What causes pain in back radiating to chest?
I would explain as follows:
Welcome and thank you for asking on HCM!
I would explain that level of 0.01 is the upper limit of normal values of troponin.
But, even there is an insignificant raise in the troponin levels, this lab finding should be coupled with the resting ECG changes during this episode, in order to conclude about any possible myocardial ischemia. You should know that troponin is an enzyme which can be found in other cells, besides cardiac cells. That is why lab finding should be correlated with ECG findings.
Could you please upload your resting ECG performed at the ER for me to review and give another professional opinion?
A cardiac stress test would be the test of choice to detect possible myocardial ischemia.
A cardiac ultrasound would be necessary to examine your cardiac structure and function.
Hope to have been helpful!
I would recommend as follows:
I would explain that this is not a significant raise in troponin values.
But, I would recommend repeating troponin levels every two hours in the next hours, in order to exclude possible myocardial ischemia.
Further increase in troponin levels would be concerning.
Hope to have been helpful!
Opinion as follows:
I would explain that such a variation in Troponin level is not clinically significant.
Slight variations within normal ranges is not rarely found in healthy individuals; but what should not be present is the increasing level trend of Troponin when the clinical symptomatology is suspicious.
As I explained you above, the best strategy for concluding about possible causes of this slight variation is to continue checking Troponin for the next couple of hours (every two hours).
If no any further rise is detected, then nothing to worry about.
But, if it continues to rise again, then a careful differential diagnosis is necessary to find the exact reason.
In order to further investigate for any cardiac reason, additional imagine tests, like cardiac ultrasound, coronary angio CT would be a rationale option, especially if you have coronary risk factors (hypertension, dyslipidemia, smoking, glucose metabolism disorder or diabetes, heredity for CAD).
But, you should also know that an abnormal Troponin rise may be cause by several extra-cardiac reasons, like disease of the aorta, pneumonia, pancreatitis, after strenuous physical exertion, systemic inflammation/sepsis, chest trauma, pericarditis, myocarditis, rhabdomyolysis etc.
That’s why it is necessary to measure serial Troponin levels and also correlate those lab values with the clinical symptomatology.
So, to conclude, I would like to assure you that the actual Troponin variations are not concerning.
But, if you want to put your mind completely at rest, you need to check Troponin levels also for a couple of hours.
Hope to have been helpful.
You are welcome!
So, nothing to worry about!
Your Troponin level has remained normal all the time.
As a conclusion, cardiac ischemia is not an issue to be considered.
Wishing you good health!
Feel free to ask me again whenever you need!
Nothing to worry about!
I could explain that your previous ECG recording shows some baseline oscillations (not optimal registration), so it’s difficult to confirm or exclude a r’ in V2.
I would like to explain you that no any significant difference exists between those two ECG, and what is more important is judging the ECG as a whole and not a single lead.
To conclude, I would say that no any abnormality is confirmed by those ECG strips.
So, relax and don’t worry!
You may upload the entire ECGs for a comprehensive review.
Your ECGs are fine!
Your ECGs are almost the same, just a more prominent J point in the last ECG.
No presence of arrhythmia, atrio-ventricular conductance disturbances, no specific repolarization abnormalities.
So, you shouldn’t worry about them!
Just relax and enjoy your day!
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