Department of Cardiology and Angiology, St. Josefskrankenhaus Heidelberg, Heidelberg, Germany.
Perm J. 2020 Dec;25:1. doi: 10.7812/TPP/20.180.
The electrocardiogram (ECG) is the key player in the diagnosis of an acute coronary syndrome. In the light of normal ECG findings, the diagnosis can be missed. The high-sensitive troponin is a necessary laboratory value for patients with uncommon symptoms.
A 53-year-old man without a history of coronary heart disease initially presented to his general practitioner with persistent hiccups for 3 weeks. In the emergency department, the patient complained of nausea and burping. The high-sensitive troponin T was 989 pg/mL and led to the diagnosis of an acute coronary syndrome.
The troponin algorithm helps to identify this patient group, especially in the setting of elevated creatine kinase and lactate dehydrogenase. Awareness of these symptoms can help lead to a timely reperfusion therapy and thus improved outcomes. The 2015 European Society of Cardiology algorithm for troponin may not only help for the initial diagnosis, but rather should be regarded as crucial.
心电图（ECG）是诊断急性冠状动脉综合征的关键。在正常心电图结果的情况下，可能会漏诊。高敏肌钙蛋白是症状不常见的患者的必要实验室值。
一名 53 岁男性，无冠心病病史，最初因持续打嗝 3 周就诊于全科医生。在急诊科，患者主诉恶心和打嗝。高敏肌钙蛋白 T 为 989pg/ml，导致急性冠状动脉综合征的诊断。
肌钙蛋白算法有助于识别此类患者群体，特别是在肌酸激酶和乳酸脱氢酶升高的情况下。对这些症状的认识有助于及时进行再灌注治疗，从而改善预后。2015 年欧洲心脏病学会肌钙蛋白算法不仅有助于初始诊断，而且应被视为至关重要。
