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肌钙蛋白显著升高伴胸痛:谨防假阳性。

Chest Pain With Significantly Elevated Troponins: Be Wary of False Positives.

作者信息

Narayanan Taarunya T, Naneishvili Tamara, Moody William, Townend John, Ludman Peter

机构信息

Department of Cardiology, Queen Elizabeth Hospital, Birmingham, GBR.

出版信息

Cureus. 2025 Jan 6;17(1):e77018. doi: 10.7759/cureus.77018. eCollection 2025 Jan.

Abstract

High-sensitivity cardiac troponins are considered a gold standard for diagnosing acute myocardial infarction and myocardial injury. However, the occurrence of false positives needs to be kept in mind.  We describe the clinical challenges in diagnosing a 45-year-old woman who repeatedly presented to the emergency department with atypical chest pain and extremely elevated high sensitivity troponin I (HsTnI), despite normal imaging including cardiac MRIs and invasive coronary angiograms, on multiple occasions.  This report emphasizes the importance of carefully interpreting elevated troponin levels, especially when clinical findings and further investigations do not support a cardiac origin for troponin (Tn) elevation.

摘要

高敏心肌肌钙蛋白被视为诊断急性心肌梗死和心肌损伤的金标准。然而,需要牢记假阳性的发生情况。我们描述了一名45岁女性的诊断过程中的临床挑战,该患者多次因非典型胸痛和高敏肌钙蛋白I(HsTnI)极度升高而前往急诊科就诊,尽管包括心脏磁共振成像和有创冠状动脉造影在内的多项影像学检查结果均正常。本报告强调了仔细解读升高的肌钙蛋白水平的重要性,尤其是当临床发现和进一步检查不支持肌钙蛋白(Tn)升高源于心脏时。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e66f/11706620/c47083230427/cureus-0017-00000077018-i01.jpg

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