title: Abnormal troponin I levels in acute pulmonary embolism without abnormal concentrations of D-dimer at admission.
abstract: Serum troponin I is a sensitive indicator of myocardial damage but abnormal troponin I levels have been reported without acute coronary syndrome and without cardiac damage. It has been reported that right ventricular overload and hypoxia in acute pulmonary embolism may lead to right ventricular myocardium injury reflected by elevated cardiac troponin levels and that in patients with acute central sub-massive or non-massive pulmonary embolism, even mild increase in troponin I >0.03 mug/L may provide relevant short-term prognostic information independent to clinical, laboratory and echocardiographic data. It has also been reported that patients with acute small pulmonary embolism might present with relatively low concentrations of D-dimer and it might have implications regarding the diagnostic yield of D-dimer in patients who are suspected of having an acute pulmonary embolism. We present a case of abnormal troponin I levels without abnormal concentrations of D-dimer at admission in a 26-year-old Italian man with acute pulmonary embolism. Also this case focuses attention on the importance of a correct evaluation of abnormal troponin I levels and not elevated D-dimer levels in acute pulmonary embolism.
authors.affiliation: Cardiologia Nuovo Presidio Ospedaliero Cutroni Zodda-Barcellona P.d.G(Me) AUSL5 Messina, Italy.
authors.forename: Salvatore
authors.initials: S
authors.lastname: Patanè
authors.forename: Filippo
authors.initials: F
authors.lastname: Marte
authors.forename: Felice Carmelo
authors.initials: FC
authors.lastname: La Rosa
authors.forename: Gianluca
authors.initials: G
authors.lastname: Di Bella
authors.forename: Roberto
authors.initials: R
authors.lastname: La Rocca
authors.forename: Santa Alessandra
authors.initials: SA
authors.lastname: Villari
mesh_terms: D000208:Acute Disease; D000328:Adult; D015415:Biomarkers / Q000097:blood*; D004562:Electrocardiography; D005338:Fibrin Fibrinogen Degradation Products / Q000378:metabolism*; D006801:Humans; D008297:Male; D011655:Pulmonary Embolism / Q000097:blood* / Q000175:diagnosis*; D019210:Troponin I / Q000097:blood*
chemical_list: D015415:Biomarkers; D005338:Fibrin Fibrinogen Degradation Products; D019210:Troponin I; C036309:fibrin fragment D