This is an automatically translated article.
The article was professionally consulted by Doctor Tran Quoc Tuan - Emergency Medicine Doctor - Emergency Resuscitation Department - Vinmec Phu Quoc International General Hospital.Troponin is a protein found in heart muscle and skeletal muscle that helps control the contractions of the heart. Troponin elevation is due to two groups of causes: increase due to myocardial infarction and increase not due to myocardial infarction. In particular, the increase in troponin in acute pulmonary embolism is one of the familiar causes of non-myocardial infarction.
1. What is acute pulmonary embolism?
Acute pulmonary embolism is a term used to refer to the condition in which the pulmonary artery or its branches are blocked due to various factors such as fat, air, blood clots, bone marrow, amniotic fluid, and contaminated materials. infection...Pulmonary embolism originates mainly from deep vein thrombosis of the lower extremities. Blood clots can form in anyone, however, some of the following groups have a high risk of forming blood clots such as:
Family history of blood clots or acute pulmonary embolism. Patients with heart failure or heart problems. Some cancers such as ovarian, pancreatic, lung cancer... Smoking Being overweight / obese... Acute pulmonary embolism can cause many obvious symptoms such as:
Sudden coughing a lot , coughing up blood or coughing up bloody mucus. Shortness of breath during sleep or with exertion, which comes on suddenly. Decreased blood oxygen. Fast heart rate, rapid breathing and wheezing. Fever, hypotension... Acute pulmonary embolism can be life-threatening if not detected and treated promptly.
2. Learn about the significance of Troponin in acute pulmonary embolism
The diagnosis of acute pulmonary embolism based on several biomarkers has been assessed to be useful. Among them, the analysis related to the increase of Troponin in the heart has been scientifically proven to be related to the electrocardiogram ECG as well as the TTE thoracic ultrasound of patients with acute pulmonary embolism.In acute pulmonary embolism, the mechanical load of the right ventricle is increased because pulmonary vascular resistance is rapidly increasing after pulmonary embolism. This can cause acute right ventricular dilatation. It is this dilation and decreased movement of the ventricles that will cause severe myocardial ischemia, thereby increasing troponin.
Doctors believe that elevated troponin in acute pulmonary embolism is more related to disease severity and later prognosis than diagnosis. Approximately 30% - 50% of patients with moderate or higher pulmonary embolism have elevated troponin I and T.
Within 40 hours of acute pulmonary embolism, troponin levels will usually return to normal. . In the case of elevated troponin due to acute myocardial infarction, this time will be prolonged. Most studies have shown that, if pulmonary embolism is accompanied by elevated troponin levels as well as NT-proBNP, patients have a relatively high risk of death compared with the group without elevated troponin in the heart.
Tăng Troponin có liên quan đến tình trạng bệnh thuyên tắc phổi
3. Elevated troponin is also associated with other diseases besides acute pulmonary embolism?
In addition to myocardial infarction and acute pulmonary embolism, troponin elevation is also associated with many other diseases such as:Chronic renal failure: an increase in troponin levels in patients with chronic renal failure of cardiac origin. That increase in troponin T is more common than troponin I. Acute and severe heart failure: in heart failure, troponin levels increase moderately, accompanied by clinical symptoms such as chest pain, shortness of breath.. Up to now, the mechanism that causes troponin elevation in acute heart failure has not been clearly defined, possibly related to the continuous degradation of contractile protein from damaged myocardial cells. Septic shock: In patients with severe infection, troponin levels are elevated, but the mechanism is still unknown. Many studies have suggested that this phenomenon occurs because intermediate chemicals circulating in the circulatory system cause direct toxicity to cardiac muscle cells. Another hypothesis is that bacterial endotoxins or dysfunctional circulatory functions in infection cause myocardial cell damage, thereby leading to myocardial ischemia and troponin elevation. Myocarditis: Inflammation of the myocardium may be accompanied by necrosis of myocardium and this inevitably increases troponin levels. Troponin is more commonly increased in diffuse myocarditis than in focal myocarditis. In myocarditis, troponin is slightly elevated, with little change. However, it takes about 8 days to several weeks for troponin levels to return to normal. Acute pericarditis: Patients with acute pericarditis often present with severe chest pain and an increase in troponin levels. In this case, the experts explain that due to the damage to the epicardial myocardium in the inflamed pericardial visceral leaf, an increase in troponin occurs. It can be said that Troponin is one of the highly sensitive cardiac biomarkers. Therefore, it can be used in the diagnosis and prognosis of many diseases. For acute pulmonary embolism, an increase in troponin levels is often a sign of serious disease progression as well as other prognosis of the disease, thereby helping doctors recommend timely treatment regimens.
Tăng Troponin có liên quan đến một số bệnh lý khác như viêm cơ tim, suy tim cấp,...
To register for medical examination and treatment at Vinmec International General Hospital, you can contact Vinmec Health System nationwide, or register online.
Please dial HOTLINE for more information or register for an appointment HERE. Download MyVinmec app to make appointments faster and to manage your bookings easily.
