CLINICAL USE OF ULTRA-SENSITIVE TROPONINS IN THE DIFFERENTIAL DIAGNOSIS OF ACUTE MYOCARDIAL INFARCTION

• DOI: 10.22533/at.ed.1593362326051

• Palavras-chave: Myocardial necrosis biomarkers. AMI differential diagnosis. ACS diagnosis. ultrasensitive troponins.

• Keywords: Myocardial necrosis biomarkers. AMI differential diagnosis. ACS diagnosis. ultrasensitive troponins.

• Abstract:

  Acute Myocardial Infarction (AMI) is when myocardial necrosis occurs through acute obstruction of a coronary artery. Its main symptom is chest pain, which is a sudden constant and constricting pain that can radiate to different parts of the body. It is usually intense and prolonged accompanied by a feeling of heaviness or tightness over the chest. However, other symptoms may occur, such as: dyspnea, nausea and/or diaphoresis. AMI can have major mechanical complications, for example, mitral valve regurgitation with or without papillary muscle rupture; ventricular septal rupture; rupture of the free wall of the ventricle; and left ventricular aneurysm. In order to have the diagnosis of AMI, there is a need to perform an ECG and verify the existence or absence of biomarkers. These biomarkers have the role of reducing the time between the onset of the heart attack and the restoration of myocardial perfusion, thus, they help in the diagnosis of AMI, risk stratification, choice of adequate treatment and prediction of events after Acute Coronary Syndrome (SCA). Among these biomarkers, we can mention the ultrasensitive troponin, which can significantly increase the diagnostic sensitivity when there is a very early phase of myocardial ischemic injury. It is also effective for detecting the risk of mortality and cardiac events in patients with unstable angina, for knowing the size of the infarction after reperfusion and because it is a specific biomarker of cardiac injury when coronary artery bypass grafting is performed.