Serial testing of hs cTn rules out low risk of AMI

Clinical Cases

Cardiology CME/CE Webinar

high sensitive troponin

troponin

unstable angina

Dr Evangelos Giannitsis Cardiologist, Medical Director of Chest Pain Unit, University Hospital of Heidelberg, Germany

Dr Hugo Katus Medical Director, Dept. of Cardiology, Angiology, and Pneumology, Heidelberg University Hospital, Germany

22 October 2020

Key Takeaways

hs-TnT change may be able to rule out low risk of AMI
Serial hs- Tn needs to be done to make the final diagnosis of AMI
Diagnosis of AMI should take into consideration the entire clinical context

Click to reveal the answer

Diagnosis

Unstable angina pectoris with typical signs and symptoms, typical risk factors for coronary heart disease (CHD), normal 12-lead ECG, no indicative laboratory changes. The cTnT-hs concentration was repeatedly below the 99 percentile cut-off value (<14 ng/L).

Coronary angiography revealed several significant sub-occlusive stenoses of the right coronary artery (RCA)

Conclusion

There is no rise or fall in cTnT-hs values needed for AMI diagnosis.

References

DOI: 10.1161/01.CIR.73.3.418
Circulation, 1985 Apr;71(4):699-708. doi: 10.1161/01.cir.71.4.699