Why the study?
Non-cardiac gastrointestinal causes of troponin elevation are rare and usually limited to critical illness, making recognition of gastrointestinal mimics of acute coronary syndrome important.
Type II achalasia should be considered as a rare non-cardiac gastrointestinal cause of markedly elevated troponins mimicking acute coronary syndrome.
May prompt consideration of achalasia in unexplained troponin elevation; case report leaves open prevalence and mechanisms.
Achalasia is an esophageal motility disorder that presents with dysphagia to solids and liquids and regurgitation of undigested food. Cardiac troponin (cTn) is a sensitive biomarker for myocardial injury, and elevated levels suggest an increased risk of mortality from acute coronary syndrome (ACS). Non-cardiac gastrointestinal (GI) causes of troponin elevation are rare and have generally been described in cases of critical illness (e.g., significant gastrointestinal bleeding (GIB) or acute liver failure). We report a rare case of type II achalasia presenting with markedly elevated troponins. This case illustrates an important GI-related mimic of ACS that should be considered by frontline providers and gastroenterologists.
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Malik et al. (2023) studied this question.
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