Lahat Yael, Shiloah Eli, Rapoport Micha
Internal Medicine Department "C", Assaf Harofe Medical Center, Zerifin.
Harefuah. 2009 Jun;148(6):359-61, 413.
A 58 year old male patient was hospitalized numerous times due to an elevated troponin I level in spite of the absence of specific chest pain and ischemic changes on ECG. The patient had undergone two coronary angiography procedures and numerous cardiac studies without evidence of ischemic heart disease. The elevated troponin level remained unchanged in between hospitalizations while the patient was asymptomatic. Further workup revealed that the troponin I level was normal when tested with an alternative laboratory kit. The troponin T level was also normal. This case report underscores the problematic nature of relying on an elevated troponin level as the sole component in the diagnosis of coronary disease.
一名58岁男性患者,尽管没有特定的胸痛症状且心电图无缺血性改变,但肌钙蛋白I水平升高,因此多次住院治疗。该患者已接受两次冠状动脉造影检查及多项心脏检查,均未发现缺血性心脏病的证据。在住院期间,患者无症状,但肌钙蛋白水平一直居高不下。进一步检查发现,使用另一种实验室检测试剂盒检测时,肌钙蛋白I水平正常。肌钙蛋白T水平也正常。本病例报告强调了仅依靠肌钙蛋白水平升高作为冠心病诊断唯一依据的问题所在。