Miranda Rafael C, Machado Maurício de N, Takakura Isabela T, da Mata Paula F, da Fonseca Carlos Guilherme B, Mouco Osana M C C, Hernandes Mauro E, Lemos Maria Angélica B T, Maia Lília N
Hospital de Base Coronary Care Unit, Cardiology and Cardiovascular Surgery Department, São José do Rio Preto Medical School, São José do Rio Preto, Brazil.
Cardiology. 2006;106(1):10-3. doi: 10.1159/000092449. Epub 2006 Apr 3.
The European Society of Cardiology and the American College of Cardiology redefined the concept of myocardial infarction in the presence of highly positive markers of myocardial injury associated with at least one of the following: ischemic symptoms; development of pathologic Q waves on the ECG or ECG changes indicative of ischemia (positive or negative deviation of the ST segment), making troponins one of the most important aspects in the evaluation and stratification of patients with chest pain in the emergency room. However, although troponin gives excellent accuracy in the identification of myocardial necrosis, it is known that it can also be elevated in a series of nonatherosclerotic heart diseases. We present the case of a 49-year-old female patient admitted to the Chest Pain Unit with a history of supraventricular tachycardia associated with chest discomfort, nausea and diaphoresis. During risk stratification, the patient presented with a high serum troponin T level (0.143 ng/ml) but with a normal coronary angiography.
欧洲心脏病学会和美国心脏病学会重新定义了心肌梗死的概念，即在存在与以下至少一项相关的高度阳性心肌损伤标志物时：缺血症状；心电图上出现病理性Q波或提示缺血的心电图改变（ST段正向或负向偏移），这使得肌钙蛋白成为急诊室胸痛患者评估和分层中最重要的方面之一。然而，尽管肌钙蛋白在识别心肌坏死方面具有出色的准确性，但众所周知，它在一系列非动脉粥样硬化性心脏病中也可能升高。我们报告一例49岁女性患者，因室上性心动过速病史伴胸部不适、恶心和出汗入住胸痛病房。在风险分层过程中，该患者血清肌钙蛋白T水平较高（0.143 ng/ml），但冠状动脉造影正常。
