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Dr. Andrew Rynne
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Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest treatment for elevated troponin levels along with high BP

Answered by
Dr.
Dr. Panagiotis Zografakis

Internal Medicine Specialist

Practicing since :1999

Answered : 3665 Questions

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Posted on Mon, 23 Mar 2015 in Medicines and Side Effects
Question: Please can you opine on attached blood and ecg report. Female, 63 yr old, admitted to hospital with high BP. 155/90. Weight 91kgs
doctor
Answered by Dr. Panagiotis Zografakis 1 hour later
Brief Answer:
You've been hospitalized for suspected acute coronary syndrome

Detailed Answer:
Hello,

you haven't mentioned your symptoms, when they started and when the blood tests and ECG were done (very important).
I've seen your troponin levels and they were a little higher than normal. Combining this finding with some T wave abnormalities on V1-V3, there is suspicion for an acute coronary syndrome. I guess that this is the reason you've been hospitalized.

The blood pressure is not normal but this is not a reason for concern in otherwise healthy individuals.

Please contact me again, using your follow-up questions, if you'd like more details about your condition. If you will, please provide more clinical information.

Kind Regards!
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Panagiotis Zografakis 4 hours later
What other clinical information you need . What is the course to treat acute coronary ayndrome
doctor
Answered by Dr. Panagiotis Zografakis 5 hours later
Brief Answer:
Symptoms, perhaps other tests

Detailed Answer:
Hi,

diagnosing anything requires information about the patient's symptoms. The patient's history contributes about 80% to the diagnosis. The tests may confirm or exclude diagnoses but they can't be used without clinical information.

So I'd like to know what kind of symptoms did she have, when did they start, how long did they last, if there was anything that made symptoms better or worse and if there were any accompanying symptoms. Putting as many details as you can will help me understand her situation better.

For example a myocardial infarction which may provide the same results in the ECG and troponin (although in most cases, more pronounced changes are expected) usually causes squeezing chest pain with sweating and nausea. The pain may radiate to the upper abdomen, jaw, left shoulder and arm and the back. It gets worse when the patient engages in physical activity and gets better with rest. It may last from 20-30 minutes (for myocardial infarction) to hours.

When a coronary syndrome is detected the treatment course may differ depending on electrocardiographic and clinical information. In the most severe cases a special catheter is inserted through a peripheral artery and fixes the coronary artery (arteries) lesion(s). Beta blockers are commonly used, antihypertensive medications also and prophylaxis for thrombosis (clopidogrel and perhaps also aspirin).

I can't tell you all the possible treatments because it depends on the case.

Kind Regards!
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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