Manjunath Lakshman, Yeluru Apurva, Rodriguez Fatima
Department of Medicine, Stanford University, Stanford, CA, USA.
Division of Cardiovascular Medicine, Department of Medicine, Stanford University, Stanford, CA, USA.
Cardiol Ther. 2018 Dec;7(2):197-204. doi: 10.1007/s40119-018-0120-3. Epub 2018 Oct 26.
In this case report, we describe a young athletic male with a family history of early sudden cardiac death who presented with atypical chest pain and was found to have a positive serum troponin. Although his symptoms resolved without intervention, workup revealed hypertension, hyperlipidemia, mild left ventricular hypertrophy, non-obstructive coronary artery disease, and the presence of serum heterophile antibodies. Ultimately, it was concluded that his rigorous exercise regimen as well as the presence of heterophile antibodies may have contributed to his positive serum troponin. This case serves as a reminder of the nonspecific diagnostic value of modern troponin assays, and that the results of these tests should always be incorporated into the clinical context.
在本病例报告中,我们描述了一名有早发性心源性猝死家族史的年轻男性运动员,他出现非典型胸痛,血清肌钙蛋白呈阳性。尽管未经干预其症状就已缓解,但检查发现他患有高血压、高脂血症、轻度左心室肥厚、非阻塞性冠状动脉疾病以及血清嗜异性抗体阳性。最终得出结论,他严格的运动方案以及嗜异性抗体的存在可能导致了他血清肌钙蛋白呈阳性。该病例提醒人们现代肌钙蛋白检测的非特异性诊断价值,并且这些检测结果应始终结合临床情况综合考虑。