[Typical laboratory constellation of a non-ST-segment elevation myocardial infarction in polymyositis].
METHODS
a 80-year-old women was admitted with a hypertensive crisis. Laboratory tests showed elevated cardiac enzymes (CK, CK-MB and troponin T). She was treated for suspected non-ST segment elevation myocardial infarction.


METHODS
a cardiovascular examination, which included echocardiography, coronary angiography and magnetic resonance imaging, excluded a cardiac cause of the laboratory reults. After complete assessment the patient was found to have long-standing polymyosits positive for Mi-2 antibodies. This had caused troponin T elevation from the release of regenerating muscles after chronic inflammatory damage. Troponin I, however, is truly cardiomyocyte specific and distinguishes between cardiac and non cardiac origin of CK, CK-MB and troponin T.


METHODS
prednisone medication was started with a single dose of 50mg, then gradually reduced. Follow-up examination merely revealed minimally active polymyositis.


CONCLUSIONS
troponin I should be measured in patients with inflammatory myositis/myopathies in order to diagnose and assess cardiac involvement.
Innere Medizin der Universitätskliniken des Saarlandes Homburg/Saar. bizzl1@aol.com
J T
JT
Bittenbring
C-H
CH
Chen
P
P
Fries
M
M
Böhm
H
H
Kilter
D000369:Aged, 80 and over; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D017023:Coronary Angiography; D003402:Creatine Kinase / Q000097:blood*; D052279:Creatine Kinase, MB Form / Q000097:blood; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D018810:Magnetic Resonance Angiography; D009203:Myocardial Infarction / Q000097:blood / Q000175:diagnosis*; D017285:Polymyositis / Q000097:blood / Q000175:diagnosis* / Q000188:drug therapy; D011241:Prednisone / Q000627:therapeutic use; D020107:Troponin T / Q000097:blood*
D000893:Anti-Inflammatory Agents; D020107:Troponin T; D003402:Creatine Kinase; D052279:Creatine Kinase, MB Form; D011241:Prednisone