Podcasts about Troponin

In this Nephrology episode, Dr.Samira Farouk discusses the nuances of AKI, why you should be trending Urine like you trend Troponin. Stay tuned to find out the final diagnosis! Session facilitator: Dr.Elena Storz Case Discussants: Dr.Douglas Farrell MD: Nephrology Fellow, Icahn School of Medicine at Mount Sinai Dr. Samira Farouk MD: Associate Professor of Medicine… Read More »Episode 389: Rafael Medina Subspecialty Series – Hypotension and Peaked T waves

Hosts Mitsuaki Sawano, MD, and co-host Satoshi Shoji, MD, welcome Kenji Inoue, MD, to discuss the DROP-Asian ACS study—a multicenter trial evaluating the 0/1-hour algorithm for chest pain assessment across 12 hospitals in five Asian countries presented as a Late Breaking Clinical Trial at the ACC.25. Dr. Inoue shares key findings from this cluster-randomized trial of nearly 4,000 patients, highlighting the algorithm's practicality in Asia's diverse healthcare settings. Despite regional differences, the 0/1-hour approach—requiring only two high-sensitivity troponin measurements—proved effective and accessible, even in low-resource environments. He also reflects on presenting at ACC, the importance of early preparation, and the growth that comes from taking on complex international research. Dr. Inoue encourages young clinicians to embrace challenges and actively engage with global networks for clinical research development.

A deep conversation about the beauty of the heart; physically and emotionally. Hear Erin's heartfelt story of her beloved sister and the heart complications that ended in her sudden passing. Learn the steps you can take to proactively care for your heart and the knowledge to equip you in the case of a heart attack or stroke, all while boldly advocating for yourself.And, it doesn't end there, our conversation dives into the emotional side of the heart and it's ancient connections that continue to serve us on our journey to “Know Thyself”.Follow Erin Moran on Instagram @LionessBossBabe and The American Heart Association Go Red for Women to learn more about heart health awareness all year round.—-------Here a few notes from our conversation:Signs and Symptoms of Stroke: F.A.S.T. (Facial Drooping, Arm Numbness/weakness, Slurred Speech, Time to call 9-1-1)If you feel as though you are having a heart attack, ask for the “differential diagnosis”, a D-dimer test, have your Troponin level measured, and bring an advocate with you if possible.Suggested books: "The Myth of Normal: Trauma, Illness and Healing in a Toxic Culture" by Daniel Mate' and Gabor Mate'ACEs (Adverse Childhood Experiences)The “Weighing of the Heart” scene, Ancient Kemet (Egypt) depicted in the  Book of Coming Forth By Day, found on papyrus scrolls.

Imagine if you could know years in advance that you're at risk for a certain illness. What if you had access to the tools and information to take action now to prevent it? In episode 209 of Eat Move Think, Dr. Peter Nord, Medcan's Chief Medical Officer, explores this topic.  Tune in to hear Dr. Nord explain: The role of genetics in predicting future health Medical advances that can help identify early risk factors and indicators What steps you can take now to improve your health into your later years What You Can Do Medcan's Annual Health Assessment is a critical first step to understanding your current health and risk factors. It consists of up to 15 screenings including the hs-Troponin test. For those who would like to take a deeper look at their genetic information, we offer our Enhanced Genetics Screening services including Whole Genome Sequencing. Learn More Annual Health Assessment: medcan.com/assess Enhanced Genetics Screening: medcan.com/genetics  

Troponin is a protein found in heart muscle that was a game changer when it came to diagnosing heart attacks and myocardial injury in the late 1990s. Three decades later, it is an invaluable test with widespread use throughout medicine. Troponin assays are venturing into their 5th generation with high-sensitivity and Point-Of-Care (POC) devices. However, there are important exceptions, caveats and pitfalls for doctors to know. This is the story of troponin. Our special guest: Our special guest is Dr Christina Trambas who is a chemical pathologist, Medical Director at St Vincent's Pathology and chair of the Royal College of Pathologists of Australiasia (RCPA) Troponin Working Party. This Medical Life podcast is available on all podcasting services and Spotify.See omnystudio.com/listener for privacy information.

