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FACP. Colegio de médicos de Tarragona Nº 4305520 / fgcapriles@gmail.com




Monday, April 2, 2012

Elevación de troponinas sin isquemia cardíaca aparente

Troponin elevation without overt cardiac ischemia
Tomado del capítulo: Biomarkers in risk stratification
W. Frank Peacock IV, MD Vice-Chair Emergency Services Institute
Cleveland Clinic - Cleveland, Ohio
A Self-Study Accredited Monograph:  Improving Efficiencies Within the Emergency Department:  A Rapid, Serial, Multimarker Approach for Managing Acute Coronary Syndrome.
Supported by an educational grant from Alere

• Congestive heart failure
• Hypertrophic obstructive cardiomyopathy with significant left ventricular hypertrophy
• Pulmonary embolism, severe pulmonary hypertension
• Renal failure
• Sepsis
• Myocarditis (e.g., Parvovirus B19, Kawasaki disease, sarcoid, smallpox vaccination)
• Myocardial extension of bacterial endocarditis
• Aortic valve disease
• Hypothyroidism
• Myocardial trauma: contusion, ablation, pacing, ICD firings, cardioversion, endomyocardial biopsy, cardiac surgery, interventional closure of ASDs
• Post percutaneous coronary intervention patients who appear to be uncomplicated
• Hypertensive emergencies
• Hypotension, often with arrhythmias
• Postoperative noncardiac surgery patients who seem to do well
• Critically ill patients, esp with diabetes, respiratory failure, GI bleeding, sepsis
• Drug toxicity (e.g., doxorubicin, 5-flurouracil, trastuzumab)
• Snake venom exposure
• Carbon monoxide poisoning
• Abnormalities in coronary vasomotion, including coronary vasospasm
• Apical ballooning syndrome
• Inflammatory diseases
• Burns, especially if exceed > 30% of body surface area
• Infiltrative diseases including amyloidosis, hemachromatosis, sarcoidosis and scleroderma
• Acute neurological disease
• Cerebrovascular accident, subarchnoid bleeds
• Rhabdomyolysis with cardiac injury
• Transplant vasculopathy
• Vital exhaustion