University of Kentucky, Lexington, Kentucky, USA
University of Kentucky, Lexington, Kentucky, USA.
BMJ Case Rep. 2023 Jun 19;16(6):e255312. doi: 10.1136/bcr-2023-255312.
Troponins are an excellent sensitive marker for myocardial ischaemic damage. However, there are several non-ischaemic cardiac and non-cardiac reasons for troponin elevation. Many cases of troponin T elevation and some troponin I cases have been reported in the literature due to inflammatory muscle disease. Here, we report a woman in her 50s who initially presents with fatigue and weakness, and is found to have elevated troponin T. The patient was appropriately worked up for cardiac causes with ECG and echocardiogram. She had positive antinuclear antibodies, antineutrophil cytoplasmic antibody and myositis panel. The elevation of troponins was attributed to polymyositis and treated with methotrexate and prednisone with recovery of patient's symptoms. This article emphasises the struggle of diagnosis in a patient with no reported medical history, having low to moderate risk of silent myocardial infarction.
肌钙蛋白是心肌缺血损伤的一个极好的敏感标志物。然而，肌钙蛋白升高有几个非缺血性心脏和非心脏原因。文献中有许多肌钙蛋白 T 升高和一些肌钙蛋白 I 升高的病例是由于炎症性肌肉疾病引起的。在这里，我们报告了一位 50 多岁的女性，最初表现为疲劳和虚弱，发现肌钙蛋白 T 升高。患者因心脏原因进行了心电图和超声心动图检查。她的抗核抗体、抗中性粒细胞胞浆抗体和肌炎谱呈阳性。肌钙蛋白的升高归因于多发性肌炎，并用甲氨蝶呤和泼尼松治疗，患者的症状得到了恢复。本文强调了在没有报告病史、有低到中度无症状心肌梗死风险的患者中进行诊断的困难。