In this week's replay episode from 2 years ago, we review the important topic of troponin levels in children. What is an abnormal high sensitivity troponin level in children and do the levels vary based upon the assay? What are the differences between high sensitivity troponin I and T levels? Are there differences between boys and girls? Why would using the 97.5%ile upper reference limit result in a more reliable 'line in the sand' in comparison with the more traditional, high sensitivity troponin level cut off of 99th%ile. These are amongst the questions we review with this week's author, Dr. J. Bill McEvoy, Professor of Preventive Cardiology at University of Galway, Ireland. DOI: 10.1161/CIRCULATIONAHA.122.063281

Darshan H. Brahmbhatt, Podcast Editor of JACC: Advances discusses a recently published original research paper on the association of Cardiac Troponin T with coronary atherosclerosis in asymptomatic primary prevention in people with HIV.

Darshan H. Brahmbhatt, Podcast Editor of JACC: Advances discusses a recently published original research paper on STEMI, revascularization, and peak troponin by adverse pregnancy outcomes in women with myocardial infarction

In this episode of the Heart podcast, Digital Media Editor, Professor James Rudd, is joined by Dr Love Cyon from Stockholm, Sweden. They discuss his paper exploring the prognostic value of troponin levels in chest pain patients in the ED. If you enjoy the show, please leave us a podcast review at https://itunes.apple.com/gb/podcast/heart-podcast/id445358212?mt=2 or wherever you get your podcasts - it's really helpful. Link to published paper: https://heart.bmj.com/content/early/2024/06/07/heartjnl-2024-323913  

Audio Commentary by Dr. Valentin Fuster, Emeritus Editor in Chief

Commentary by Dr. Candice Silversides

Dr. Pregerson reviews the ACC Expert Consensus Decision Pathway on the Evaluation and Disposition of Acute Chest Pain by focusing on high-sensitivity troponin, delta troponin, unstable angina, renal failure, and baseline troponin, only in this month's podcast. Read more in the Show Notes.

Commentary by Dr. Valentin Fuster

Pre-Hospital Rule-Out of Non-ST-Segment Elevation Acute Coronary Syndrome by a Single Troponin Measurement: Final One-Year Outcomes of the ARTICA Randomised Trial (AHA 2023)

Our latest episode dissects three groundbreaking studies that are reshaping our understanding of the heart and its intricate connections to the body and mind.   STUDY #1: First, we explore the potential of high-sensitivity cardiac troponin I (hs-cTnI) in risk-stratifying patients with known coronary artery disease. While current guidelines don't yet recommend these tests, could there be untapped value in using troponin concentration as a preventive treatment guide? Join us as we explore the intriguing possibilities and implications presented in this study from the Journal of the American College of Cardiology. Wereski, R, Adamson, P, Daud, NSS, et al. 2023. High-sensitivity cardiac troponin for risk assessment in patients with chronic coronary artery disease. J Am Coll Cardiol. 6: 473–485. (https://doi.org/10.1016/j.jacc.2023.05.046)   STUDY #2: Next, we shift our focus to the brain-heart connection. Ever wondered about the cognitive repercussions of a myocardial infarction (MI)? This study from JAMA Neurology sheds light on the potential cognitive consequences of an MI.  Johansen, MC, Ye, W, Gross, A, et al. 2023. Association between acute myocardial infarction and cognition. JAMA Neurol. 7: 723–731. (https://doi.org/10.1001/jamaneurol.2023.1331)   STUDY #3: Third, we dive deep (pun intended!) into decompression illness. Certain divers might want to reconsider their next dive because a recent Annals of Internal Medicine study suggests a primary mechanism behind decompression illness that could change the way we perceive diving risks. What are the implications for those passionate about the deep blue? Lee, H-J, Lim, DS, Lee, J, et al. 2023. Decompression illness in divers with or without patent foramen ovale: A cohort study. Ann Intern Med. 7: 934–939. (https://doi.org/10.7326/M23-0260)   Don't miss out on these captivating discussions. Listen in to stay at the forefront of cardiology insights and to satiate your curiosity about these studies' findings. We promise, it's a heartbeat away from being your favorite episode yet! For show notes, visit us at https://www.medmastery.com/podcasts/cardiology-podcast.

