thanks for the lecture...very informative and detailed. I had the test done here recently in our er and it saved my life! so I am most interested in your work and analysis...keep it up!
Small rise in Trop in 2hrs ER Couldn't determine a Heart attack. Suggested broken heart syndrome due to a death. Maybe that's why ER referred patient to cardiologist for further testing and why cardiologist tests was scheduled weeks out. Still waiting to go to stress/ nuclear tests. Thanks for info. Trying to stay positive
4 to 5 in a week or two... stays at 4a week or two ago, then tests at 5 with cardiac symptoms and atrial flutter on EKG. The new testing seems to be causing more confusion than not, unless it is clear from other signs and symptoms that either it's an MI or not. Ultra sensitive troponin levels in a couple of hours in an ED may not show any changes, yet there can still be major symptoms, abnormal troponin levels in blood samples, especially chronic tachycardia and/or bradycardia. It seems there is far, far too much emphasis on troponin levels and not enough time in an ED to see changes that are important. To send a patient on their way without followup is likely to result in a catostraphic event, yet reliance on troponin level changes in an ED is not advisable. Find out what is causing the problem. Having a test with so many false positives or negatives, as you said, you may as well flip a coin to guess.. 50-50% chance of an MI or not, yet the patients come in with symptoms. It may not be a cardiac problem, but you should be aware of what brought a person to the ED, and be able to make a diagnosis, and not leave a patient with very comcerning symptoms and no answers. Keep in mind that different tests have different reference ranges as well. Here, we have
Thanks for your comment! You’re right about other causes but the key is to remember that troponin is just a marker of myocardial injury. There are many other problems that don’t cause injury to the myocardium, so we can’t expect troponin to detect them. It’s not a failure of the test - more a matter of understanding the test and it’s role. Troponin is extremely helpful to detect myocardial injury and myocardial infarction - we just couldn’t detect many of the conditions we can now with high-sensitivity troponin assays. However, you’re absolutely right that it is just a blood test for one thing - and therefore only one part of a more holistic evaluation, which is crucial for every patient encounter.
Thank you for this video, I’d love to know why Cardiologist say “don’t worry” when I’ve consistently had mildly raised Troponins for the past year or so - but ….ECG , Cardisc MRI , CT angiogram show heart is fine no damage?
@@irineojason thing is it changes in different country and even within country different hospitals so in lines the heart attack number was >30 and I had 33
Probably. It depends on the particular test (assay) and the units that this was measured in. 4.5ng/L would be within normal for every commercially available assay at the moment. However, 4.5 micrograms per litre would be very high.
thanks for the lecture...very informative and detailed. I had the test done here recently in our er and it saved my life! so I am most interested in your work and analysis...keep it up!
Very useful 🙏🙏🙏🙏Thank you very much 🌹
Thank you!
Thank you very much for this great explanation.
👍👍👍👍👍👏👏👏👏👏
Small rise in Trop in 2hrs ER
Couldn't determine a Heart attack. Suggested broken heart syndrome due to a death.
Maybe that's why ER referred patient to cardiologist for further testing and why cardiologist tests was scheduled weeks out. Still waiting to go to stress/ nuclear tests. Thanks for info. Trying to stay positive
I’m sorry to hear about that. I hope it all goes well for you from here.
4 to 5 in a week or two... stays at 4a week or two ago, then tests at 5 with cardiac symptoms and atrial flutter on EKG.
The new testing seems to be causing more confusion than not, unless it is clear from other signs and symptoms that either it's an MI or not.
Ultra sensitive troponin levels in a couple of hours in an ED may not show any changes, yet there can still be major symptoms, abnormal troponin levels in blood samples, especially chronic tachycardia and/or bradycardia.
It seems there is far, far too much emphasis on troponin levels and not enough time in an ED to see changes that are important.
To send a patient on their way without followup is likely to result in a catostraphic event, yet reliance on troponin level changes in an ED is not advisable.
Find out what is causing the problem.
Having a test with so many false positives or negatives, as you said, you may as well flip a coin to guess.. 50-50% chance of an MI or not, yet the patients come in with symptoms. It may not be a cardiac problem, but you should be aware of what brought a person to the ED, and be able to make a diagnosis, and not leave a patient with very comcerning symptoms and no answers.
Keep in mind that different tests have different reference ranges as well. Here, we have
Thanks for your comment! You’re right about other causes but the key is to remember that troponin is just a marker of myocardial injury. There are many other problems that don’t cause injury to the myocardium, so we can’t expect troponin to detect them. It’s not a failure of the test - more a matter of understanding the test and it’s role.
Troponin is extremely helpful to detect myocardial injury and myocardial infarction - we just couldn’t detect many of the conditions we can now with high-sensitivity troponin assays.
However, you’re absolutely right that it is just a blood test for one thing - and therefore only one part of a more holistic evaluation, which is crucial for every patient encounter.
Thank you for this video, I’d love to know why Cardiologist say “don’t worry” when I’ve consistently had mildly raised Troponins for the past year or so - but ….ECG , Cardisc MRI , CT angiogram show heart is fine no damage?
Like what?
How mild?
@@irineojason pretty mild
Do you know the the number? I had elevated troponin of 0.26 ng/mL (Normal is 0.04
@@irineojason thing is it changes in different country and even within country different hospitals so in lines the heart attack number was >30 and I had 33
Excellent talk thanks so much
4.50 result of high sensitive troponin T is normal?
Probably. It depends on the particular test (assay) and the units that this was measured in. 4.5ng/L would be within normal for every commercially available assay at the moment. However, 4.5 micrograms per litre would be very high.
Aaaaand, fun as f*ck…
😂…, 👍 great