Septic shock can cause extremely high and persistent troponin elevations in the absence of acute myocardial infarction.
Alerts clinicians to prolonged troponin elevation in sepsis; leaves open mechanisms and diagnostic thresholds for study.
BACKGROUND: Troponin levels can be elevated in various diseases other than acute myocardial infarction, including sepsis. In diseases without myocardial necrosis, the elevated troponin levels are relatively low and normalize quickly. CASE PRESENTATION: A 61-year-old Japanese man with impaired consciousness was transported to our hospital. He was diagnosed as having pneumonia and septic shock. His condition was severe, but his clinical course was good. However, his troponin level remained extremely high during admission; on the second day, it was higher than the measurable range. We consulted a cardiologist and performed echocardiography and myocardial perfusion scintigraphy but found no new ischemic changes. CONCLUSION: In septic shock, troponin levels can be extremely high, which can persist even after recovery, as in very large myocardial infarctions.
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Matsunaga et al. (2021) studied this question.
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