A patient with septic shock has high-sensitivity troponin 140 ng/L falling to 115 ng/L. There is no chest pain, no ischaemic ECG change and

Question

A patient with septic shock has high-sensitivity troponin 140 ng/L falling to 115 ng/L. There is no chest pain, no ischaemic ECG change and echocardiography shows global rather than regional dysfunction. Which classification is most defensible?

Accepted Answer

Acute non-ischaemic myocardial injury unless objective evidence of myocardial ischaemia emerges

Answer

Type 2 myocardial infarction because sepsis provides adequate evidence of ischaemia

Answer

Type 1 myocardial infarction because a falling troponin trajectory during septic shock indicates transient plaque rupture

Answer

Chronic myocardial injury because the second troponin concentration is lower

Answer

ST-elevation myocardial infarction because global dysfunction is an ischaemic equivalent

Type 2 Myocardial Infarction — RACP Adult Medicine MCQ

A patient with septic shock has high-sensitivity troponin 140 ng/L falling to 115 ng/L. There is no chest pain, no ischaemic ECG change and echocardiography shows global rather than regional dysfunction. Which classification is most defensible?