; line-height: 18px; text-align: left;\" valign=\"top\">This is a good example why an initially very high cTnT-hs qualifies for rule-in of myocardial infarction.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/td>\n<\/tr>\n<tr class=\"answer3\">\n<td align=\"left\" style=\"padding-bottom:4px;\" valign=\"top\">\n<table border=\"0\" cellpadding=\"0\" cellspacing=\"0\" width=\"100%\">\n<tbody>\n<tr>\n<td align=\"left\" valign=\"middle\">\n<table align=\"center\" border=\"0\" cellpadding=\"0\" cellspacing=\"0\" width=\"100%\">\n<tbody>\n<tr>\n<td align=\"left\" style=\"font-family: Arial; font-size: 11px; font-weight: normal; color: #544F40; line-height: 16px; text-align: left;\" valign=\"top\" width=\"8\"><strong>\u2022<\/strong><\/td>\n<td align=\"left\" style=\"font-family: Arial; font-size: 13px; font-weight: normal; color:#544F40; line-height: 18px; text-align: left;\" valign=\"top\">The patient had late onset of chest pain and presented with very high concentration of cTnT-hs at admission. Mueller-Hennessen et al study showed diagnostic performance was not further improved with repeat troponin testing when baseline cTnT-hs concentration &gt; 80 ng\/L.<font style=\"font-size:9px;line-height:9px;vertical-align:5px;\">11<\/font><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/td>\n<\/tr>\n<tr class=\"answer3\">\n<td align=\"left\" style=\"padding-bottom:4px;\" valign=\"top\">\n<table border=\"0\" cellpadding=\"0\" cellspacing=\"0\" width=\"100%\">\n<tbody>\n<tr>\n<td align=\"left\" valign=\"middle\">\n<table align=\"center\" border=\"0\" cellpadding=\"0\" cellspacing=\"0\" width=\"100%\">\n<tbody>\n<tr>\n<td align=\"left\" style=\"font-family: Arial; font-size: 11px; font-weight: normal; color: #544F40; line-height: 16px; text-align: left;\" valign=\"top\" width=\"8\"><strong>\u2022<\/strong><\/td>\n<td align=\"left\" style=\"font-family: Arial; font-size: 13px; font-weight: normal; color:#544F40; line-height: 18px; text-align: left;\" valign=\"top\">Therefore, in chest pain patients with highly abnormal cTnT-hs concentrations at presentation, subsequent blood draws may not be required due to high PPV with single cTnT-hs result at admission. This is in line with current European Society of Cardiology guideline recommendation.<font style=\"font-size:9px;line-height:9px;vertical-align:5px;\">2<\/font><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/td>\n<\/tr>\n<tr class=\"answer3\">\n<td height=\"15\" style=\"font-size:1px; line-height:1px;\">&nbsp;<\/td>\n<\/tr>\n<tr class=\"answer3\">\n<td height=\"20\" style=\"font-size:1px; line-height:1px;\">&nbsp;<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/div><\/div><\/div>\n\t<\/p><\/div>\n","protected":false},"excerpt":{"rendered":"<p>\u81e8\u5e8a\u75c7\u4f8b\u306e\u8a73\u7d30\u3092\u63d0\u793a\u3057\u3066\u3044\u307e\u3059\u3002\u4ee5\u4e0b\u306e\u3046\u3061\u6700\u3082\u53ef\u80fd\u6027\u306e\u9ad8\u3044\u8a3a\u65ad\u3092\u9078\u629e\u3057\u3066\u304f\u3060\u3055\u3044\u3002 \u8a3a\u65ad\u304a\u3088\u3073Dr Lee\u306e\u898b\u89e3\u306b\u95a2\u3059\u308b\u8a73\u7d30\u306f\u3001\u300c\u30af\u30ea\u30c3\u30af\u3057\u3066\u56de\u7b54\u3092\u8868\u793a\u300d\u30dc\u30bf\u30f3\u3092\u30af\u30ea\u30c3\u30af\u3057\u3066\u3054\u78ba\u8a8d\u304f\u3060\u3055\u3044\u3002 \u9ad8\u611f\u5ea6\u30c8\u30ed\u30dd\u30cb\u30f3T\uff08hs-TnT\uff09\u304c\u6162\u6027\u7684\u306b\u4e0a\u6607\u3057\u3066\u3044\u308b\u975e\u6025\u6027\u5fc3\u7b4b\u6897\u585e\u306e\u75c7\u4f8b\u306b\u3064\u3044\u3066\u306f\u3001\u3053\u3053\u3092\u30af\u30ea\u30c3\u30af\u3057\u3066\u304f\u3060\u3055\u3044\u3002 \u4ee5\u4e0b\u306e\u30bf\u30d6\u3092\u30af\u30ea\u30c3\u30af\u3059\u308b\u3068\u3001\u75c7\u4f8b\u304c\u5207\u308a\u66ff\u308f\u308a\u307e\u3059\u3002 [&#8230;]<\/p>\n<p><a class=\"btn btn-secondary understrap-read-more-link\" href=\"https:\/\/cardiothinklab.com\/ja\/dr-lee-chien-changs-clinical-cases-on-hs-tnt-assays-part-1\/\">Read More&#8230;<\/a><\/p>\n","protected":false},"author":3,"featured_media":2918,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[323,273,234],"tags":[],"specialty":[694],"class_list":["post-3590","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-323","category-cardiology-cme","category-234","specialty-cardiovascular-ja"],"acf":[],"_links":{"self":[{"href":"https:\/\/cardiothinklab.com\/ja\/wp-json\/wp\/v2\/posts\/3590","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/cardiothinklab.com\/ja\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/cardiothinklab.com\/ja\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/cardiothinklab.com\/ja\/wp-json\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/cardiothinklab.com\/ja\/wp-json\/wp\/v2\/comments?post=3590"}],"version-history":[{"count":3,"href":"https:\/\/cardiothinklab.com\/ja\/wp-json\/wp\/v2\/posts\/3590\/revisions"}],"predecessor-version":[{"id":3738,"href":"https:\/\/cardiothinklab.com\/ja\/wp-json\/wp\/v2\/posts\/3590\/revisions\/3738"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/cardiothinklab.com\/ja\/wp-json\/wp\/v2\/media\/2918"}],"wp:attachment":[{"href":"https:\/\/cardiothinklab.com\/ja\/wp-json\/wp\/v2\/media?parent=3590"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/cardiothinklab.com\/ja\/wp-json\/wp\/v2\/categories?post=3590"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/cardiothinklab.com\/ja\/wp-json\/wp\/v2\/tags?post=3590"},{"taxonomy":"specialty","embeddable":true,"href":"https:\/\/cardiothinklab.com\/ja\/wp-json\/wp\/v2\/specialty?post=3590"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}