In this episode, Our guest host Avromi talks about pushing GDMT via the STRONG-HF trial. We also start our MHP2023 recap series with some pearls from Dr. Zier's cardiology update session. | 00.33 - TOC | | 01.19 - MHP2023 Afib updates | AFFIRM 2002 (rate and rhythm non-inferior) EAST-AFNET 4 - using dofetilide CABANA - using ablation and evaluating HF patients ESC commentary - impact of AFFIRM and changes in management to today | 03.04 - Guest host Avromi and STRONG-HF [Lancet 2022]. Click here for a slide deck overview of the study. | | 08.49 - MHP2023 high-sensitivity Troponin and AMI management | COMPASS-MI - using hs-cTnT for early rule out PLATO (lower primary outcome w/ ticagrelor v clopidogrel, equivalent bleeding), TRITON-TIMI 38 (lower primary outcome w/ prasugrel v clopidogrel, equivalent bleeding), ISAR-REACT 5 (lower mortality w/prasugrel v ticagrelor w/ similar bleeding risks) RAPID CABG (NOT PEER REVIEWED YET)- similar rates of bleeding waiting off ticagrelor 2-3d vs 5-7d REVERSE-IT - bentracimab for reversal of ticagrelor 2023 ESC Guidelines for ACS | 11.17 - Closing | [The appearance of external hyperlinks does not constitute endorsements by UCSF of the linked websites, or the information, products, or services contained therein. UCSF does not exercise any editorial control over the information found therein, nor does UCSF make any representation of their accuracy or completeness. All information contained in this episode are the opinions of the respective speakers and not necessarily the views their respective institutions or UCSF, and is only provided for information purposes, not to diagnose or treat.] png image from pngtree.com

Calling the cardiologist unnecessarily from the ED for every little raised troponin is one of my pet peeves. In this episode, I discuss what troponins are and what are the conditions in which they shoot up. Don't just believe me. Do your own research too. You can go through some of the following literature - 1. https://pubmed.ncbi.nlm.nih.gov/20685679/ 2. https://pubmed.ncbi.nlm.nih.gov/15136402/ 3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4554225/ 4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1860726/ 5. https://pubmed.ncbi.nlm.nih.gov/15736582/ 6. https://pubmed.ncbi.nlm.nih.gov/12460876/ 7. https://pubmed.ncbi.nlm.nih.gov/9510880/ 8. https://pubmed.ncbi.nlm.nih.gov/22105197/ 9. https://pubmed.ncbi.nlm.nih.gov/26346942/

We now have a blood test that tells us with absolute certainty whether or not someone is having a heart attack. https://dralo.net/links

Commentary by Dr. Valentin Fuster

In this episode of Heart Doc VIP with Dr. Joel Kahn, you'll discover recent groundbreaking scientific studies that are closely tied to your well-being and lifespan. Dr. Kahn delves into the importance of requesting a high-sensitivity troponin blood test, a key measure that can provide insights into your potential risk for heart conditions and overall longevity. Available at Quest and various other labs, troponin is a vital biomarker that complements BNP and galectin-3 as indicators of heart failure. Furthermore, Dr. Kahn is excited to announce a 6-week online seminar and interactive Q&A, commencing in August. Discover more and register for this invaluable opportunity to engage with a heart health expert at Dr. Joel Kahn's Whole Heart Masterclass.

