Myasthenia gravis. A potential cause of false positively elevated troponin T? Case report and brief review

Stavroulakis, G.; Papadopoulou, Maria; Koutroulis, George; Zouvelou, Vasiliki; Katsavochristos, J.; Georgiadis, E.; Baltogiannis, C.; Avrampos, George

doi:10.1016/j.ijcard.2015.06.165

Cited by 8 publications

(2 citation statements)

References 10 publications

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“…This MACCE denotes that elevated troponin in non-cardiac conditions confers a significant implication at 6 months clinical outcomes and is not to be ignored. Our findings are in agreement with the result of a recent cross-sectional study of high-sensitivity cardiac troponins T which concluded that Significant illnesses apart from the acute coronary syndrome acute coronary syndrome as recent research has shed light on many other medical causes of troponin rise besides the ACS [29][30][31][32][33][34][35][36][37][38][39][40][41]. Troponin elevation was also reported in healthy young adults and children [33].…”

Section: Discussionsupporting

confidence: 90%

The Prognostic Significance of Elevated Cardiac Troponin in Non-Cardiac Medical Disorders. Pilot Study

AlQassas¹,

Walid²,

Nadia³

et al. 2019

Int J Clin Cardiol

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Background: Several studies have linked elevated cardiac troponin to increased overall risk in patients with acute coronary syndrome but the prognostic significance of elevated troponin in non-cardiac conditions remains scanty. Objectives:The primary aim of this study was to investigate the prognostic significance of elevated high sensitivity troponin T (TnT-HS) in non-cardiac disorders outside the remit of an acute coronary syndrome (ACS). Secondarily we aimed to investigate the impact of cardiovascular comorbidities and other clinical presentations in the release of cardiac biomarkers in non-cardiac disorders.Methodology: This was a retrospective electronic patient record pilot review where all patients with elevated TnT-HS without acute coronary syndrome, recent angioplasty or heart failure within a three month period were enrolled into the study and subsequently followed prospectively for a six month period. From January 1, 2016 to June 30, 2016, a total of 2535 patients were screened of which 306 patients had elevated TnT-HS and 162 patients met the study inclusion criteria.Data were encrypted and collected in Google database format, exported into excel spreadsheet, analyzed and computed using SPSS (version 24) to identify clinical associations with increased values of TnT-HS.Results: Most troponin TnT-HS samples (77.1%) were obtained from emergency room (ER) attendance and 63.4% of patients were male. The mean age was 72 years and no Conclusions: TnT-HS positivity should be cautiously interpreted in patients exhibiting non acute cardiac conditions associated CKD, infections, and CVAs. This troponin elevation in non-cardiac conditions still carries a significant adverse prognosis.After adjusting for age and renal insufficiency, we can suggest a new cut off level of TnT-HS > 30 ng/l to have increased risk of MACCE within 180 days in non-cardiac conditions.

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Section: Discussionsupporting

confidence: 90%

The Prognostic Significance of Elevated Cardiac Troponin in Non-Cardiac Medical Disorders. Pilot Study

AlQassas¹,

Walid²,

Nadia³

et al. 2019

Int J Clin Cardiol

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“…His troponin remained elevated and was not associated with any other features of cardiac injury. There are reports of elevated troponins without myocardial infarction in patients with myasthenia gravis (6).…”

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confidence: 99%

June 2023 Pulmonary Case of the Month: An Invisible Disease

Wesselius¹

2023

Southwest J Pulm Crit Care Sleep

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No abstract available. Article truncated after 150 words. History of Present Illness A 78-year-old man presented to the emergency Department on April 7 for shortness of breath and weakness over the last 2 weeks. He was in good health prior to an outside hospitalization March 29-April 3 for pneumonia and possible a non-ST-elevation myocardial infarction (elevated troponins). He had a bronchoscopy during his recent outside hospitalization without specific pathogen identified but treated with antibiotics, discharged on levofloxacin. Since his hospital discharge 4 days previously he feels weaker and increasingly short of breath. SOB even walking around in his home. He denies fever or a productive cough. Past Medical History, Family History and Social History Atrial fibrillation, s/p ablation. On Eliquis. Prior renal cell carcinoma, s/p resection, no recurrence DM Type 2 GERD OSA Essential tremor Never smoked Medications Apixaban Aspirin Atorvastatin Flecanide Insulin Levofloxacin Lisinopril Pantoprazole Tamsulosin Physical Examination General: The patient looks comfortable and is in no …

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Exercise‐induced release of troponin

Stavroulakis¹,

George

2020

Clinical Cardiology

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It is well established that regular physical activity reduces cardiovascular disease risk; however, numerous studies have demonstrated postexercise elevations in cardiac troponin (cTn), indicative of cardiac injury in apparently healthy individuals. The prevalence of these findings in different exercise settings and population groups, as well as potential underlying mechanisms and clinical significance of exercise‐induced cTn release are not yet quite determined. The present review will discuss the cTn response to exercise in light of developing cTn assays and the correlation between postexercise cTn release and cardiac function. Additionally, recent data regarding the potential link between strenuous endurance exercise and its relationship with unfavorable cardiac effects in athletes, as well as the management of patients presenting at emergency care after sport events will be briefly reviewed.

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Myasthenia gravis. A potential cause of false positively elevated troponin T? Case report and brief review

Cited by 8 publications

References 10 publications

The Prognostic Significance of Elevated Cardiac Troponin in Non-Cardiac Medical Disorders. Pilot Study

The Prognostic Significance of Elevated Cardiac Troponin in Non-Cardiac Medical Disorders. Pilot Study

June 2023 Pulmonary Case of the Month: An Invisible Disease

Exercise‐induced release of troponin

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