Marked elevation of troponin I without wall motion abnormality in a patient with myocarditis: Cardiac enzymes may not predict the outcome in myocarditis
A seventeen-year-old male presented with severe substernal
chest pain after an episode of upper respiratory tract infection. On clinical
grounds, a diagnosis of myocarditis was established. He had a peak troponin I
level as high as 40.4 ng/dl but interestingly with no abnormal wall motion
and normal ejection fraction in echocardiography. Coronary artery disease was excluded with normal coronary angiography. Diagnosis of myocarditis was confirmed
with cardiac MRI. After one month, patient had no complaint and ejection fraction
were still normal. Our case emphasizes that the troponin levels predict neither
the early nor the late outcome of the left ventricular functions
in myocarditis, therefore serum troponin I
may not be helpful in determining the prognosis of patients with myocarditis.
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