Commentary by Dr. Valentin Fuster

In dieser Podcastfolge sprechen wir über den Laborwert Troponin und klären die Frage, ob es möglich ist mit dem Troponin-Wert einen Myokardinfarkt zu diagnostizieren...? kostenloser Blog https://natuerlich-elli.de/blog-heilpraktikeranwaerter/ Unverbindliche Anmeldung Prüfungsvorbereitung https://natuerlich-elli.de/hppruefung/ Folge mir auf Instagram: https://www.instagram.com/natuerlich_elli/ Komm in unsere kostenlose FB-Lerngruppe: https://www.facebook.com/groups/natuerlichelli (bearbeitet)

Overview Troponin I Normal value range Pathophysiology Special considerations Elevations in lab values Nursing Points General Normal value range Typically, less than 0.035 ng/mL or less Can vary among institutions Has to be greater than the 99th percentile Pathophysiology Troponin is released during myocardial cell damage Decreased perfusion causes myocardial cell damage Causes of myocardial cell damage Myocardial infarction Demand ischemia Cardiogenic ACS Noncardiogenic Sepsis Renal failure Extreme exercise Special considerations Submitted in green top tube Value peak Detection 6-12 hours after acute injury Peaks 24 hours after injury Can stay elevated for a week Knowing patient history is critical Increased values Any elevated value is typically considered critical Acute elevations warrant immediate investigation Typically PCI (percutaneous coronary intervention)/Angiography and EKG to rule out MI or ACS (acute coronary syndrome) Other elevations CABG Extreme exercise End Stage Renal Failure Assessment Assess for: Acute chest pain Symptoms of MI Nausea Vomiting Angina in any form Reflux (especially in women) Therapeutic Management EKG Angiography or PCI Management of non-cardiogenic etiology Nursing Concepts Lab Values Perfusion Patient Education Educate patient on keeping history of elevated levels or cardiac disease for future reference Educate patient on duration of elevated troponin levels, post injury

Commentary by Dr. Valentin Fuster

Commentary by Dr. Valentin Fuster

In this week's episode we review the important topic of troponin levels in children. What is an abnormal high sensitivity troponin level in children and do the levels vary based upon the assay? What are the differences between high sensitivity troponin I and T levels? Are there differences between boys and girls? Why would using the 97.5%ile upper reference limit result in a more reliable 'line in the sand' in comparison with the more traditional, high sensitivity troponin level cut off of 99th%ile. These are amongst the questions we review with this week's author, Dr. J. Bill McEvoy, Professor of Preventive Cardiology at University of Galway, Ireland. DOI: 10.1161/CIRCULATIONAHA.122.063281

Get a free nursing lab values cheat sheet at NURSING.com/63labs   What is the Lab Name for Troponin I (cTNL) Lab Values? Troponin I   What is the Lab Abbreviation for Troponin I? cTNL   What is Troponin I in terms of Nursing Labs? Troponins are proteins that initiate contraction of muscle fibers. Troponin I (cTNL) is specific to heart muscle. Troponin levels stay elevated for a week after muscle damage before returning to normal.   What is the Normal Range for Troponin I? There is a wide range of normal values among varying institutions and texts with regard to Troponin I. It is essential to verify institutional norms. < 0.035 ng/mL   What are the Indications for Troponin I? Evaluating damage to heart muscle Diagnose a Myocardial Infarction (MI)   What would cause Increased Levels of Troponin I? Heart damage Myocardial Infarction (MI)   What would cause Decreased Levels of Troponin I? N/A

