Amle Dnyanesh, Patil Nilaya, Sakarde Apurva, John Dr Jyoti, Mehra Bhupendra
Biochemistry, All India Institute of Medical Sciences, Nagpur, Nagpur, IND.
General Surgery, All India Institute of Medical Sciences, Nagpur, Nagpur, IND.
Cureus. 2022 Dec 31;14(12):e33194. doi: 10.7759/cureus.33194. eCollection 2022 Dec.
Cardiac troponin I (cTnI) is regarded as a gold standard investigation for the diagnosis of acute myocardial infarction (AMI). However, cTnI may be elevated in certain non-AMI cardiac conditions and even in certain noncardiac conditions. We report a case of a young female presenting with symptoms suggestive of acute cholecystitis with elevated high-sensitive cardiac troponin I (hs-cTnI). The patient developed acute chest pain during the hospital stay. On evaluation, quantitative assay for hs-cTnI was found to be elevated; however, other markers of cardiac damage such as creatinine kinase-MB (CK-MB), qualitative cTnI by card test, and even echocardiogram (ECG) were found to be negative. As the patient was a young female with no significant history of coronary diseases, the spurious elevation of hs-TnI due to a noncardiac ailment was suspected. The patient was managed with minimal cardiological management till AMI was excluded. The hs-cTnI levels returned to normal post-cholecystectomy. A patient presenting with symptoms suggestive of cholecystitis and elevated hs-cTnI must be carefully evaluated before resorting to any invasive management for AMI. In most cases, hs-cTnI will return to normal post-cholecystectomy.
心肌肌钙蛋白I(cTnI)被视为诊断急性心肌梗死(AMI)的金标准检查项目。然而,cTnI在某些非AMI的心脏疾病中甚至在某些非心脏疾病中也可能升高。我们报告一例年轻女性病例,该患者表现出提示急性胆囊炎的症状,同时高敏心肌肌钙蛋白I(hs-cTnI)升高。患者在住院期间出现急性胸痛。经评估,发现hs-cTnI定量检测升高;然而,其他心脏损伤标志物如肌酸激酶同工酶(CK-MB)、通过卡片检测的定性cTnI,甚至超声心动图(ECG)均为阴性。由于该患者是一名无明显冠心病病史的年轻女性,怀疑hs-TnI因非心脏疾病而出现假性升高。在排除AMI之前,对该患者进行了最小限度的心脏治疗。胆囊切除术后hs-cTnI水平恢复正常。对于出现提示胆囊炎症状且hs-cTnI升高的患者,在采取任何针对AMI的侵入性治疗之前,必须进行仔细评估。在大多数情况下,胆囊切除术后hs-cTnI会恢复正常。