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Had Chest Pain. ECG Normal But Blood Test Showed High Tromonin Levels. Given Aspirin, Ramapril And Bisoprolol. Cause?

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Posted on Sat, 5 Oct 2013
Question: Hi my dad was admitted to hospital following chest pain . An ecg was done which was normal but a blood test showed high tromonin levels. We are a little confussed how ecg could be normal when dr said he has probably had a heart attack?

Following a angiogram, no arteries were blocked and he was sent home with asprin, ramapril, bisoprolol and a few other meds.

Can he have had an attack if ecg was normal? Also how can he know how much damage has occured to the heart? This had not been mentioned?
doctor
Answered by Dr. Nsah Bernard (5 hours later)
Brief Answer:
It might just be angina pectoris

Detailed Answer:
Hello XXXXXXX

Thanks for posting on XXXXXXX

It might not necessarily be heart attack or myocardial infarction but rather angina pectoris. Both conditions are coronary artery diseases but myocardial infarction is a much more severe form. Heart attack usually associated with other symptoms such as over sweating, palpitation etc and believe me, he would not recover so fast and be sent home the same day. ECG can be normal after the attack but it would actually show some abnormality if it was myocardial infarction.
To me, I think he had unstable angina pectoris which can be treated with just the prescribed medications.
I think your father should be placed permanently or 'baby aspirin' and do regular cardiovascular exams.

Hope this helps and wish you the best
Dr. Nsah
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Nsah Bernard (4 hours later)
Thanks alot.

He was kept few days snf given blood clot injections and then abgiogram was done. It was the raised tromonin levels which made them day its a heart attack. How can we find out from how much of the heart is damaged if any?
doctor
Answered by Dr. Nsah Bernard (7 minutes later)
Brief Answer:
Then it might be heart attack then

Detailed Answer:
You are welcome XXXXXXX

When troponin levels are elevated after an acute chest pain, it is often related to damaged heart muscle usually from heart attack. To find out how the heart has been damaged you may request from cardiac ultrasound, angiography and/or CT.
Your father will need to be followed-up by a cardiologist.

Hope this helps further.
Dr. Nsah
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Nsah Bernard (37 hours later)
Hi an angiogram was done and dr mentioned there was a bit of plaque near the artery otherwise arteries were fine but we were confussed why nothing was said re heart damage.

Should we request an ultrasound ?
doctor
Answered by Dr. Nsah Bernard (12 hours later)
Brief Answer:
artheromatic plague

Detailed Answer:
The plaque that is found may be the reason for the myocardial infarction. Damage must not be there but needs to be investigated. I think you should talk first with your doctor. The treatment in place will help treat the condition. I feel ultrasound will ne helpful but angiogram is superior.

Hope this helps further
Dr. Nsah
Note: For further follow-up it is advisable to consult an emergency medicine specialist. Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Nsah Bernard

General & Family Physician

Practicing since :2012

Answered : 1704 Questions

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Had Chest Pain. ECG Normal But Blood Test Showed High Tromonin Levels. Given Aspirin, Ramapril And Bisoprolol. Cause?

Brief Answer:
It might just be angina pectoris

Detailed Answer:
Hello XXXXXXX

Thanks for posting on XXXXXXX

It might not necessarily be heart attack or myocardial infarction but rather angina pectoris. Both conditions are coronary artery diseases but myocardial infarction is a much more severe form. Heart attack usually associated with other symptoms such as over sweating, palpitation etc and believe me, he would not recover so fast and be sent home the same day. ECG can be normal after the attack but it would actually show some abnormality if it was myocardial infarction.
To me, I think he had unstable angina pectoris which can be treated with just the prescribed medications.
I think your father should be placed permanently or 'baby aspirin' and do regular cardiovascular exams.

Hope this helps and wish you the best
Dr. Nsah