Justin Harris is the owner of Troponin Nutrition and 1st Detachment supplements. He specializes in customized training and performance nutrition. He works with the world's top bodybuilders and powerlifters to take their strength and physiques to the next level. Justin is an accomplished academic with a masters degree in atomic physics an undergraduate in kinesiology along with an exercise science degree. On top of exceptional degrees he has put his knowledge to the test in the trenches. He was the 2004 Mr. Michigan, Super Heavyweight Champion for the 2006 Jr. USA's, 2007 and 2008 APF Michigan Powerlifting Champion totaling elite both years. Justin has published two books along with multiple comprehensive ebooks along with countless articles and podcasts. https://1stdetachment.com/https://www.troponinnutrition.com/https://instagram.com/troponin_nutrition?igshid=YmMyMTA2M2Y=https://youtube.com/@platesandpancakes4593https://instagram.com/voodoo4power?igshid=YmMyMTA2M2Y=https://voodoo4ranch.com/To possibly be a guest or support the show email Voodoo4ranch@gmail.comhttps://www.paypal.com/paypalme/voodoo4ranch

A Novel Breakthrough In Wrist-Worn Transdermal Troponin-I-Sensor Assessment For Acute Myocardial Infarction

In this episode, as part of American Heart Month, we chat with Dr. Deborah Diercks at ACEP22 about the current landscape of ACS and troponin.

elitefts Limited Edition Apparel: https://www.elitefts.com/shop/apparel/limited-edition.html      Support and help the Podcast grow by Joining The Crew: https://glow.fm/davetatestabletalk/       Justin Harris takes a seat in this 169th podcast episode of Dave Tate's Table Talk.   Justin Harris is the owner of the customized training and performance nutrition company Troponin Nutrition and co-owner of 1st Detachment. He helps serious athletes who train hard by providing expert coaching and performance nutrition built on results. He holds a Master's degree in Atomic Physics with an undergraduate degree in Kinesiology.   As a top-level competitor, Justin was the: Overall winner of the 2004 Mr. Michigan Superheavyweight champion for the 2006 Jr. USAs 2007 and 2008 APF Michigan powerlifting champion, totaling “Elite” in both competitions 1st Detachment: https://1stdetachment.com/ Troponin Nutrition: https://www.troponinnutrition.com/ Justin's IG: https://www.instagram.com/troponin_nutrition/?hl=en       ABOUT THE HOST   Dave Tate is the founder and co-owner of elitefts.com. He is the author of twenty books and has logged more than 40,000 hours of training and consulting. Dave is married to elitefts co-owner Traci Arnold-Tate, and they reside in London, Ohio, with their two sons. Personal Credo: Live, Learn, Pass on™.   Dave's IG: https://www.instagram.com/underthebar/?hl=en     SPONSORS     Marek Health    Marek Health is the telehealth platform that connects customers to partnered providers focusing on hormone optimization and preventative medicine—offering self-service labs at great prices and guided optimization.     www.MarekHealth.com/tabletalk  Use Code Tabletalk for 10% off your first order. Also, check out the Table Talk Panel: www.MarekHealth.com/tabletalk         1st Detachment    1st Detachment (1D) is a veteran-founded, expert-formulated supplement company led by renowned coach Justin Harris and optimal living specialist Joe Miller. From a game-changing pre-workout to potent glucose disposal agents & industry-leading intra-workout, we've combined science with real-world experience to custom-formulate each product.   We are battle tested. Are you? Find your battle today!   Use code TABLETALK10 at checkout for 10% OFF your order.   https://1stdetachment.com/       Power Rack Strength CBD    Our CBD Isolate is derived from hemp, not Marijuana, and is 100% THC-FREE, with testing on the website for each batch. It won't get you high or make you fail a drug test.    Many law enforcement, fire department, military, and truck driver personnel use our products. For those who need to relax, struggle with sleep, or have achy muscles, CDB is a must-have, especially for athletes.    Use discount code: TABLETALK2023 - 35% off ANY order, no limit.  CBD: https://powerrackstrengthcbd.com     Gift of Injury: https://www.powerrackstrength.com/gift-of-injury/         elitefts   If you can put it in a gym bag or load weight on it, we have you covered.   https://www.elitefts.com/     Use Code TABLE TALK for 10% off your first elitefts order.     SUPPORT THE SHOW   All profits from elitefts Limited Edition Apparel, Table Talk Coffee, and Team elitefts Workouts, Programs, and Training eBooks support Dave Tate's Table Talk Podcast. Shop these elitefts items: https://www.elitefts.com/content/table-talk/   Support Dave Tate's Table Talk podcast by joining the crew.  https://glow.fm/davetatestabletalk/    elitefts Shop: https://www.elitefts.com/   elitefts IG: https://www.instagram.com/elitefts/

Many Coders tend to read a physician's note and make assumptions without first reading the coding guidelines. One particular entry, which is found in many admission notes is “elevated troponin”. An elevated troponin does not always mean that a heart attack has occurred, many many coders will leap to that conclusion before reviewing the documentation. […] The post Elevated troponin levels: may not be what you think! appeared first on Terry Fletcher Consulting, Inc..

Commentary by Dr. Valentin Fuster

In this month's EM Quick Hits podcast: Anand Swaminathan on GI balloon tamponade preparation and indications, Jesse McLaren on why troponin is rarely useful in SVT, Christina Shenvi on why we should not use the term "mechanical fall" in older patients, Nour Khatib & Jonathan Wallace on rural vertical vertigo case and Reuben Strayer on VAFEI - Video-Assisted Flexible Endoscopic Intubation for the anatomically challenging airway... The post EM Quick Hits 40 – GI Balloon Tamponade, SVT and Troponin, Falls in Older Patients, Vertical Vertigo, VAFEI Airway appeared first on Emergency Medicine Cases.

A cry for help from a 70-year-old physician living in a wealthy country. Hi Bob, I wanted to tell you about my experiences with the bad effect of the Covid vaccine on me. 1. I was vaccinated twice with AstraZeneca as a result of pressure from family. I did not take a booster. 2. Despite having normal blood pressure, blood sugars (on Metformin), normal cholesterol (on statins) and on Eliquis (blood thinner), on February 9th, I woke up with severe chest pain around 7 AM. 3. Ambulance was in my bedroom within 10 minutes 4. Cardiogram showed ST-elevation heart attack (n.b. severe type that is frequently fatal)5. Rushed to the hospital and my cardiologist was already waiting for me6. Cardiac stents were used to open my coronary arteries within an hour 7. I saw the blood flow return immediately and the ST elevation and pain went away 8. Troponin (heart enzyme) was zero after 1 week9. Back to work after 1 week Also, my hearing had deteriorated dramatically since the vax. I now have trouble living without a hearing aid. My staff had to shout for me to hear them. RegardsSamDear Sam:Jeez, you knew the truth from my emails, and yet you bowed to idiots. You now know why I call it the clot shot. You got lucky.  The vax is a purpose-designed bioweapon that, like the virus, is being used for genocide. The criminality proven by the Pfizer data dump destroys any of the jab's credibility for treatment or prevention of disease. By the second month after its release, the company knew their injection was going to murder millions worldwide—by then, they had killed 1200 in the US alone—yet they proceeded anyway. Worse: the FDA approved it for babies. The evidence it is evil includes the VAERS database, military records, country comparisons, and insurance data that shows vastly increased population-wide fatalities. Deaths are up by a stunning 40 percent overall and far more in younger people. You damaged your immunity by getting jabbed. So now your chance of dying from COVID and other causes is higher. Vax damage involves multiple organ systems—heart, brain, circulatory system, and general inflammatory conditions that may continue years later. Lots of my friends have died and some had terrible strokes. Your experience is hardly unique. Well, I don't want to lose you. Ignore the advice of jackasses from now on. BestRobert See RobertYoho.substack.com for the complete essay. See RobertYohoAuthor.com to learn about my books, Butchered by “Healthcare” and Hormone Secrets. My essay with links to COVID treatment and more is HERE. “LEGAL” DISCLAIMER: Use this information at your own risk. It is general commentary and not medical advice. Robert Yoho is retired and no longer practices medicine. Make your healthcare decisions with the help of a physician or other licensed provider. Support the show

In this episode of EMplify: Conversation, Sam Ashoo, MD and TR Eckler, MD discuss high sensitivity troponin testing and clinical pathways.Topics discussed include: Which troponin assay are you currently using and what are its limits of detection? Do delta troponin results only count if they increase? If the test result is indeterminate, then what? repeat in 1 hr (European standard), repeat in 3 hours (depending on chest pain onset), or just admit if the HEAR(T) score is high? What does one negative troponin on presentation mean? No death in 30 days to 1 year but still missed MI?And more... ReferencesAnand A, et al; HiSTORIC Investigators†. High-Sensitivity Cardiac Troponin on Presentation to Rule Out Myocardial Infarction: A Stepped-Wedge Cluster Randomized Controlled Trial. Circulation. 2021 Jun 8;143(23):2214-2224. doi: 10.1161/CIRCULATIONAHA.120.052380. Epub 2021 Mar 23. PMID: 33752439; PMCID: PMC8177493.Chapman AR, et al. Association of High-Sensitivity Cardiac Troponin I Concentration With Cardiac Outcomes in Patients With Suspected Acute Coronary Syndrome. JAMA. 2017 Nov 21;318(19):1913-1924. doi: 10.1001/jama.2017.17488. Erratum in: JAMA. 2018 Mar 20;319(11):1168. Soerensen NA [corrected to Sorensen NA]. PMID: 29127948; PMCID: PMC5710293.Chenevier-Gobeaux C, et al. Multi-centre evaluation of recent troponin assays for the diagnosis of NSTEMI. Pract Lab Med. 2018 Feb 26;11:23-32. doi: 10.1016/j.plabm.2018.02.003. PMID: 30014015; PMCID: PMC6045566.Chiang CH, Chiang CH, Lee GH, Qian F, Chen SC, Lee CC. Time to Implement the European Society of Cardiology 0/1-Hour Algorithm. Ann Emerg Med. 2020 Nov;76(5):690-692. doi: 10.1016/j.annemergmed.2020.05.038. PMID: 33097132; PMCID: PMC7575504.McCarthy CP, Januzzi JL Jr. Increasingly Sensitive Troponin Assays: Is Perfect the Enemy of Good? J Am Heart Assoc. 2020 Dec;9(23):e019678. doi: 10.1161/JAHA.120.019678. Epub 2020 Nov 26. PMID: 33238785; PMCID: PMC7763764.Neumann JT, et al. Application of High-Sensitivity Troponin in Suspected Myocardial Infarction. N Engl J Med. 2019 Jun 27;380(26):2529-2540. doi: 10.1056/NEJMoa1803377. PMID: 31242362.Miller J, Cook B, Singh-Kucukarslan G, Tang A, Danagoulian S, Heath G, Khalifa Z, Levy P, Mahler SA, Mills N, McCord J. RACE-IT - Rapid Acute Coronary Syndrome Exclusion using the Beckman Coulter Access high-sensitivity cardiac troponin I: A stepped-wedge cluster randomized trial. Contemp Clin Trials Commun. 2021 Apr 23;22:100773. doi: 10.1016/j.conctc.2021.100773. PMID: 34013092; PMCID: PMC8114080.

Contributor: Jared Scott, MD Educational Pearls: A study randomized 34 healthy patient to have their left anterior descending artery (LAD) occluded by balloon for 0, 15, 30, or 90 seconds   Subsequently,  cardiac troponins (cTns) and Copeptin were measured every 15 minutes for 3 hours, then every 30 minutes for the next 3 hours 5 conclusions were drawn: Copeptin is not a useful marker of cardiac ischemia  cTn may be detected after only 30 seconds of ischemia  cTn may be detected in a little as 15 minutes after ischemic event  After only 90 seconds of ischemia, cTn levels met threshold for MI  Troponin I is a better marker than troponin T as it rises faster and reaches a higher peak Patients very recent or very brief ischemic events may have elevated troponin in the ED References Árnadóttir Á, Pedersen S, Bo Hasselbalch R, et al. Temporal Release of High-Sensitivity Cardiac Troponin T and I and Copeptin After Brief Induced Coronary Artery Balloon Occlusion in Humans [published correction appears in Circulation. 2021 Jun 22;143(25):e1116]. Circulation. 2021;143(11):1095-1104. doi:10.1161/CIRCULATIONAHA.120.046574 Summarized by Kirsten Hughes, MS4 | Edited by John Spartz, MD, MPH & Erik Verzemnieks, MD   The Emergency Medical Minute is excited to announce that we are now offering AMA PRA Category 1 credits™ via online course modules. To access these and for more information, visit our website at https://emergencymedicalminute.org/cme-courses/ and create an account.  Donate to EMM today!

Overview Troponin I Normal value range Pathophysiology Special considerations Elevations in lab values Nursing Points General Normal value range Typically less than 0.035 ng/mL or less Can vary among institutions Has to be greater than the 99th percentile Pathophysiology Troponin is released during myocardial cell damage Decreased perfusion causes myocardial cell damage Causes of myocardial cell damage Myocardial infarction Demand ischemia Cardiogenic ACS Noncardiogenic Sepsis Renal failure Extreme exercise

Overview Troponin I Normal value range Pathophysiology Special considerations Elevations in lab values Nursing Points General Normal value range Typically less than 0.035 ng/mL or less Can vary among institutions Has to be greater than the 99th percentile Pathophysiology Troponin is released during myocardial cell damage Decreased perfusion causes myocardial cell damage Causes of myocardial cell damage Myocardial infarction Demand ischemia Cardiogenic ACS Noncardiogenic Sepsis Renal failure Extreme exercise

Overview Troponin I Normal value range Pathophysiology Special considerations Elevations in lab values Nursing Points General Normal value range Typically less than 0.035 ng/mL or less Can vary among institutions Has to be greater than the 99th percentile Pathophysiology Troponin is released during myocardial cell damage Decreased perfusion causes myocardial cell damage Causes of myocardial cell damage Myocardial infarction Demand ischemia Cardiogenic ACS Noncardiogenic Sepsis Renal failure Extreme exercise

The JournalFeed podcast for the week of March 14-18, 2022. Chest Tube Cutoffs Spoon Feed: Implementation of a guideline for chest tube placement with pneumothorax size cutoff of ≤35 mm in stable patients increased rates of observation for pneumothorax, with no apparent increase in rates of complication or observation failure. Pediatric Intubations Spoon Feed: There was no difference in first pass success rate or hypoxemic events when children were intubated with videolaryngoscopy (VL) versus direct laryngoscopy (DL). Intubations in children that took longer than 45 seconds had a greater incidence of hypoxemia, and overall, there was very low utilization of apneic oxygenation during laryngoscopy. Pre-intubation Atropine Spoon Feed: Atropine pretreatment was not associated with a reduction in the incidence of bradycardia in this tiny, single center study of pediatric intubations. hs-Troponin algorithms Spoon Feed: Accelerated diagnostic protocols using delta high-sensitivity cardiac troponin (hs-cTn) assays had high diagnostic accuracy. WCT gone wrong Spoon Feed: When treating this wide complex tachycardia (WCT) with synchronized cardioversion, the machine interpreted the T wave as the R wave. Nothing good comes of that!

Measuring cardiac injury marker(Troponin) tied to hospital mortality and long term symptoms! (My breakdown of the study for non medical people to understand.) A summary of an excellent prospective study from Harvard's Brigham and Women's Hospital. --- Support this podcast: https://anchor.fm/steven-donchey/support